Subscribe to RSS
DOI: 10.1055/s-0042-1757886
LPL Gene Mutation in Type 1 Familial Triglyceridemia Presenting as Recurrent Pancreatitis and Complicated by COVID19
Abstract
A 7-year-old girl with recurrent episodes of pancreatitis with risk factor of poorly controlled hyperglyceridemia presented with an acute episode of pancreatitis. She was managed conservatively and underwent whole exome sequencing which showed a likely pathogenic LPL gene mutation. Incidentally, she was diagnosed with COVID-19 on screening, which we hypothesize to have triggered the recent episode. On further examination, she was found to have bilateral cataracts. Her hypercholesterolemia was effectively managed with dietary therapy, high dose omega 3, and gemfibrozil. Our case report sensitizes the clinician to use a modern diagnostic tool such as whole exome sequencing in children with recurrent pancreatitis where hypertriglyceridemia is a known risk factor. This child is the first case of LPL mutation reported in India.
Publication History
Received: 07 November 2021
Accepted: 06 September 2022
Article published online:
01 November 2022
© 2022. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
References
- 1 Valaiyapathi B, Sunil B, Ashraf AP. Approach to hypertriglyceridemia in the paediatric population. Pediatr Rev 2017; 38 (09) 424-434
- 2 Asakura L, Lottenberg AM, Neves MQ. et al. Dietary medium-chain triacylglycerol prevents the postprandial rise of plasma triacylglycerols but induces hypercholesterolemia in primary hypertriglyceridemic subjects. Am J Clin Nutr 2000; 71 (03) 701-705
- 3 Berglund L, Brunzell JD, Goldberg AC. et al; Endocrine society. Evaluation and treatment of hypertriglyceridemia: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2012; 97 (09) 2969-2989
- 4 De La Torre A, Hamilton L, Wilson DP. A clinical approach to aggressive treatment of children with severe hypertriglyceridemia (Updated Feb 09, 2020). In: Feingold KR, Anawalt B, Boyce A. et al, eds. Comprehensive Free Online Endocrinology Book. South Dartmouth, MA: Endotext.org; 2000
- 5 Shah MH, Roshan R, Desai R, Kadam SS. Neonatal hyperlipidemia with pancreatitis: novel gene mutation of lipoprotein lipase. J Postgrad Med 2018; 64 (04) 247-249
- 6 Hanan SALA, AlAlwan I. Two siblings with familial chylomicronemia syndrome: disease course and effectiveness of early treatment. Case Rep Med 2010;(1687-9627):807434
- 7 Freed D. et al. The Sentieon genomics tools—a fast and accurate solution to variant calling from next-generation sequence data. BioRxiv:115717 2017
- 8 Li H, Durbin R. Fast and accurate long-read alignment with Burrows-Wheeler transform. Bioinformatics 2010; 26 (05) 589-595
- 9 McLaren W, Pritchard B, Rios D, Chen Y, Flicek P, Cunningham F. Deriving the consequences of genomic variants with the Ensembl API and SNP effect predictor. Bioinformatics 2010; 26 (16) 2069-2070
- 10 Zerbino DR, Achuthan P, Akanni W. et al. Ensembl 2018. Nucleic Acids Res 2018; 46 (D1): D754-D761
- 11 Landrum MJ, Lee JM, Benson M. et al. ClinVar: public archive of interpretations of clinically relevant variants. Nucleic Acids Res 2016; 44 (D1): D862-D868
- 12 McKusick VA. Mendelian Inheritance in Man. A Catalog of Human Genes and Genetic Disorders. 12th ed. Baltimore: Johns Hopkins University Press; 1998
- 13 Welter D, MacArthur J, Morales J. et al. The NHGRI GWAS catalog, a curated resource of SNP-trait associations. Nucleic Acids Res 2014; 42 (Database issue): D1001-D1006
- 14 Stenson PD, Mort M, Ball EV. et al. The human gene mutation database: towards a comprehensive repository of inherited mutation data for medical research, genetic diagnosis and next-generation sequencing studies. Hum Genet 2017; 136 (06) 665-677
- 15 Mottaz A, David FP, Veuthey AL, Yip YL. Easy retrieval of single amino-acid polymorphisms and phenotype information using SwissVar. Bioinformatics 2010; 26 (06) 851-852
- 16 Wang Y, Sternfeld L, Yang F. et al. Enhanced susceptibility to pancreatitis in severe hypertriglyceridaemic lipoprotein lipase-deficient mice and agonist-like function of pancreatic lipase in pancreatic cells. Gut 2009; 58 (03) 422-430
- 17 Petersen OH, Gerasimenko JV, Gerasimenko OV, Gryshchenko O, Peng S. The roles of calcium and ATP in the physiology and pathology of the exocrine pancreas. Physiol Rev 2021; 101 (04) 1691-1744