Abstract
Lysosomal acid lipase (LAL) deficiency is an underrecognized lysosomal disease caused by deficient enzymatic activity of LAL. In this report we describe two affected female Mexican siblings with early hepatic complications. At two months of age, the first sibling presented with alternating episodes of diarrhea and constipation, and later with hepatomegaly, elevated transaminases, high levels of total and low-density lipoprotein cholesterol, and low levels of highdensity lipoprotein. Portal hypertension and grade 2 esophageal varices were detected at four years of age. The second sibling presented with hepatomegaly, elevated transaminases and mildly elevated lowdensity lipoprotein and low high-density lipoprotein at six months of age. LAL activity was deficient in both patients. Sequencing of LIPA revealed two previously unreported heterozygous mutations in exon 4: c.253C>A and c.294C>G. These cases highlight the clinical continuum between the so-called Wolman disease and cholesteryl ester storage disease, and underscore that LAL deficiency represents a single disease with a degree of clinical heterogeneity.
| Original language | English |
|---|---|
| Pages (from-to) | 1001-1008 |
| Number of pages | 8 |
| Journal | World Journal of Gastroenterology |
| Volume | 21 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - 21 Jan 2015 |
Bibliographical note
We would like to thank Radhika Tripuraneni, MD, MPH, for critical reading of the manuscript, Angelica TorizOrtiz, MD, for ultrasound imaging, and the medical staff of the Endoscopy and Pathology Department of CMN “20 de Noviembre”, along with all the personnel involved in the care of the patients. This work was presented in abstract form at 2013’s National Week of Gastroenterology (Semana Nacional de Gastroenterologia de la AMG) in Veracruz, Mexico and at Ⅸ Congress of SLEIMPN in Medellín, Colombia.UN SDGs
This output contributes to the following UN Sustainable Development Goals (SDGs)
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SDG 3 Good Health and Well-being
Keywords
- Cholesteryl ester storage disease
- Dyslipidemia
- Liver fibrosis
- Liver steatosis
- Wolman disease
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