Diagnostic approach to low LDL cholesterol

LDL-C: low-density lipoprotein cholesterol.

* In patients with severe illness, the LDL-C is likely acquired and is secondary to the illness. This can be due to cirrhosis, sepsis, malignancy, or other diseases. In this case, low LDL is likely to reverse once the underlying illness is treated and the patient recovers. Refer to UpToDate content for further detail.

¶ In some cases, low LDL-C values have been reported up to 20 mg/dL, but this is uncommon. Genetic testing can confirm the diagnosis.

Δ Patients with ANGPTL3 or heterozygous hypobetalipoproteinemia without liver disease should be followed for development of liver dysfunction, as it can develop in a subset of patients with these genetic variants. Refer to UpToDate content for further information.

◊ Refer to UpToDate content for guidance on specific evaluation and diagnostic testing.