Changes in circulating lipid status were studied in a 70-year-old woman during management of chylothorax that included chest drainage, pleuroperitoneal shunting, and a successful thoracic duct ligation. Hypolipidemia with a relative decline in high-density lipoprotein (HDL) cholesterol was apparent at presentation. Following recovery, serum HDL cholesterol rose to the upper limit of normal. Apolipoprotein A-l (Apo A-l) was discordantly raised during the period of pleuroperitoneal shunting. We speculate that diversion of chylomicrons to the liver with subsequent hydrolysis accounted for a release of Apo A-l particles into the circulation at a time when the formation of HDL was compromised by a state of starvation.
McKenna, Malachi J.; Chu, Jau-Wen; and Kahkonen, Dorothy M.
"Disturbances in Lipid Metabolism Associated with Chylothorax and its Management,"
Henry Ford Hospital Medical Journal
: Vol. 39
Available at: https://scholarlycommons.henryford.com/hfhmedjournal/vol39/iss1/10