HELP LDL-apheresis in two cases of familial hypercholesterolemic pregnant women.

We report our experience with selective LDL-apheresis in two women affected by autosomal recessive hypercholesterolemia and heterozygous familial hypercholesterolemia respectively, during pregnancy. To date only a few cases have been reported, because of the rarity of pregnancy in these patients and a hesitation of physicians to perform extracorporeal treatment. One of the patients had severe coronary artery disease, an absolute contraindication for pregnancy. Both patients had extremely elevated lipoprotein values because of their primary dyslipidemia, pregnancy-related modification of their lipid profile, and mandatory discontinuation of lipid-lowering drugs. In both cases the use of the Heparin-induced Extracorporeal Lipoprotein Precipitation (HELP) therapy improved the clinical situation and resulted in a good outcome for both mother and fetus.