TREATMENT OF HOMOZYGOUS FAMILIAL HYPERCHOLESTEROLEMIA BY PLASMA-EXCHANGE AND LDL-APHERESIS

Two girls with familial hypercholesterolemia were treated for 7 years by plasma exchanges (PE) or LDL-apheresis (LA). We compared different methods of treatment; PE with or without reuse of the plasma separator , LA of varying frequency, and LA with or without oral administration of simvastatin. We assessed the long-term results by measuring the blo od levels of the biochemical parameters before sessions, and determine d the effectiveness of each session by the percentage of decrease in t he blood levels between the beginning and the end of the sessions. LA led to a more selective treatment (lowering of LDL cholesterol and mai ntenance of HDL cholesterol), but the blood levels of total cholestero l before sessions were the same as those obtained by PE. IgG and haemo globin levels decreased little with LA. The rhythm of one session a we ek gave better results in LA. Although reuse of the plasma separator r epresents a financial saving it produced poorer results. The oral admi nistration of simvastatin improved the results of LA.