Case Report
Copyright ©2013 Baishideng. All rights reserved.
World J Clin Cases. Apr 16, 2013; 1(1): 44-48
Published online Apr 16, 2013. doi: 10.12998/wjcc.v1.i1.44
Treatment of a patient with congenital analbuminemia with atorvastatin and albumin infusion
Maria Del Ben, Francesco Angelico, Lorenzo Loffredo, Francesco Violi
Maria Del Ben, Francesco Angelico, Lorenzo Loffredo, Francesco Violi, Clinica Medica I, Sapienza University, 00161 Rome, Italy
Author contributions: All authors contributed to the writing of the manuscript and approved the final manuscript.
Correspondence to: Francesco Angelico, Professor, Clinica Medica I, Sapienza University, Viale del Policlinico 155, 00161 Rome, Italy. francesco.angelico@uniroma1.it
Telephone: +39-6-49972249 Fax: +39-6-49972249
Received: November 25, 2012
Revised: January 24, 2013
Accepted: February 5, 2013
Published online: April 16, 2013
Processing time: 136 Days and 13.6 Hours
Abstract

Congenital analbuminemia is a rare autosomic recessive inherited disorder characterized by low plasma albumin and hypercholesterolemia, which may increase cardiovascular risk. Patients are essentially asymptomatic, apart from ease of fatigue, minimal ankle oedema and hypotension. There is no accepted strategy for safely treating both hypercholesterolemia and analbuminemia in order to eventually decrease the atherosclerotic risk. We report a case of congenital analbuminemia (1.0 g/dL)

in a 38-year-old male with hypercholesterolemia (range: 406-475 mg/dL) and severe arterial dysfunction [no brachial artery flow-mediated dilation (FMD)]. Long-term, cholesterol-lowering treatment with atorvastatin was associated with the appearance of peripheral edema. Two-months of infusion with albumin improved FMD (7%) and reduced serum cholesterol (273 mg/dL), supporting the hypothesis of a compensatory role of hypercholesterolemia. Statin treatment, together with periodical albumin infusions, may contribute to the safe reduction of cardiovascular risk.

Keywords: Analbuminemia; Hypercholesterolemia; Atorvastatin; Albumin infusion; Endothelial dysfunction

Core tip: Congenital analbuminemia is characterized by low plasma albumin and compensatory hypercholesterolemia, which may increase cardiovascular risk. We report a case of congenital analbuminemia (1.0 g/dL) in a 38-year-old male with hypercholesterolemia (range: 406-475 mg/dL) and severe arterial dysfunction [no brachial artery flow-mediated dilation (FMD)]. Long-term, cholesterol-lowering treatment with atorvastatin was associated with the appearance of peripheral edema. Two-months of infusion with albumin improved FMD (7%) and reduced serum cholesterol (273 mg/dL). Statin treatment, together with periodical albumin infusions, may contribute to the safe reduction of cardiovascular risk.