发疹性黄瘤为哨兵的年轻男性混合型高脂血症伴高血糖和血液异常
Journal: Basic Medical Theory Research DOI: 10.32629/bmtr.v8i3.20464
Abstract
发疹性黄瘤是严重高甘油三酯血症的典型皮肤标志，常提示急性胰腺炎等系统性风险。本文报道一例极具复杂性的22岁男性病例，其因双上肢突发黄色丘疹就诊，皮损符合典型发疹性黄瘤。然而，实验室检查揭示其病情远超寻常皮肤表现：患者存在极重度混合型高脂血症（甘油三酯高达32.18 mmol/L）、新发空腹高血糖，并伴有罕见的血液学异常谱，包括显著单核细胞增多、淋巴细胞减少、高血红蛋白血症及“奶酪粘稠状”高粘滞血液状态。该病例的独特性在于，如此多重且严重的代谢与血液学紊乱在年轻且无明确家族史的个体中集中出现实属罕见。本病例强有力地证明，发疹性黄瘤可作为潜伏的、危及生命的系统性代谢危机的“哨兵”体征。它警示临床医生，对于任何出现此类皮疹的患者，尤其是年轻患者，必须进行超越皮肤检查的全面代谢与血液学评估，以早期识别并干预潜在的严重紊乱，充分体现了皮肤表现在整体健康管理中的关键预警价值。
Keywords
发疹性黄瘤；混合型高脂血症；高血糖；血液异常；年轻男性
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[1] Ren C, Zhu L, Niu YC, Tu LY, Jin ZF, Zhang J. Eruptive xanthomas in a patient with severe hypertriglyceridemia: A case report. World J Clin Cases. 2024;12(16):2842-2846.
[2] Molnár G, Gyarmathy VA, Zádori N, Hegyi P, Kanizsai P. Severe Hypertriglyceridemia-Induced Acute Pancreatitis. Case Rep Gastroenterol. 2021 Jan-Apr;15(1):218-224. Published 2021 Jan-Apr None.
[3] Vu PQ, Thiriveedi M, Patel S, Metuku R. Case Report: Acute Pancreatitis in an Uncontrolled Diabetic Patient Presenting With a Skin Rash Later Found to Be Eruptive Xanthoma, a Dermatological Manifestation and Diagnostic Clue to Recognizing Hypertriglyceridemia as the Cause of Disease. Cureus. 2024;16(7):e64563. Published 2024 Jul.
[4] Malick WA, Do R, Rosenson RS. Severe hypertriglyceridemia: Existing and emerging therapies. Pharmacol Ther. 251:108544.
[5] Rathmann W, Kuss O, Kostev K. Incidence of newly diagnosed diabetes after Covid-19. Diabetologia. 2022;65(6):949-954.
[6] Johnson JT, Paul J, Cherian KE, Kapoor N, Asha HS, Paul TV. Familial hypercholesterolemia: The skin speaks. J Family Med Prim Care. 2020;9(8):4451-4453. Published 2020 Aug.
[7] Xia Y, Zheng W, Du T, et al. Clinical profile, genetic spectrum and therapy evaluation of 19 Chinese pediatric patients with lipoprotein lipase deficiency. J Clin Lipidol. 2023 Nov-Dec;17(6):808-817.
[8] Hajj F, Singh V, Al Akoum N, et al. Skin as a Reflection of Gut Health: An Overview of Dermatological Manifestations in Primary Neoplastic and Autoimmune Gastrointestinal Disorders. Cureus. 2024;16(10):e71313. Published 2024 Oct.
[9] Marogi EP, Ohiomoba RO, Stone NJ. Eruptive Xanthomas: Importance of Recognition to Reduce Delay of Effective Triglyceride Reduction. Am J Med. 2022;135(4):444-447.
[10] Zhu Y, He X, Lan Y, Deng Y. From Eruptive Xanthoma to Acute Pancreatitis: Clinical Warning and Implications of Rapid Disease Progression. Int Med Case Rep J. 18:943-947. Published 2025 None.
[11] Du ZZ, Zhou M, Ling J, et al. PD-1 Checkpoint Blockade in Patients for Acute Myeloid Leukemia after HSCT Relapse Resulted in Severe GVHD and sHLH. Case Rep Hematol. 2022:1705905. Published 2022 None.
[12] Liquidano-Perez E, Maza-Ramos G, Salazar-Bailón JL, Yamazaki-Nakashimada MA, Rivas-Larrauri F. Therapeutic plasma exchange in refractory macrophage activation syndrome complicating systemic juvenile idiopathic arthritis: a case-based review. Rheumatol Int. 2023;43(1):183-189.
