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Amelioration of circulating lipoprotein profile and proteinuria in a patient with LCAT deficiency due to a novel mutation (Cys74Tyr) in the lid region of LCAT under a fat-restricted diet and ARB treatment.

Abstract
Familial lecithin-cholesterol acyltransferase (LCAT) deficiency is a hereditary disease characterized by an abnormal lipid profile, corneal opacity, anemia and progressive renal disease. We report a patient with complete loss of LCAT activity due to a novel lcat gene mutation of Cys74Tyr in the lid region of LCAT protein. Esterification of cholesterol in this patient was disturbed by disruption of a substrate binding loop of Cys50-Cys74 in LCAT protein. She had progressive renal dysfunction, proteinuria, corneal opacity, anemia and an abnormal lipid profile. Her serum lipids showed a significant increase in abnormal lipoproteins at the original position in agarose gel electrophoresis and VLDL-cholesterol, and a severe decrease in serum HDL-cholesterol. Lipoprotein analyzes also revealed the presence of an abnormal midband lipoprotein, and a maturation disturbance of HDL particles. Renal function and proteinuria improved following the adoption of a fat-restricted diet and administration of an angiotensin II receptor blocker. The abnormal lipoproteins also decreased after this treatment.
AuthorsShokichi Naito, Mariko Kamata, Masako Furuya, Miyuki Hayashi, Masayuki Kuroda, Hideaki Bujo, Kouju Kamata
JournalAtherosclerosis (Atherosclerosis) Vol. 228 Issue 1 Pg. 193-7 (May 2013) ISSN: 1879-1484 [Electronic] Ireland
PMID23522979 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
CopyrightCopyright © 2013 Elsevier Ireland Ltd. All rights reserved.
Chemical References
  • Angiotensin II Type 1 Receptor Blockers
  • Disulfides
  • Lipoproteins
  • Cholesterol
  • Phosphatidylcholine-Sterol O-Acyltransferase
Topics
  • Angiotensin II Type 1 Receptor Blockers (therapeutic use)
  • Cholesterol (blood)
  • Corneal Opacity (genetics, metabolism)
  • Diet, Fat-Restricted
  • Disulfides (metabolism)
  • Esterification
  • Female
  • Humans
  • Lecithin Cholesterol Acyltransferase Deficiency (diet therapy, drug therapy, genetics)
  • Lipoproteins (blood)
  • Middle Aged
  • Phosphatidylcholine-Sterol O-Acyltransferase (genetics, metabolism)
  • Point Mutation
  • Proteinuria (diet therapy, drug therapy, genetics)

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