An antibody against the lecithin:cholesterol acyltransferase (LCAT) enzyme, which negates cholesterol esterification in plasma, causing severe high-density lipoprotein deficiency (HD), was identified in a woman with a large-cell non-Hodgkin lymphoma. Successful treatment of the lymphoma resulted in clearance of the antibody and complete correction of the defective cholesterol esterification and HD. To our knowledge, an acquired LCAT deficiency leading to severe HD has not been reported previously in association with a malignant disease, and this patient represents the first such documented case.
Figure. Detection of anti–lecithin:cholesterol acyltransferase (LCAT) IgG. A, The patient's plasma collected in May 2007 (lane 1) but not that collected in November 2007 (lane 2) reacts with purified human LCAT. Human LCAT (4.6 ng) was run on a 10% sodium dodecyl sulfate polyacrylamide gel and electrophoretically transferred to a nitrocellulose membrane; the membrane was incubated with the patient's plasma (diluted 1:100 in tris buffered saline) and probed with a commercial rabbit anti-human IgG antibody. The upper band in lane 1 is LCAT (76 kDa); the lower band in lanes 1 and 2 is an unspecific signal. B, The presence in the patient's plasma collected in May 2007 (lane 2) but not in November 2007 (lane 3) of an LCAT-IgG complex. Purified human LCAT (lane 1) and the patient's plasma were run on a nondenaturing polyacrylamide gradient (4%-20%) gel and transferred to a nitrocellulose membrane, which was incubated with a rabbit anti-human LCAT antibody (left). The membrane was then stripped and probed with a commercial rabbit anti-human IgG antibody (right). The arrow indicates the LCAT-IgG complex.
Thank you for submitting a comment on this article. It will be reviewed by JAMA Internal Medicine editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest*
Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 4
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.