[13] Morka J, Morajko A, Otulak S, Zarańska K, Wąsik G. Cutaneous Manifestation of Eruptive Xanthoma as a Consequence of Severe Hypertriglyceridemia: A Case Report Highlighting Diagnostic and Therapeutic Challenges. Cureus. 2025;17(2):e78329. Published 2025 Feb.
[14] Gonzalez-Lopez G, Fried I, Schadelbauer E, Cerroni L. Foamy Macrophages in a Case of Mononucleosis With Amoxicillin-Induced Rash, Hyperlipidemia, and Hemophagocytic Lymphohistiocytosis. Am J Dermatopathol. 2024;46(2):104-106.
[15] Marinescu M, Botnariu GE, Vâță D, et al. Diabetic Dermopathies as Predictive Markers of Cardiovascular and Renal Complications: A Narrative Review. J Clin Med. 2025;14(21). Published 2025 Oct 30.
[2] Molnár G, Gyarmathy VA, Zádori N, Hegyi P, Kanizsai P. Severe Hypertriglyceridemia-Induced Acute Pancreatitis. Case Rep Gastroenterol. 2021 Jan-Apr;15(1):218-224. Published 2021 Jan-Apr None.
[3] Vu PQ, Thiriveedi M, Patel S, Metuku R. Case Report: Acute Pancreatitis in an Uncontrolled Diabetic Patient Presenting With a Skin Rash Later Found to Be Eruptive Xanthoma, a Dermatological Manifestation and Diagnostic Clue to Recognizing Hypertriglyceridemia as the Cause of Disease. Cureus. 2024;16(7):e64563. Published 2024 Jul.
[4] Malick WA, Do R, Rosenson RS. Severe hypertriglyceridemia: Existing and emerging therapies. Pharmacol Ther. 251:108544.
[5] Rathmann W, Kuss O, Kostev K. Incidence of newly diagnosed diabetes after Covid-19. Diabetologia. 2022;65(6):949-954.
[6] Johnson JT, Paul J, Cherian KE, Kapoor N, Asha HS, Paul TV. Familial hypercholesterolemia: The skin speaks. J Family Med Prim Care. 2020;9(8):4451-4453. Published 2020 Aug.
[7] Xia Y, Zheng W, Du T, et al. Clinical profile, genetic spectrum and therapy evaluation of 19 Chinese pediatric patients with lipoprotein lipase deficiency. J Clin Lipidol. 2023 Nov-Dec;17(6):808-817.
[8] Hajj F, Singh V, Al Akoum N, et al. Skin as a Reflection of Gut Health: An Overview of Dermatological Manifestations in Primary Neoplastic and Autoimmune Gastrointestinal Disorders. Cureus. 2024;16(10):e71313. Published 2024 Oct.
[9] Marogi EP, Ohiomoba RO, Stone NJ. Eruptive Xanthomas: Importance of Recognition to Reduce Delay of Effective Triglyceride Reduction. Am J Med. 2022;135(4):444-447.
[10] Zhu Y, He X, Lan Y, Deng Y. From Eruptive Xanthoma to Acute Pancreatitis: Clinical Warning and Implications of Rapid Disease Progression. Int Med Case Rep J. 18:943-947. Published 2025 None.
[11] Du ZZ, Zhou M, Ling J, et al. PD-1 Checkpoint Blockade in Patients for Acute Myeloid Leukemia after HSCT Relapse Resulted in Severe GVHD and sHLH. Case Rep Hematol. 2022:1705905. Published 2022 None.
[12] Liquidano-Perez E, Maza-Ramos G, Salazar-Bailón JL, Yamazaki-Nakashimada MA, Rivas-Larrauri F. Therapeutic plasma exchange in refractory macrophage activation syndrome complicating systemic juvenile idiopathic arthritis: a case-based review. Rheumatol Int. 2023;43(1):183-189.
[13] Morka J, Morajko A, Otulak S, Zarańska K, Wąsik G. Cutaneous Manifestation of Eruptive Xanthoma as a Consequence of Severe Hypertriglyceridemia: A Case Report Highlighting Diagnostic and Therapeutic Challenges. Cureus. 2025;17(2):e78329. Published 2025 Feb.
[14] Gonzalez-Lopez G, Fried I, Schadelbauer E, Cerroni L. Foamy Macrophages in a Case of Mononucleosis With Amoxicillin-Induced Rash, Hyperlipidemia, and Hemophagocytic Lymphohistiocytosis. Am J Dermatopathol. 2024;46(2):104-106.
[15] Marinescu M, Botnariu GE, Vâță D, et al. Diabetic Dermopathies as Predictive Markers of Cardiovascular and Renal Complications: A Narrative Review. J Clin Med. 2025;14(21). Published 2025 Oct 30.
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