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Clinical Observation |

Severe High-Density Lipoprotein Deficiency Associated With Autoantibodies Against Lecithin:Cholesterol Acyltransferase in Non-Hodgkin Lymphoma

Sara Simonelli, PhD; Elisabetta Gianazza, PhD; Giuliana Mombelli, MD; Alighiero Bondioli, MD; Giovanni Ferraro, MD; Silvana Penco, PhD; Cesare R. Sirtori, MD, PhD; Guido Franceschini, PhD; Laura Calabresi, PhD
Arch Intern Med. 2012;172(2):179-181. doi:10.1001/archinternmed.2011.661.
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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.

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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.

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