Clinical, molecular genetic analysis, and treatment of 3 children with sitosterolemia

Objective: To investigate clinical, molecular genetic characteristics, and treatment outcomes of 3 children with sitosterolemia. Methods: Three cases of children presented with multiple xanthomas during June 2016 to June 2017 were included. The clinical manifestations, laboratory examinations and fo...

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Veröffentlicht in:Zhonghua er ke za zhi = Chinese journal of pediatrics. - 1960. - 56(2018), 6 vom: 02. Juni, Seite 435-439
1. Verfasser: Fang, D (VerfasserIn)
Weitere Verfasser: Liang, L L, Qiu, W J, Fan, Y J, Sun, Y, Yan, H, Yu, Y G, Gu, X F
Format: Online-Aufsatz
Sprache:Chinese
Veröffentlicht: 2018
Zugriff auf das übergeordnete Werk:Zhonghua er ke za zhi = Chinese journal of pediatrics
Schlagworte:Case Reports Journal Article Genes High-throughput nucleotide sequencing Hypercholesterolemia Xanthomatosis ABCG8 protein, human ATP Binding Cassette Transporter, Subfamily G, Member 5 ATP Binding Cassette Transporter, Subfamily G, Member 8 ATP-Binding Cassette Transporters mehr... Lipoproteins Phytosterols Cholesterol 97C5T2UQ7J
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245 1 0 |a Clinical, molecular genetic analysis, and treatment of 3 children with sitosterolemia 
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520 |a Objective: To investigate clinical, molecular genetic characteristics, and treatment outcomes of 3 children with sitosterolemia. Methods: Three cases of children presented with multiple xanthomas during June 2016 to June 2017 were included. The clinical manifestations, laboratory examinations and follow-up data were retrospectively analyzed. DNA was extracted from peripheral blood and analyzed with whole exome sequencing(WES). All the detected variants were confirmed by Sanger sequencing. Plasma plant sterol concentrations were measured by gas chromatography-mass spectrometry. Results: Three cases of children including 1 boy and 2 girls presented with multiple linear and intertriginous xanthomas around skin of the joint areas at the age from 15 months to 6 years and 2 months. Total cholesterol of the 3 cases was elevated to 14.45, 15.47 and 15.85 mmol/L (3.36-6.46), and low density lipoprotein cholesterol was 9.02, 13.54 and 12.47 mmol/L (< 3.36) respectively. Genetic analysis with WES revealed that 2 cases carried compound heterozygous variants in ABCG5 gene, 1 case carried compound heterozygous variants in ABCG8 gene. Two reported variants (p. N437K, p.R446X) and one novel variant (p.Q251X) of ABCG5 were identified in case 2 and 3. Two novel ABCG8 variants (p.R263Q, c.1528_1530delATC) were found in case 1. All these children had extremely high plasma plant sterol levels, thus the diagnosis of sitosterolemia was confirming. The campesterol level was 111.35, 102.86 and 58.91 μmol/L(0.01-10.00), the stigmasterol was 14.97, 29.43 and 17.79 μmol/L (0.10-8.50) and the sitosterol was 231.20, 177.66 and 114.20 μmol/L (1.00-15.00) respectively. The total serum cholesterol levels of three children decreased to nomal after the patients were placed on the low plant sterol/low cholesterol diet. The xanthomas regressed gradually, and almost disappeared after 8 months of treatment in case 1 and 3. Conclusions: Children with sitosterolemia presented with skin xanthomas around the joint areas. The level of total cholesterol, low density lipoprotein cholesterol and plant sterols increased obviously. One novel variant (p.Q251X) of ABCG5 and 2 novel variants (p.R263Q, c.1528_1530delATC) of ABCG8 were identified. Children with sitosterolemia responded well to a low plant sterols/low cholesterol diet 
650 4 |a Case Reports 
650 4 |a Journal Article 
650 4 |a Genes 
650 4 |a High-throughput nucleotide sequencing 
650 4 |a Hypercholesterolemia 
650 4 |a Xanthomatosis 
650 7 |a ABCG8 protein, human  |2 NLM 
650 7 |a ATP Binding Cassette Transporter, Subfamily G, Member 5  |2 NLM 
650 7 |a ATP Binding Cassette Transporter, Subfamily G, Member 8  |2 NLM 
650 7 |a ATP-Binding Cassette Transporters  |2 NLM 
650 7 |a Lipoproteins  |2 NLM 
650 7 |a Phytosterols  |2 NLM 
650 7 |a Cholesterol  |2 NLM 
650 7 |a 97C5T2UQ7J  |2 NLM 
700 1 |a Liang, L L  |e verfasserin  |4 aut 
700 1 |a Qiu, W J  |e verfasserin  |4 aut 
700 1 |a Fan, Y J  |e verfasserin  |4 aut 
700 1 |a Sun, Y  |e verfasserin  |4 aut 
700 1 |a Yan, H  |e verfasserin  |4 aut 
700 1 |a Yu, Y G  |e verfasserin  |4 aut 
700 1 |a Gu, X F  |e verfasserin  |4 aut 
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