症例

亜急性壊死性リンパ節炎のステロイド加療中に
高脂血症の増悪したと思われる一小児例

工　藤　真理子*1　佐　藤　裕　久*2　貝　森　光　大*3
林　　　香　織*4　櫻　林　郁之介*5　　　　　　　　

　　　　　　　　　　　　　　　　　　　　　　
A Case of Hyperlipoproteinemia Caused by Corticosteroid Therapy
in a Child with Subacute Necrotizing Lymphadenitis

Mariko KUDOH*1, Hirohisa SATOH*2, Mituomi KAIMORI, MD*3,
Kaori HAYASHI, MD*4 and Ikunosuke SAKURABAYASHI, MD, PhD*5

A 10-year-old child was diagnosed as subacute necrotizing lymphadenitis. After a steroid hormone (predonine) administration for 17 days, he showed total cholesterol(TC) 420mg/dl, triglyceride(TG) 839mg/dl, and LDL-cholesterol 241mg/dl. The hyperlipidemia seemed to be a side effect of the steroid at the onset. However, the lipoprotein fraction by the agarose gel and polyacrylamide gel(PAG) electrophoresis showed type III of the WHO classification, that is, presence of broad band as well as appearance of mid band, small dense-LDL and the disrupted type of LDL band. In addition, there were hyperlipidemia(high levels of the TC, TG, LDL-cholesterol) in 4 persons out of 6 family members, and LDL pattern of the PAG electrophoresis, 4 persons showed the nodular type. They have higher possibility of combined-type familial hyperlipemia from the above results, and it seemed to be the case in which the hyperlipidemia was exacerbated by the steroid administration.
[Rinsho Byori 51 : 419〜424, 2003]

*1Department of Clinical Pathology, Aomori Prefectural Central Hospital, Aomori 030-8553

【Key Words】corticosteroid therapy(ステロイド治療)，serum lipids(血清脂質)，familial combined hyperlipidemia(家族性複合型高脂血症)，subacute necrotizing lymphadenitis(亜急性壊死性リンパ節炎)

受付2002年12月6日・受理2003年4月17日
*1〜3青森県立中央病院臨床検査部，*4同　小児科(〒030-8553 青森市東造道2-1-1)

E-mail :mako323@infoaomori.ne.jp