Case Reports and SeriesNodular Excision for Painful Localized Achilles Tendon Xanthomas in Type II Hyperlipoproteinemia: A Case Report
Section snippets
Case Report
A 45-year-old woman was referred with painful nodules in both Achilles tendons that had been observed for 6 months. On physical examination, multiple tender nodules were palpated along her Achilles tendons bilaterally. She was barely able to perform a single or double heel raise posture because of the pain (Fig. 1). The pain was worse during the first few steps in the morning and after rising from chairs, closely resembling the symptoms of usual Achilles tendinitis. No definite masses were
Discussion
Heterozygous FH is an autosomal dominant disorder that causes severe elevations in total cholesterol and LDL. Although moderate hyperlipoproteinemia is a common finding in industrialized countries, heterozygous FH occurs in approximately 1 per 500 persons worldwide (9). Untreated, it is associated with high mortality and morbidity from coronary heart disease. One study reported that about 80% of men with FH develop ischemic heart disease by 50 years of age (11). Achilles tendon xanthomas can
References (21)
Familial hypercholesteremic xanthomatosis: a preliminary report
Am J Med
(1959)- et al.
An ultrasonographic method for detection of Achilles tendon xanthomas in familial hypercholesterolemia
Atherosclerosis
(1989) - et al.
Fine-mapping, mutation analyses, and structural mapping of cerebrotendinous xanthomatosis in U.S. pedigrees
J Lipid Res
(2001) - et al.
Lipid storage disease. Part 1: ultrastructure of xanthoma cells in various diseases
Acta Pathol Jpn
(1983) - et al.
Diagnosis of Achilles tendon xanthoma in patients with heterozygous familial hypercholesterolemia: MR vs sonography
AJR Am J Roentgenol
(1994) - et al.
Pathogenesis, detection and treatment of Achilles tendon xanthomas
Eur J Clin Invest
(2005) - et al.
MR imaging of Achilles tendon in patients with familial hyperlipidemia: comparison with plain films, physical examination, and patients with traumatic tendon lesions
AJR Am J Roentgenol
(1995) - et al.
Xanthoma of Achilles tendon: seven cases with familial hyperbetalipoproteinemia
J Bone Joint Surg [Am]
(1973) - et al.
Xanthomas of the Achilles tendon: a case report of bilateral total resection and tendon reconstruction using the fascia lata
J Bone Joint Surg Am
(1980) - et al.
Familial hypercholesterolaemia commonly presents with Achilles tenosynovitis
Ann Rheum Dis
(2006)
Cited by (6)
Surgical treatment of multiple large tuberous xanthomas in familial hypercholesterolemia: A case report
2021, International Journal of Surgery Case ReportsCitation Excerpt :Small tuberous xanthomas and tendon xanthomas may regress with medicament or plasma exchange (LDL-C apheresis) after several months to 12 months [7–9]. Surgical excision is indicated for patients with large tuberous xanthomas large without regression after lipid-lowering therapy [7,10]. This paper aims to present a successful surgical treatment for patients with multiple large tuberous xanthomas related to FH.
Multiple large xanthomas: A case report
2016, Oncology LettersTendons involvement in congenital metabolic disorders
2016, Advances in Experimental Medicine and BiologyAn Unusual Case of Multiple Tendinous Xanthomas Involving the Extremities and the Ears
2015, Case Reports in DermatologyFamilial hypercholesterolaemia with tuberous and tendinous xanthomas: Case report and mutation analysis
2015, Clinical and Experimental DermatologyLipids, adiposity and tendinopathy: Is there a mechanistic link? Critical review
2015, British Journal of Sports Medicine
Financial Disclosure: None reported.
Conflict of Interest: None reported.