Inborn error of lipid metabolism

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Inborn error of lipid metabolism
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Hyperlipidemia, lipid storage disorder
Complications	Atherosclerosis, pancreatitis
Onset	Varies by specific condition
Duration	Chronic
Types	N/A
Causes	Genetic mutations affecting lipid metabolism
Risks	Family history, genetic predisposition
Diagnosis	Blood test, genetic testing
Differential diagnosis	Hyperlipoproteinemia, Gaucher's disease, Niemann-Pick disease
Prevention	Genetic counseling
Treatment	Dietary management, medication
Medication	Statins, fibrates, bile acid sequestrants
Prognosis	Varies by specific condition
Frequency	Rare
Deaths	N/A

An inborn error of lipid metabolism refers to a group of genetic disorders that affect the body's ability to metabolize lipids, which are essential components of cell membranes and serve as energy sources. These disorders are typically caused by mutations in genes that encode enzymes or proteins involved in lipid metabolism.

Pathophysiology

Lipid metabolism involves the breakdown, synthesis, and transport of lipids within the body. Inborn errors of lipid metabolism can lead to the accumulation or deficiency of specific lipids, resulting in a variety of clinical manifestations. These disorders can affect multiple organ systems, including the nervous system, liver, and cardiovascular system.

Types of Inborn Errors

There are several types of inborn errors of lipid metabolism, each associated with specific enzyme deficiencies or transport defects. Some of the most well-known include:

• Gaucher's disease: Caused by a deficiency in the enzyme glucocerebrosidase, leading to the accumulation of glucocerebroside.
• Niemann-Pick disease: Characterized by the accumulation of sphingomyelin due to a deficiency in sphingomyelinase.
• Fabry disease: Results from a deficiency in alpha-galactosidase A, causing the accumulation of globotriaosylceramide.
• Tay-Sachs disease: Caused by a deficiency in hexosaminidase A, leading to the accumulation of GM2 ganglioside.

Clinical Manifestations

The clinical presentation of inborn errors of lipid metabolism can vary widely depending on the specific disorder and the severity of the enzyme deficiency. Common symptoms may include:

• Neurological deficits, such as developmental delay, seizures, and neuropathy.
• Hepatosplenomegaly, or enlargement of the liver and spleen.
• Cardiovascular complications, including heart disease and stroke.
• Skin abnormalities, such as angiokeratomas in Fabry disease.

Diagnosis

Diagnosis of inborn errors of lipid metabolism typically involves a combination of clinical evaluation, biochemical testing, and genetic analysis. Enzyme assays can be used to measure the activity of specific enzymes in blood or tissue samples. Genetic testing can identify mutations in the genes associated with these disorders.

Treatment

Treatment options for inborn errors of lipid metabolism vary depending on the specific disorder. Approaches may include:

• Enzyme replacement therapy, such as imiglucerase for Gaucher's disease.
• Substrate reduction therapy, which aims to decrease the production of toxic metabolites.
• Supportive care to manage symptoms and prevent complications.

Prognosis

The prognosis for individuals with inborn errors of lipid metabolism depends on the specific disorder and the availability of effective treatments. Early diagnosis and intervention can improve outcomes and quality of life for affected individuals.

See also

• Metabolic disorder
• Lipid metabolism
• Genetic disorder