Deficiencia de lipasa ácida lisosomal

Lysosomal acid lipase deficiency is a metabolic lipid storage disease. Two rare conditions may result from this deficiency (likely representing two ends of a clinical spectrum): Symptoms include an enlarged liver and spleen (hepatosplenomegaly), poor weight gain, a yellowish color of the skin and the whites of the eyes (jaundice), vomiting, diarrhea, fatty stool (steatorrhea), and poor absorption of nutrients from food (malabsorption), as well as calcium deposits in adrenal glands, anemia, liver disease (cirrhosis), and developmental delay. Infants with this form of Lysosomal acid lipase deficiency develop failure in multiple organs, and severe malnutrition. Cholesteryl ester storage disease: Less severe and starting later in life. Symptoms may include hepatosplenomegaly, liver disease (cirrhosis), and malabsorption with diarrhea, vomiting, and steatorrhea. Lysosomal acid lipase deficiency is caused by genetic changes in the LIPA gene, which provides instructions to produce the lysosomal acid lipase enzyme. When there is not enough of this enzyme, the body cannot break down certain fats and this leads to a toxic buildup of fatty substances in the body’s cells and tissues. Inheritance is autosomal recessive. Enzyme replacement therapy for both Wolman disease and cholesteryl ester storage disease is currently approved for use in the United States, European Union, and Japan.

Genetic Mutations: Lysosomal acid lipase deficiency is caused by genetic mutations, also known as pathogenic variants. Genetic mutations can be hereditary, when parents pass them down to their children, or they may occur randomly when cells are dividing. Genetic mutations may also result from contracted viruses, environmental factors, such as UV radiation from sunlight exposure, or a combination of any of these.

Si sospecha que puede tener esta enfermedad, se recomienda que empiece a recopilar el historial de salud de su familia. Debe comentar con su equipo médico cualquier información sobre otros familiares que hayan tenido síntomas similares, cuándo aparecieron por primera vez dichos síntomas (en usted o en sus parientes) o la exposición a factores ambientales que pudieran, potencialmente, causar la enfermedad.

Disruption in Metabolism: Lysosomal acid lipase deficiency is caused by a disruption in a person’s metabolism. Metabolism is the series of chemical reactions in our body that turns the food we eat into energy and removes toxins. Hormones and specific proteins, called enzymes, help make the right chemical reactions happen in the right order. However, genetic changes can prevent hormones or enzymes from working properly, which can lead to a disruption in metabolism such as energy not being created for the body or toxins not being removed from the body.

Impaired Lysosomal Function: This disease is caused by an impairment, or issue, in lysosomal function. Lysosomes are located inside cells and contain digestive enzymes that help break down fats, sugars, and other substances to create energy for the body. Genetic mutations can affect lysosomes such as having a missing or non-functioning digestive enzyme. This can prevent cells from properly breaking down toxins or moving them out of the cell. If toxins build up, the cell may become damaged or die. Depending on their location in the body, these damaged or dead cells may affect different organs and body systems.

Sí. Es posible que un progenitor biológico transmita a su hijo mutaciones genéticas que causen esta enfermedad o que aumenten las probabilidades de heredarla. Esto se conoce como herencia. Saber si otros miembros de la familia han tenido previamente esta enfermedad o, dicho de otro modo, su historial familiar de salud, puede ser una información muy importante para su equipo médico.

Existen diversas formas o patrones en los que una enfermedad puede heredarse en función del gen o los genes implicados. A partir de los datos actuales del GARD, esta enfermedad puede heredarse según los siguientes patrones:

Autosómica recesiva: autosómica significa que el gen implicado se encuentra en uno de los cromosomas no sexuales. Recesiva significa que una persona debe heredar dos copias del gen mutado, una de cada progenitor biológico, para verse afectada por la enfermedad. Un portador es una persona que solo tiene una copia de la mutación genética. Por lo general, el portador no muestra ningún síntoma de la enfermedad.

Si ambos padres biológicos son portadores, existe un 25 % de probabilidades de que su hijo o hija herede ambas copias del gen mutado, y se vea afectado por la enfermedad. Además, existe un 50 % de probabilidades de que herede solo una copia del gen mutado y sea portador.