Genetic and clinical characteristics of patients with lipoprotein lipase deficiency from Slovenia and Pakistan: case series and systematic literature review

Autor: Quratul Ain, Matija Cevc, Tatiana Marusic, Jaka Sikonja, Fouzia Sadiq, Ursa Sustar, Matej Mlinaric, Jernej Kovac, Hijab Batool, Mohammad Iqbal Khan, Katarina Trebusak Podkrajsek, Barbara Jenko Bizjan, Tadej Battelino, Zlatko Fras, Muhammad Ajmal, Urh Groselj
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Frontiers in Endocrinology, Vol 15 (2024)
Druh dokumentu: article
ISSN: 1664-2392
DOI: 10.3389/fendo.2024.1387419
Popis: IntroductionHypertriglyceridemia (HTG) is a complex disorder caused by genetic and environmental factors that frequently results from loss-of-function variants in the gene encoding lipoprotein lipase (LPL). Heterozygous patients have a range of symptoms, while homozygous LPL deficiency presents with severe symptoms including acute pancreatitis, xanthomas, and lipemia retinalis.MethodsWe described the clinical characteristics of three Slovenian patients (an 8-year-old female, an 18-year-old man, and a 57-year-old female) and one Pakistani patient (a 59-year-old male) with LPL deficiency. We performed next-generation sequencing (NGS) targeting all coding exons and intron-exon boundaries of the LPL gene, and Sanger sequencing for variant confirmation. In addition, we performed a systematic literature review of all cases with three identified variants and described their clinical characteristics.ResultsTwo Slovenian patients with a heterozygous pathogenic variant NM_000237.3:c.984G>T (p.Met328Ile) were diagnosed within the first three years of life and had triglyceride (TG) values of 16 and 20 mmol/L. An asymptomatic Pakistani patient with TG values of 36.8 mmol/L until the age of 44 years, was identified as heterozygous for a pathogenic variant NM_000237.3:c.724G>A (p.Asp242Asn). His TG levels dropped to 12.7 mmol/L on dietary modifications and by using fibrates. A Slovenian patient who first suffered from pancreatitis at the age of 18 years with a TG value of 34 mmol/L was found to be homozygous for NM_000237.3:c.337T>C (p.Trp113Arg).ConclusionsPatients with LPL deficiency had high TG levels at diagnosis. Homozygous patients had worse outcomes. Good diet and medication compliance can reduce severity.
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