Acquired Severe Hypercholesterolemia from Elevated Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) in a Middle-Aged Woman Following COVID-19 Vaccination
نویسندگان
1 Institute of Biomedical Electronics and Bioinformatics, College of Electrical Engineering and Computer Science, National Taiwan University, Taipei, Taiwan
2 Division of Endocrinology and Metabolism, Department of Medicine, Taichung Veterans General Hospital, Taichung, & School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
3 Division of Endocrinology and Metabolism, Department of Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
doi
10.22034/ircmj.2025.467306.1304چکیده
Background and Objectives: Thrombosis and thrombocytopenia have occurred in patients following vaccination with the coronovirus disease (COVID-19) vaccine (Vaxzevria). However, the ocurrence of hypercholesterolemia had not yet been reported after COVID-19 vaccination. Proprotein convertase subtilisin/kexin type 9 (PCSK9) reduces hepatic uptake of low-density lipoprotein (LDL) through degradation of LDL receptor, and leads to an increase in serum LDL levels. PCSK9 was reported to be higher in patients with sepsis and COVID-19 infection, compared with those who had sepsis but no COVID-19 infection. Whether there are some pathophysiologic mechanism or interaction between vaccine antibodies and PCSK9 remains unclear. In this report, we present the first case of acquired severe hypercholesterolemia after COVID-19 vaccine and discuss the relevant pathophysiologic process behind this phenomenon.. Case presentation: We presented a case of acquired severe hyperlipidemia in a 43-year-old Taiwanese woman without hyperlipidemia history after COVID-19 vaccination. Conclusion: COVID-19 vaccination may result in acquired severe hypercholesterolemia in healthy individuals. Statin therapy was shown to be effective in lowering LDL-C levels and should be the first-line treatment in order to lower the incidence of cardiovascular events..
