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  2. Keyword: Familial hypercholesterolemia
Cascade Screening in Adolescents with Lipid Disorders Suggestive of Familial Hypercholesterolemia: Findings from the ERICA Study in Curitiba
ABC
Original Article

Cascade Screening in Adolescents with Lipid Disorders Suggestive of Familial Hypercholesterolemia: Findings from the ERICA Study in Curitiba

Vivian Freitas Rezende Bento et al. Tatiana Lorena da Luz Kaestner Amauri de Vargas Junior Renan Barbosa Lopes … Fernando Pinotti Scariot Leiza Loiane Hollas Marcia Olandoski Cristina Pellegrino Baena Katia Vergetti Bloch José Rocha Faria Neto

Abstract

Background

Familial hypercholesterolemia (FH) is a common genetic cause of premature coronary heart disease due to prolonged exposure to high levels of LDL cholesterol (LDL-C). Its prevalence in the heterozygous form ranges from 1:200 to 1:500, and early diagnosis is fundamental for treatment and risk reduction. Cascade screening is recommended upon the identification of index cases.

Objectives

To assess the prevalence of lipid disorders suggestive of FH in students aged 12 to 17 years participating in the ERICA study in Curitiba and to determine the prevalence of FH based on clinical and laboratory criteria in these adolescents and their first-degree relatives undergoing cascade screening.

Methods

Using data from the ERICA study, adolescents with LDL-C levels > 160 mg/dL or non-HDL cholesterol > 190 mg/dL were identified, along with their first-degree relatives. The clinical diagnosis of the study participants was based on the DUTCH MedPed criteria. Statistical significance was defined as P < 0.05.

Results

Eleven adolescents with lipid disorders suggestive of FH were identified among the 2,383 evaluated (1:216). Of these, 7 students and 15 first-degree relatives were assessed. None of the adolescents had a diagnosis of possible FH confirmed by the clinical score. However, 3 family members (20%) were diagnosed with possible/probable FH.

Conclusion

Although the clinical score application did not confirm any cases among adolescents with lipid disorders suggestive of FH, indicating a limitation of the diagnostic method in this population, cascade screening identified potential cases in first-degree relatives.

  • Cholesterol
  • Dyslipidemias
  • Familial hypercholesterolemia
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Creative Commons Attribution (CC BY) Creative Commons license
31/03/2025 DOI: 10.36660/abc.20240468i Views 1
ABC
Original Article

Screening for Familial Hypercholesterolemia in Small Towns: Experience from 11 Brazilian Towns in the Hipercolbrasil Program

Cinthia Elim Jannes et al. Júnea Paolucci Paiva Silvino Pãmela Rodrigues de Souza Silva Isabella Ramos Lima … Mauricio Teruo Tada Theo Gremen Mimary Oliveira Raul D. Santos José Eduardo Krieger Alexandre da Costa Pereira

Abstract

Background

Familial hypercholesterolemia (FH) is a genetic disease characterized by elevated serum levels of low-density lipoprotein cholesterol (LDL-C), and it is associated with the occurrence of early cardiovascular disease. In Brazil, HipercolBrasil, which is currently the largest FH cascade screening program, has already identified more than 2000 individuals with causal genetic variants for FH. The standard approach is based on cascade screening of referred index cases, individuals with hypercholesterolemia and clinical suspicion of FH.

Objectives

To perform targeted screening of 11 small Brazilian cities with a suspected high prevalence of people with FH.

Methods

The selection of cities occurred in 3 ways: 1) cities in which a founder effect was suspected (4 cities); 2) cities in a region with high rates of early myocardial infarction as described by the National Health System database (2 cities); and 3) cities that are geographically close to other cities with a high prevalence of individuals with FH (5 cities). Statistical significance was considered as p value < 0.05.

Results

One hundred and five index cases and 409 first-degree relatives were enrolled. The yield of such approach of 4.67 relatives per index case was significantly better (p < 0.0001) than the general HipercolBrasil rate (1.59). We identified 36 IC with a pathogenic or likely pathogenic variant for FH and 240 affected first-degree relatives.

Conclusion

Our data suggest that, once detected, specific geographical regions warrant a target approach for identification of clusters of individuals with FH.

