CASE REPORT article
Front. Pediatr.
Sec. Pediatric Cardiology
Volume 13 - 2025 | doi: 10.3389/fped.2025.1559147
Outpatient Monthly Plasmapheresis with Post-PLEX Evinacumab in Pediatric Homozygous Familial Hypercholesterolemia: A Case Report on Port Access and Immunoglobulin Preservation
Provisionally accepted
- Western University, London, Canada
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Homozygous familial hypercholesterolemia (HoFH) is a rare genetic disorder characterized by severely elevated low-density lipoprotein (LDL) cholesterol levels, predisposing patients to early cardiovascular disease. While LDL apheresis is the standard extracorporeal therapy, plasmapheresis (PLEX) is often used in younger children due to limitations in vascular access. Evinacumab, an ANGPTL3 inhibitor, has emerged as an effective adjunct for lowering LDL cholesterol. This case, to our knowledge, describes the first pediatric outpatient implementation of monthly plasmapheresis with post-PLEX Evinacumab infusions, enabled by dual-port access and Octaplasma support to maintain immunoglobulin levels. This report highlights procedural innovations that enabled sustained therapy and emphasizes the need for
Keywords: Homozygous familial hypercholesterolemia, Evinacumab, Plasmapheresis, Pediatric Hyperlipidemia, case report
Received: 11 Jan 2025; Accepted: 23 Jun 2025.
Copyright: © 2025 Filler and Norozi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Guido Filler, Western University, London, Canada
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