endocrine and metabolic disorders
Dyslipidemia
Symptoms and Signs of Dyslipidemia
Dyslipidemia itself usually causes no symptoms, although very high TG levels can cause paresthesias, dyspnea, and confusion. Lipid disorders can lead to symptomatic end-organ disease, including Vascular disease (eg, Overview of Coronary Artery Disease (CAD), Acute Pancreatitis can be caused be high TG levels ( Hepatosplenomegaly can be caused by very high TG levels Findings in patients with severe dyslipidemia may include localized lipid deposits (xanthomas) or other findings caused by high serum concentrations or accumulation of lipids. High LDL-C levels can cause tendinous xanthomas at the Achilles, elbow, and knee tendons and over metacarpophalangeal joints. Other clinical findings that occur in patients with high LDL-C (eg, in familial hypercholesterolemia or dysbetalipoproteinemia) include planar or tuberous xanthomas. Planar xanthomas are flat or slightly raised yellowish patches. Tuberous xanthomas are painless, firm nodules typically located over extensor surfaces of joints. Patients with high levels of LDL-C can develop arcus corneae (lipid deposits in the cornea around the iris) and xanthelasma (lipid-rich, yellow plaques on the medial eyelids). Xanthelasma can also occur in patients with Primary Biliary Cholangitis (PBC) and normal lipid levels. Extremely high total cholesterol levels give a lactescent (milky) appearance to blood plasma. Severe elevations of TGs can cause eruptive xanthomas over the trunk, back, elbows, buttocks, knees, hands, and feet. Severe hypertriglyceridemia (>2000 mg/dL [>22.6 mmol/L]) can also give retinal arteries and veins a creamy white appearance (lipemia retinalis). Eruptive xanthomas are skin manifestations of elevated triglyceride levels. Photo provided by Thomas Habif, MD. Patients with severe elevations of TGs can have eruptive xanthomas over the trunk, back, elbows, buttocks, knees, hands, and feet. © Springer Science+Business Media Tuberous xanthomas are painless, firm nodules typically located over extensor surfaces of joints. © Springer Science+Business Media Achilles tendon xanthomas are diagnostic of familial hypercholesterolemia. Image courtesy of Michael H. Davidson, MD. Tendon xanthomas (arrow) are diagnostic of familial hypercholesterolemia. Image courtesy of Michael H. Davidson, MD. 