IDIOPATHIC HYPERLIPEMIA ASSOCIATED WITH CORONARY ATHEROSCLEROSIS

THE CLINICAL syndrome of idiopathic hyperlipemia has been described fully in several recent surveys.* In essence it embodies a triad of signs and symptoms which include abdominal pain, hepatosplenomegaly, and cutaneous xanthomata with an elevated fasting level of serum neutral fat. Increase of serum neutral fat may also be seen in diabetes mellitus, nephrosis, alcoholic cirrhosis, hypothyroidism, and glycogen-storage disease. In the absence of other causative disease, hyperlipemia may be termed idiopathic.⁵ Although it has been suspected that this disorder of lipid metabolism might predispose to coronary atherosclerosis, as yet no pathological reports of such association have been found. That hyperlipemia may be associated with coronary artery disease has been demonstrated clinically.† The single report in the literature of the postmortem findings in a case of idiopathic hyperlipemia revealed no evidence of coronary atherosclerosis, with death being due to an intercurrent infection.⁷ The following case history records the