Hypocholesterolemia: A Neglected Laboratory Finding

Abstract

Although there is an increased awareness against hypercholesterolemia to prevent its hazardous effects on health, the physicians may neglect hypocholesterolemia that has been associated with various pathological situations. Hypocholesterolemia is defined as a total serum cholesterol level lower than 120 mg/dl whereas some authors suggest a cut-off level to be 160 mg/dl. Primary hypocholesterolemia is observed due to genetic mutations leading to hypobetalipoproteinemia and abetalipoproteinemia and Tangier disease. Secondary hypocholesterolemia is more common and observed in patients with anemia, infection, inflammation, sepsis, malabsorption, hyperthyroidism, myeloproliferative diseases, leukemias and other malignancies as well as in hospitalized patients. Each of the above pathological states may present with hypocholesterolemia either individually or as combinatory entities. Serum cholesterol level is an important laboratory parameter in monitoring disease progression and determining severity of the clinical condition.

Key words: Hypocholesterolemia, anemia, infection, hyperthyroidism, cancer, hospitalized patient