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Table 1 Distinction in the Clinical Versus Genetic Nomenclature of Familial Hypercholesterolemia

From: Familial Hypercholesterolemia: The Lipids or the Genes?

Genetically (Genotype)

Homozygous

Homozygous for a mutation in one of the candidate genesa known to cause FH

Combined Heterozygous

Heterozygous for two different mutations in the same or different candidate genes known to cause FH

Heterozygous

Heterozygous for a mutation in one of the candidate genes known to cause FH

Unknown

No causative mutation could be detected after screening all candidate genes known to cause FH

Clinically (Phenotype)

Severe

LDL-C levels that are three to four times the normal and externalb or cardiovascularc manifestations of FH

Mild

Elevated LDL-C levels that do not exceed three times the normal

Pardoxical

LDL-C levels that are three to four times the normal and with no external or cardiovascular manifestations of FH

OR

Normal to slightly elevated LDL-C levels with external or cardiovascular manifestations of FH

  1. a Candidate genes include LDLR, ApoB, PCSK9, and ARH/LDLRAP1
  2. b External manifestations means one or more of tendinous xanthomas, xanthelasmas, or corneal arcus
  3. c Cardiovascular manifestations means the presence of premature cardiovascular disease as judged clinically