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Familial Hypercholesterolemia (FH) Screen
- FH Screen
- LDL and Non-HDLC FH Screen
The 2011 clinical guidance from the National Lipid Association Expert Panel1 recommends universal screening of children age 9 to 11 years and adults with a fasting lipid profile that include LDL cholesterol and/or non-HDL cholesterol for identification of patients at risk of familial hypercholesterolemia (FH). Cholesterol screening should be considered beginning at age two for children with a family history of premature cardiovascular disease or elevated cholesterol. All individuals should be screened by age 20. For all patients with LDL-C and/or non-HDL-C levels listed in the table above, a family history of high cholesterol and heart disease in first-degree relatives should be collected. The likelihood of FH is higher in individuals with a positive family history of hypercholesterolemia or of premature CHD (onset in men before age 55 years and women before age 65 years). Cascade screening of all first-degree relatives for lipid levels is considered the most cost-effective lifesaving procedure. Genetic screening for FH-associated mutations in LDL receptor, Apo B, and proprotein convertase subtilisin/kexin type 9 (PCSK9) genes may be useful when the diagnosis is uncertain. The prevalence of FH in general population is reported to be 1 in 300 to 500 making FH among one of the most common serious genetic disorders. Some populations, such as French Canadian and Dutch Afrikaner, have a prevalence as high as 1 in 100.
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FH should be suspected if at age:
FH should be strongly suspected (with approximate probability of 80%) if at age:
1 mL (Note: This volume does not allow for repeat testing.)
Separate serum from cells within 45 minutes of venipuncture. Lipid profiles are best avoided following acute myocardial infarction, for up to three months, although cholesterol can be in the first 24 hours.
Causes for Rejection
|Order Code||Order Code Name||Order Loinc||Result Code||Result Code Name||UofM||Result LOINC|
|368600||Familial Hypercholesterolemia||001065||Cholesterol, Total||mg/dL||2093-3|
|368600||Familial Hypercholesterolemia||011817||HDL Cholesterol||mg/dL||2085-9|
|368600||Familial Hypercholesterolemia||011976||Non-HDL Cholesterol||mg/dL||43396-1|
|368600||Familial Hypercholesterolemia||120297||LDL Chol. (Direct)||mg/dL||18262-6|