  • Cardiovascular disease
  • Familial hypercholesterolemia
  • Genetic Testing
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Creative Commons Attribution (CC BY) Creative Commons license
07/02/2022 DOI: 10.36660/abc.20201371
ABC
Brief Communication

Compound Heterozygous Familial Hypercholesterolemia Caused by LDLR Variants

Heloisa Pamplona-Cunha et al. Marcela Freitas Medeiros Thaís Cristine Marques Sincero Isabela de Carlos Back Edson Luiz da Silva

Abstract

Familial hypercholesterolemia (FH) is a genetic disease caused by a primary defect in the LDL-receptor gene. Distinct variants in the same gene characterize a compound heterozygote, but little is known about the phenotypes of the carriers. Therefore, herein, we describe the cascade screening of a Brazilian family with this characteristic. The index case, a 36-year-old male, had a total cholesterol level of 360 mg/dL (9.3 mmol/L) and LDL-c value of 259 mg/dL (6.7 mmol/L), in addition to Achilles tendon xanthomas, obesity and prehypertension. Genotyping identified the variants 661G>A, 670G>A, 682G>A in exon 4 and 919G>A in exon 6. The same variant in exon 4 was found in the index case’s son (7-y), who also had hypercholesterolemia and xanthomas, while the index case’s daughter (9-y) had the variant in exon 6 and hyperlipidemia, without xanthomas. In summary, this report allows for a better insight into the molecular basis of FH in Brazil, a multi-racial country where a heterogeneous population is expected.

  • Atherosclerosis
  • Compound Heterozygous
  • Familial hypercholesterolemia
  • Genetic Cascade Screening
  • Genotyping
  • Hyperlipoproteinemia Type II
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Creative Commons Attribution (CC BY) Creative Commons license
28/09/2020 DOI: 10.36660/abc.20190582

How to cite this article

EndNote RIS

Electronic Document Format (Vancouver)

Bento VFR, Kaestner TLL, Vargas Junior A, Lopes RB, Scariot FP, Hollas LL, Olandoski M, et al. Cascade Screening in Adolescents with Lipid Disorders Suggestive of Familial Hypercholesterolemia: Findings from the ERICA Study in Curitiba. Arquivos Brasileiros de Cardiologia 2025;122(3):e20240468.

Electronic Document Format (ABNT)

Bento, Vivian Freitas Rezende; Kaestner, Tatiana Lorena da Luz; Vargas Junior, Amauri de; Lopes, Renan Barbosa; Scariot, Fernando Pinotti; Hollas, Leiza Loiane; Olandoski, Marcia; Baena, Cristina Pellegrino; Bloch, Katia Vergetti; Faria Neto, José Rocha. Cascade Screening in Adolescents with Lipid Disorders Suggestive of Familial Hypercholesterolemia: Findings from the ERICA Study in Curitiba. Arquivos Brasileiros de Cardiologia, v. 122, n. 3, e20240468, Mar. 2025.

Electronic Document Format (APA)

Bento, V. F. R., Kaestner, T. L. L., Vargas Junior, A. , Lopes, R. B., Scariot, F. P., Hollas, L. L., Olandoski, M., Baena, C. P., Bloch, K. V., & Faria Neto, J. R. (2025). Cascade Screening in Adolescents with Lipid Disorders Suggestive of Familial Hypercholesterolemia: Findings from the ERICA Study in Curitiba. Arquivos Brasileiros de Cardiologia, 122(3), e20240468.

Electronic Document Format (ISO)

Bento, Vivian Freitas Rezende and Kaestner, Tatiana Lorena da Luz and Vargas Junior, Amauri de and Lopes, Renan Barbosa and Scariot, Fernando Pinotti and Hollas, Leiza Loiane and Olandoski, Marcia and Baena, Cristina Pellegrino and Bloch, Katia Vergetti and Faria Neto, José Rocha. Cascade Screening in Adolescents with Lipid Disorders Suggestive of Familial Hypercholesterolemia: Findings from the ERICA Study in Curitiba. Arquivos Brasileiros de Cardiologia [online]. 2025, vol. 122, n. 3, [cited 2026-10-14], e20240468. Available from: <https://journals.cardiol.br/en/article/cascade-screening-in-adolescents-with-lipid-disorders-suggestive-of-familial-hypercholesterolemia-findings-from-the-erica-study-in-curitiba/>. ISSN 0066-782X

EndNote RIS

Electronic Document Format (Vancouver)

Jannes CE, Silvino JPP, Silva PRS, Lima IR, Tada MT, Oliveira TGM, Santos RD, et al. Screening for Familial Hypercholesterolemia in Small Towns: Experience from 11 Brazilian Towns in the Hipercolbrasil Program. Arquivos Brasileiros de Cardiologia 2022;118(4):669-77.

