Marked lowering of high-density lipoprotein cholesterol levels due to high dose bexarotene therapy

摘要: Context Bexarotene is a retinoid X receptor agonist, which currently used for the treatment of cutaneous T-cell lymphoma (CTCL). It known to induce central hypothyroidism as well dyslipidemia including elevation triglycerides (TG) and low-density lipoprotein cholesterol along with slight lowering high-density (HDL-C). Marked HDL-C has never been previously reported in bexarotene-treated patients whether it related remains unclear. Case Report A 49-year-old African female history CTCL on bexarotene 300 mg/d, presented serum total level 249 mg/dL (6.4 mmol/L), TG 92 (1.03 78 (2.02 thyroid stimulating hormone (TSH) 0.68 μIU/mL, free thyroxine 0.5 ng/dL. Six months later, increasing dose 600 mg daily, increased 310 (3.5 mmol/L) dropped 3 5 (0.077–0.13 whereas TSH was undetectable (0.01 μIU/mL). Despite adequate levothyroxine replacement 225 μg daily resulting levels up 1.5 ng/dL, remained extremely low 4 9 (0.103–0.233 mmol/L). discontinued due poor response CTCL, after her returned baseline 80 90 (2.07–2.33 Conclusions High can markedly lower levels, normalize discontinuation drug. Lowering may be an increase ester transfer protein activity appears independent hypothyroidism.