Extreme hyperalphalipoproteinaemia in a patient with a solitary paraspinal lipoma

This version was published on 1 January 2010

Ann Clin Biochem 2010;47:90-93
© 2010 Association for Clinical Biochemistry


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Case Reports

Samarina Musaad1,
Ken Robertson2,
Michael W Clarke2,
Amanda J Hooper2,4,
Gary French3,
Weldon Chiu1 and
John R Burnett2,4

1 Department of Chemical Pathology, Middlemore Hospital, Auckland, New Zealand;
2 Department of Core Clinical Pathology and Biochemistry, PathWest Laboratory Medicine, Royal Perth Hospital, Perth, Australia;
3 Department of Orthopaedic Surgery, Middlemore Hospital, Auckland, New Zealand;
4 Schools of Medicine and Pharmacology and Pathology and Laboratory Medicine, University of Western Australia, Royal Perth Hospital, Perth, Australia

Corresponding author: Dr Samarina Musaad. Email: sseljack{at}yahoo.com

Increased high-density lipoprotein (HDL)-cholesterol (hyperalphalipoproteinaemia; HALP) is commonly genetic, but may have secondary causes. An association between multiple lipomatosis and HALP has been reported; however, the mechanism for this is unclear. We report the case of a 69-year-old Cook Island woman with extreme HALP who presented with a large paraspinal lipoma. Magnetic resonance imaging showed no other lipomas. She had the metabolic syndrome, a family history suggestive of lipomas and was on lipid-lowering and antihypertensive therapy. Her plasma HDL-cholesterol concentration was 4.9 mmol/L (>95th percentile for age and sex) and was not explained by typical secondary causes. HDL2 and HDL3 subfractions were increased, with HDL2 predominance. The excised lipoma histologydemonstrated benign tissue and normal karyotype. Postoperativelipid profiles showed no change in HDL-cholesterol concentrations.In summary, we report a case of extreme HALP that persistedafter excision of a solitary paraspinal lipoma.

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