title: A case of hyperlipidemia with homozygous apolipoprotein E5 (Glu3-->Lys).
abstract: In this study, we present clinical feature of a novel case with homozygous apolipoprotein (apo) E5. The patient was a 53-year-old Japanese woman. She was from a small island off the coast of Kagoshima Prefecture, Japan. Her parents were first degree cousins. No corneal opacification, xanthomatosis, lymphadenopathy, or hepatosplenomegaly was observed. There have been no signs of clinically overt atherosclerosis to date. Her serum total cholesterol, triglycerides (TG) and high-density lipoprotein (HDL)-cholesterol levels were 11.6, 6.1 and 1.2 mmol/l, respectively, and apo A-I, A-II, B, C-II, C-III and E levels were 121, 34.8, 269, 10.4, 25.7 and 10.3 mg/dl, respectively. Serum lipoprotein profile analyzed by agarose gel electrophoresis and differential staining revealed markedly increased cholesterol and TG in both beta and prebeta-migrated lipoproteins, whereas alpha-migrated lipoprotein showed decreased cholesterol. Her apo E isoform analyzed by isoelectric focusing (IEF) was found to be homozygous apo E5. Polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) analysis of her apo E and lipoprotein lipase (LPL) genes revealed that she had a homozygous apo E (Glu3-->Lys) and heterozygous LPL variant Ser447 to Ter. Her son and daughter, both of whom had hyperlipidemia, were found to have apo E3/5 phenotype. Direct sequencing analysis of her apo E gene confirmed a homozygous one nucleotide change: G to A at nucleotide position of 2836 in the exon 3, resulting in Glu3-->Lys mutation. This is the first report of lipids and lipoprotein profiles in patients with homozygous apo E5 (Glu3-->Lys).
authors.affiliation: Department of Internal Medicine, Chibaken Saiseikai Narashino Hospital, 1-1-1 Izumicho, Chiba 275-8580, Japan. maryland95@angel.ne.jp
authors.forename: Junji
authors.initials: J
authors.lastname: Kobayashi
authors.forename: Kouji
authors.initials: K
authors.lastname: Shirai
authors.forename: Takeyoshi
authors.initials: T
authors.lastname: Murano
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Misawa
authors.forename: Jun
authors.initials: J
authors.lastname: Tashiro
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Yoshida
authors.forename: Masaki
authors.initials: M
authors.lastname: Shinomiya
mesh_terms: D000328:Adult; D019943:Amino Acid Substitution; D001057:Apolipoproteins E / Q000737:chemistry / Q000235:genetics*; D001483:Base Sequence; D017931:DNA Primers; D004587:Electrophoresis, Agar Gel; D005260:Female; D005838:Genotype; D018698:Glutamic Acid / Q000235:genetics*; D006801:Humans; D006949:Hyperlipidemias / Q000235:genetics*; D008071:Lipoprotein Lipase / Q000235:genetics; D008239:Lysine / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D016133:Polymerase Chain Reaction; D012150:Polymorphism, Restriction Fragment Length
chemical_list: D001057:Apolipoproteins E; D017931:DNA Primers; D018698:Glutamic Acid; D008071:Lipoprotein Lipase; D008239:Lysine