Severe chronic diarrhea and weight loss in cholesteryl ester storage disease: a case report.
OBJECTIVE
An inherited deficiency of human lysosomal acid lipase (LAL) results in the rare conditions of Wolman disease and cholesteryl ester storage disease (CESD). We want to present the rare case of CESD in an adult.


METHODS
We report about an adult female patient with severe chronic diarrhea and weight loss as a consequence of CESD. Clinical examination revealed signs of malabsorption and slightly elevated liver enzymes.


RESULTS
Histopathologic changes in the liver tissue and DNA sequence analysis confirmed the diagnosis of CESD due to homozygosity for the most common CESD mutation, a G934A splice site defect encoded by exon 8 of the lysosomal acid lipase (LIPA) gene.


CONCLUSIONS
It is the first case in the literature with diarrhea as a putative symptom of CESD in adult patients.
Drebber
Uta
U
Institute of Pathology, University of Cologne, Joseph-Stelzmann-Strasse 9, D-59031 Cologne, Germany. u.drebber@uni-koeln.de
Andersen
Matthias
M
Kasper
Hans U
HU
Lohse
Peter
P
Stolte
Manfred
M
Dienes
Hans P
HP
D000328:Adult; D000367:Age Factors; D002788:Cholesterol Esters / Q000378:metabolism; D002908:Chronic Disease; D003967:Diarrhea / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D024661:Potassium Channels, Inwardly Rectifying; D012720:Severity of Illness Index; D002787:Sterol Esterase; D015431:Weight Loss; D015223:Wolman Disease / Q000150:complications* / Q000378:metabolism / Q000473:pathology
C489478:BIK channel; D002788:Cholesterol Esters; D024661:Potassium Channels, Inwardly Rectifying; C503451:LIPA protein, human; D002787:Sterol Esterase