RESEARCH ARTICLE


Successful Direct Adsorption of Lipoproteins (DALI) Apheresis During Pregnancy in an Omani Woman with Homozygous Familial Hypercholesterolemia



Tamima Al-Dughaishi1, Khalid Al-Waili2, Yajnavalka Banerjee3, Shahila Sheik1, Hilal Al-Sabti4, Ibrahim Al-Zakwani5, 6, Suad Al-Mukhaini7, Khalifa Al Wahaibi8, Ali T. Al-Hinai9, Khalid Al-Rasadi2, *
1 Department of Obstetrics & Gynecology, Sultan Qaboos University Hospital, Muscat, Oman
2 Department of Clinical Biochemistry, Sultan Qaboos University Hospital, Muscat, Oman
3 Department of Biochemistry, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
4 Department of Surgery, Cardiothoracic Unit, Sultan Qaboos University Hospital, Muscat, Oman
5 Department of Pharmacology and Clinical Pharmacy, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
6 Gulf Health Research, Muscat, Oman
7 Department of Nursing, Sultan Qaboos University Hospital, Muscat, Oman
8 Department of Surgery, Vascular Unit, Sultan Qaboos University Hospital, Muscat, Oman
9 Ministry of Health, Muscat, Oman


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© Al-Dughaishi et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (https://creativecommons.org/licenses/by-nc/4.0/legalcode), which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Clinical Biochemistry, Sultan Qaboos University Hospital, PO Box 38, Al-Khodh, PC-123, Sultanate of Oman, Tel: +968-96780908; Fax: +968-24141786; E-mail: khalid77@squ.edu.om


Abstract

We report our experience with Direct Adsorption of Lipoproteins (DALI) apheresis in an Omani pregnant woman affected by homozygous familial hypercholesterolemia. To the best of our knowledge this is the first successful pregnancy treated with DALI apheresis.

The patient had a history of coronary artery disease, supra-aortic valvular stenosis and severe carotid artery disease with right carotid artery stenting. She was on a regular biweekly DALI apheresis since 2008. In May 2013, she became pregnant and rosuvastatin and ezetimibe were stopped while she continued on DALI apheresis biweekly. This treatment during pregnancy was successful with no major complications. The average low-density lipoprotein cholesterol reduction during therapy was 50%. She spontaneously delivered a healthy male infant (2,400 g) at 37 weeks. We showed that DALI apheresis therapy was safe during pregnancy with a good outcome for both mother and neonate.

Keywords: Familial hypercholesterolemia, low density lipoprotein receptor, xanthoma, LDL-apheresis, pregnancy.