After the first description in 1974 [22], more and more reports have been published on patients with xanthomas and macrothrombocytopenia, homozygous or compound heterozygous for mutations in the ABCG5 or ABCG8 gene, and thus biochemically and genetically diagnosed phytosterolemia, but without evidence of clinically relevant atherosclerosis [33,43,44,45,46,47,48,49,50,51,52,53,54]. The gene discussed is ABCG8; the disease is atherosclerosis.