Genetic and Clinical Characteristics of Patients with Lipoprotein Lipase Deficiency from Slovenia and Pakistan: Case Series and Systematic Literature Review

Overview

Journal Front Endocrinol (Lausanne)

Specialty Endocrinology

Date 2024 Jun 24

PMID 38911039

Authors

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

Affiliations

Soon will be listed here.

Abstract

Introduction: Hypertriglyceridemia (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.

Methods: We 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 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.

Results: Two 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).

Conclusions: Patients 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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