title: Type 1 hyperlipoproteinemia and recurrent acute pancreatitis due to lipoprotein lipase antibody in a young girl with Sjogren's syndrome.
abstract: BACKGROUND
  Type 1 hyperlipoproteinemia (T1HLP) in childhood is most often due to genetic deficiency of lipoprotein lipase (LPL) or other related proteins.
  
  
  OBJECTIVE
  The aim was to report a case of marked hypertriglyceridemia and recurrent acute pancreatitis due to the presence of LPL autoantibody in a young girl who was subsequently diagnosed with Sjögren's syndrome.
  
  
  METHODS
  A 9-yr-old African-American girl presented with acute pancreatitis and serum triglycerides of 4784 mg/dl. Strict restriction of dietary fat reduced serum triglycerides, but she continued to experience recurrent pancreatitis. Approximately 18 months thereafter, she developed transient pauciarticular arthritis with elevated serum antinuclear antibody (>1:1280). Minor salivary gland biopsy revealed chronic sialadenitis with a dense periductal lymphocytic aggregate suggestive of Sjögren's syndrome. Genomic DNA was analyzed for LPL, GPIHBP1, APOA5, APOC2, and LMF1. Immunoblotting was performed to detect serum LPL autoantibody.
  
  
  RESULTS
  The patient had no disease-causing variants in LPL, GPIHBP1, APOA5, APOC2, or LMF1. Immunoblotting revealed serum LPL antibody. The patient responded to immunosuppressive therapy for Sjögren's syndrome with resolution of hypertriglyceridemia.
  
  
  CONCLUSIONS
  Unexplained T1HLP in childhood could be secondary to LPL deficiency induced by autoantibodies. Therefore, diagnosis of autoimmune T1HLP should be entertained if clinical features are suggestive of an autoimmune process.
authors: Division of Pediatric Endocrinology, University of Alabama at Birmingham, Birmingham, Alabama 35294, USA.
authors: Ambika P
authors: AP
authors: Ashraf
authors: Timothy
authors: T
authors: Beukelman
authors: Valerie
authors: V
authors: Pruneta-Deloche
authors: David R
authors: DR
authors: Kelly
authors: Abhimanyu
authors: A
authors: Garg
mesh_terms: D001323:Autoantibodies / Q000276:immunology*; D001327:Autoimmune Diseases / Q000175:diagnosis / Q000276:immunology*; D002648:Child; D005260:Female; D006801:Humans; D008072:Hyperlipoproteinemia Type I / Q000150:complications / Q000175:diagnosis / Q000276:immunology*; D008071:Lipoprotein Lipase / Q000276:immunology*; D019283:Pancreatitis, Acute Necrotizing / Q000150:complications / Q000175:diagnosis / Q000276:immunology*; D012859:Sjogren's Syndrome / Q000150:complications / Q000276:immunology*
chemical_list: D001323:Autoantibodies; D008071:Lipoprotein Lipase