Sudden Death Associated with Hypercholesterolemia and Severe Atherosclerosis in a 9 Month Old Harbor Seal
Randall W. Davis, PhD; James McBain, DVM; Thomas E. Carew, PhD; Joseph L.
Witztum, MD
The occurrence and severity of spontaneous atherosclerotic lesions
varies considerably among vertebrate animals. Gross atherosclerosis rarely develops in seals
despite plasma lipid levels that are among the highest reported for mammals. We report here
the sudden death of a 9 month old harbor seal with severe hypercholesterolemia and
atherosclerosis.
The harbor seal was born at Sea World in San Diego on April 9, 1987 and
was eating normally until the time of death. It died suddenly on January 3, 1988 from a
spontaneous rupture of the left ventricle and exsanguination. Gross examination revealed
tuberous xanthomas on the face, tongue, fore flippers and hind flippers. The xanthomas ranged
in size from 1-6 mm and were concentrated around the eyes and nose. The arterial vasculature
had severe atherosclerosis, and all of the arteries 2 mm or less in diameter were severely
stenotic from the presence of yellow-white plaque. Light microscopy of the arteries showed
advanced, proliferative atherosclerotic lesions composed of extensive foam cells and
extracellular lipid. The lungs, liver and kidneys were congested.
Serum samples taken two weeks and ten weeks prior to death were very
turbid due to the accumulation of large, light scattering lipoprotein particles. The plasma
concentrations of total cholesterol (TC) and triglycerides ranged from 4643-5590 mg/dl and
781-955 mg/dl, respectively. These are some of the highest plasma cholesterol concentrations
ever reported for a vertebrate animal. The plasma was ultracentrifuged to separate the
lipoprotein classes (chylomicrons, VLDL, LDL, HDL, density <1.006 g/ml, 1.006-1.063 g/ml
and 1.063-1.21 g/ml, respectively). Seventy percent of the cholesterol occurred in the
chylomicrons and VLDL, although the LDL cholesterol was also elevated above normal levels.
Agarose gel electrophoresis demonstrated a broadly migrating, lipid staining band between the
prebeta and beta positions consistent with the accumulation of B-VLDL (chylomicron and VLDL
remnants) in the plasma.
The apoprotein profile on SDS-polyacrylamide gel electrophoresis was
typical for harbor seals. Although no apoproteins were absent, we have recently discovered
that the apoprotein E of harbor seals is about ten kilodaltons heavier than typical mammalian
apoprotein E (e.g., 33 kilodaltons).
Although the etiology of this unusual condition in seals remains
uncertain, the high cholesterol concentration in the VLDL fraction, large ratio of
cholesterol to triglycerides, and presence of xanthomas are most analogous to Type III
hypercholesterolemia, a heritable condition resulting from defective apoprotein E. There is
evidence that this seal was the offspring of consanguineous mating between a female and one
of her earlier male offspring. The female, which is still alive, has moderate
hypercholesterolemia (483 mg/dl), but the male is normal. If the female and male are
heterozygous for the defective apoprotein E, then their mating may have produced a homozygous
condition for the defective apoprotein E, resulting in severe hypercholesterolemia and
atherosclerosis in the seal that died.