Use of Diet and Probucol

To the Editor.—  Reference has been made in the Archives (137:1429-1434, 1977) to the use of diet and probucol for lowering plasma cholesterol in type II hyperlipoproteinemia, thus confirming other reports in the literature.¹ We have used this drug in a 12-year-old girl with homozygous hypercholesterolemia who had diffuse xanthomas and a positive treadmill ECG. Three months after treatment with diet plus 16 g/day of cholestyramine resin, bone pain, growth retardation, and a sharp rise in alkaline phosphatase levels developed in the patient, with radiologic signs of rickets. These abnormalities withdrew with high doses of intramuscularly given cholecalciferol (Figure). After including probucol in her treatment, dosages of cholestyramine and cholecalciferol could be suppressed without observing any changes in cholesterol or alkaline phosphatase concentrations. She is now symptom-free with no growing of xanthomas and a normal treadmill ECG.As work in progress in our institution has demonstrated, by means of