While these drugs are useful for patients with hyperlipidemia, Tangiers disease patients do not benefit from these pharmaceutical interventions.Therefore, the only current treatment modality for Tangiers disease is diet modification. A low-fat diet can reduce some of the symptoms, especially those involving neuropathies. History
In 1959, a five-year-old patient named Teddy Laird from Tangier Island, Virginia, presented with strikingly large and yellow-orange tonsils which were removed by armed forces physicians. After initial diagnosis with Niemann-Pick he was transferred to Dr. Louis Avioli at the National Cancer Institute. Donald Fredrickson, then head of the Molecular Disease Branch, became aware of the case and had a hunch that the original diagnosis was incorrect. In 1960, he traveled with Dr. Avioli to Tangier Island for further investigation. After finding the same symptom in Teddys sister, an investigation revealed an extremely high number of foam cells (cholesterol ester-laden macrophages) in not only the tonsils, but also in a wide-range of tissues, including the bone marrow and spleen. During a second trip to the island, they found that the family had very low levels of HDL cholesterol, suggesting a genetic basis of the disease. References
External links
Tangier disease at NLM Genetics Home Reference
Signs and symptoms
Pain on the outer part of the elbow (lateral epicondyle)
Point tenderness over the lateral epicondyle—a prominent part of the bone on the outside of the elbow
Pain with resisted wrist extension or passive wrist flexionSymptoms associated with tennis elbow include, but are not limited to, pain from the outside of the elbow to the forearm and wrist and pain during extension of wrist. Terminology
The term "tennis elbow" is widely used (although informal), but the condition should be understood as not limited to tennis players. Historically, the medical term "lateral epicondylitis" was most commonly used for the condition, but "itis" implies inflammation and the condition is not inflammatory.Since histological findings reveal noninflammatory tissue, the terms “lateral elbow tendinopathy" and "tendinosis” are suggested. In 2019, a group of international experts suggested that "lateral elbow tendinopathy" was the most appropriate terminology. But a disease of an attachment point (or enthesia) is most accurately referred to as an "enthesopathy." Causes
Enthesopathy of the extensor carpi radialis brevis origin is idiopathic, meaning that it has no known cause.Tennis players generally believe tennis elbow is caused by the repetitive nature of hitting thousands of tennis balls, which leads to tiny tears in the forearm tendon attachment at the elbow. Traditionally, people have speculated that tennis elbow is a type of repetitive strain injury resulting from tendon overuse and failed healing of the tendon, but there is no evidence of injury or repair on histopathology, and misinterpretation of painful activities as a source of damage is common.