What is the initial treatment for pediatric lipid disorders?

Updated: Jun 27, 2019
  • Author: Henry J Rohrs, III, MD; Chief Editor: Stuart Berger, MD  more...
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Answer

If a child’s total cholesterol (TC) level is less than 170 mg/dL, no further testing is required for 5 years, when the TC measurement should be repeated. Patients and families should be educated about healthy eating patterns, exercise, and risk-factor reduction. If the TC level is 170-199 mg/dL, TC measurements should be repeated within the next few weeks, and the two results should be averaged.

A fasting lipid profile should be obtained, with calculation of low-density lipoprotein cholesterol (LDL-C), in individuals in whom the TC level is initially at least 200 mg/dL or in whom the average TC level is at least 170 mg/dL. Two lipid profiles should be obtained, and the results should be averaged. If the LDL-C level is below 110 mg/dL and the triglyceride (TG) level is less than 125 mg/dL, no further testing is required for 5 years, when the lipid profile should be repeated. Again, patients and families should be educated about healthy eating patterns, exercise, and risk-factor reduction.

Previously, the recommendation was for the child to first be placed on a step-one diet, which allowed as much as 300 mg of cholesterol and as much as 10% of total fat as saturated fat in the diet. However, guidelines now establish a single dietary recommendation to improve blood lipid levels.


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