Robinson - Figure 16 - Consider referring Text

Finally, FH is a complex and difficult to treat condition where failure to properly screen, diagnose, and treat can have very damaging consequences. It seems entirely reasonable, therefore, to recommend that all patients with FH should be referred at least once to a lipid specialist. Especially patients who are at particularly high risk or have a very early family history, or where finding an appropriate medication regimen is proving difficult, deserve referral to a lipid specialist, if available.

In addition, the FNLA recommends cascade screening, meaning that when you find an index patient you then find and assess all their first-degree relatives, ie, brothers, sisters, children – all should have fasting lipid panels, and as each additional new case appears, this means continuing to screen additional family members to try to ensure that people are identified and treated at a young age. If you do not have the ability to do that in your own office, a lipid specialist certainly should be able to help facilitate that, because basically we recommend starting with this important first step to try to prevent the adverse consequences of a really severe genetic disorder.

Robinson J. J Clin Lipidol. 2011; 5(6).