Electronic Document Format (ABNT)

Jannes, Cinthia Elim; Silvino, Júnea Paolucci Paiva; Silva, Pãmela Rodrigues de Souza; Lima, Isabella Ramos; Tada, Mauricio Teruo; Oliveira, Theo Gremen Mimary; Santos, Raul D.; Krieger, José Eduardo; Pereira, Alexandre da Costa. Screening for Familial Hypercholesterolemia in Small Towns: Experience from 11 Brazilian Towns in the Hipercolbrasil Program. Arquivos Brasileiros de Cardiologia, v. 118, n. 4, p. 669-677, Feb. 2022.

Electronic Document Format (APA)

Jannes, C. E., Silvino, J. P. P., Silva, P. R. S., Lima, I. R., Tada, M. T., Oliveira, T. G. M., Santos, R. D., Krieger, J. E., & Pereira, A. C. (2022). Screening for Familial Hypercholesterolemia in Small Towns: Experience from 11 Brazilian Towns in the Hipercolbrasil Program. Arquivos Brasileiros de Cardiologia, 118(4), 669-677.

Electronic Document Format (ISO)

Jannes, Cinthia Elim and Silvino, Júnea Paolucci Paiva and Silva, Pãmela Rodrigues de Souza and Lima, Isabella Ramos and Tada, Mauricio Teruo and Oliveira, Theo Gremen Mimary and Santos, Raul D. and Krieger, José Eduardo and Pereira, Alexandre da Costa. Screening for Familial Hypercholesterolemia in Small Towns: Experience from 11 Brazilian Towns in the Hipercolbrasil Program. Arquivos Brasileiros de Cardiologia [online]. 2022, vol. 118, n. 4, [cited 2026-10-14], pp. 669-677. Available from: <https://journals.cardiol.br/en/article/screening-for-familial-hypercholesterolemia-in-small-towns-experience-from-11-brazilian-towns-in-the-hipercolbrasil-program/>. ISSN 0066-782X

EndNote RIS

Electronic Document Format (Vancouver)

Pamplona-Cunha H, Medeiros MF, Sincero TCM, Back IC, Silva EL. Compound Heterozygous Familial Hypercholesterolemia Caused by LDLR Variants. Arquivos Brasileiros de Cardiologia 2020;115(3):587-9.

Electronic Document Format (ABNT)

Pamplona-Cunha, Heloisa; Medeiros, Marcela Freitas; Sincero, Thaís Cristine Marques; Back, Isabela de Carlos; Silva, Edson Luiz da. Compound Heterozygous Familial Hypercholesterolemia Caused by LDLR Variants. Arquivos Brasileiros de Cardiologia, v. 115, n. 3, p. 587-589, Sep. 2020.

Electronic Document Format (APA)

Pamplona-Cunha, H., Medeiros, M. F., Sincero, T. C. M., Back, I. C., & Silva, E. L. (2020). Compound Heterozygous Familial Hypercholesterolemia Caused by LDLR Variants. Arquivos Brasileiros de Cardiologia, 115(3), 587-589.

Electronic Document Format (ISO)

Pamplona-Cunha, Heloisa and Medeiros, Marcela Freitas and Sincero, Thaís Cristine Marques and Back, Isabela de Carlos and Silva, Edson Luiz da. Compound Heterozygous Familial Hypercholesterolemia Caused by LDLR Variants. Arquivos Brasileiros de Cardiologia [online]. 2020, vol. 115, n. 3, [cited 2026-10-14], pp. 587-589. Available from: <https://journals.cardiol.br/en/article/compound-heterozygous-familial-hypercholesterolemia-caused-by-ldlr-variants/>. ISSN 0066-782X

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