A Case of Obstructive Jaundice with Severe Hypercholesterolemia Probably Due to Lipoprotein-Y

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Aim: We analyzed the lipoproteins of a patient with pancreatic cancer causing obstructive jaundice, with marked hypercholesterolemia.
Methods: The patient was a 49-year-old female. Serum total cholesterol, triglyceride, LDL-cholesterol and HDL-cholesterol levels were 1,170 mg/dL, 282 mg/dL, 1,070 mg/dL and 53 mg/dL, respectively. Cholesterol ester and lecithin:cholesterol acyltransferase decreased, and so-called remnant like particle-cholesterol increased remarkably.
Results: Fractionation of the patient's serum by polyacrylamide gel disc electrophoresis showed an abundant VLDL fraction, whereas agarose gel electrophoresis demonstrated a high level of beta-lipoprotein. Sepharose 6B gel filtration of the serum revealed that the levels of free cholesterol and apolipoprotein B were high in the VLDL- corresponding fraction.
Conclusion: The results suggested that the high cholesterol level was due to the presence of abnormally large particles rich in free cholesterol and apoB, and this abnormal fraction may correspond to lipoprotein-Y that was increased in obstructive jaundice.