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Iatrogenic profound hypoalphalipoproteinaemia: an unrecognised cause of very low HDL cholesterol.
  1. M. J. Murphy,
  2. A. Duncan,
  3. B. D. Vallance,
  4. C. J. Packard,
  5. D. S. O'Reilly
  1. Institute of Biochemistry, Royal Infirmary, Glasgow, UK.


    A significant reduction in plasma high density lipoprotein (HDL) cholesterol is a recognised consequence of treatment with probucol. By contrast, fibrate therapy in general has the opposite effect. We report two cases where the combination of probucol and a fibrate led to profoundly reduced plasma levels of HDL cholesterol associated with very low levels of apolipoprotein A-I (apoA-I). In the first, bezafibrate was added to probucol, and in the second, probucol added to a combination of simvastatin and fenofibrate. In both cases, plasma levels of HDL and apoA-I returned towards normal after discontinuation of one or both drugs, indicating that the reduction was reversible.

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