Apolipoprotein deficiency and chronic liver disease.
Deficiency of apolipoprotein can be of genetic origin or due to diseases like advanced chronic liver disease. Deficiency of apolipoprotein A causes Tangier disease without any major hepatic involvement being reported. Deficiency of apolipoprotein B causes abetalipoproteinemia or familial hypobetalipoproteinemia; with hepatic involvement in the form of raised transaminases, fatty liver and cirrhosis. Advanced chronic liver disease itself can cause reduction of apolipoprotein A and apolipoprotein B levels and acanthocytosis. In patients with chronic liver disease of undetermined etiology, lipid profile and apolipoprotein levels should be obtained routinely. If it suggests apolipoprotein B deficiency, then liver biopsy can be avoided, as the etiology of chronic liver disease is established. Isolated deficiency of either apolipoprotein A or apolipoprotein B suggests etiology of chronic liver disease, while deficiency of both apolipoprotein A and apolipoprotein B is a manifestation of advanced chronic liver disease.
Shah
S S
SS
Department of Gastroenterology, Jaslok Hospital and Research Centre, Dr. G Deshmukh Marg, Mumbai 26.
Desai
H G
HG
D001054:Apolipoproteins A / Q000172:deficiency*; D001055:Apolipoproteins B / Q000172:deficiency*; D002779:Cholestasis / Q000473:pathology; D006801:Humans; D008099:Liver / Q000473:pathology; D008107:Liver Diseases / Q000209:etiology* / Q000473:pathology; D012720:Severity of Illness Index
D001054:Apolipoproteins A; D001055:Apolipoproteins B