Hyperlipidemia and the rheumatic diseases

Premature atherosclerosis is a recognized complication of systemic lupus erythematosus. Atherosclerosis begins in the pediatric age group, and interventions directed toward prevention should begin in childhood as well. A possible cause of premature atherosclerosis is dyslipoproteinemia from the underlying chronic inflammatory disease or from corticosteroid therapy. A relationship between dyslipoproteinemia and anticardiolipin antibodies has been demonstrated. Dietary therapy is helpful, but many patients continue to have significant dyslipoproteinemia after both dietary modification and fish oil supplementation. Lipid-lowering drugs may be indicated in this subgroup. Potential mechanisms of dyslipoproteinemia are discussed.