Two Cases of Acquired High-Density Lipoprotein Deficiency with Immunoglobulin G4-Related Lecithin–Cholesterol Acyltransferase Autoantibody

Tomohiro Komatsu; Yuka Katsurada; Kazuya Miyashita; Satomi Abe; Takafumi Nishida; Yasuhiro Endo; Manami Teramoto; Kei Sasaki; Junko Arakawa; Makoto Sasaki; Natsuko Suzuki; Koji kuwata; Toshihiko Imakiire; Takayuki Miyake; Masami Sakurada; Susumu Matsukuma; Tsutomu Hirano; Yoshinari Uehara; Katsunori Ikewaki

doi:10.5551/jat.63616

Case Report

Two Cases of Acquired High-Density Lipoprotein Deficiency with Immunoglobulin G4-Related Lecithin–Cholesterol Acyltransferase Autoantibody

Tomohiro Komatsu, Yuka Katsurada, Kazuya Miyashita, Satomi Abe, Takafumi Nishida, Yasuhiro Endo, Manami Teramoto, Kei Sasaki, Junko Arakawa, Makoto Sasaki, Natsuko Suzuki, Koji kuwata, Toshihiko Imakiire, Takayuki Miyake, Masami Sakurada, Susumu Matsukuma, Tsutomu Hirano, Yoshinari Uehara, Katsunori Ikewaki

Author information

Tomohiro Komatsu
Division of Anti-aging and Vascular Medicine, Department of Internal Medicine, National Defense Medical College
Research Institute for Physical Activity, Fukuoka University
Center for Preventive, Anti-aging and Regenerative Medicine, Fukuoka University Hospital
Yuka Katsurada
Department of Pathology and Laboratory Medicine, National Defense Medical College
Kazuya Miyashita
Immuno.Biological Laboratories (IBL) Co, Ltd
Satomi Abe
Research Institute for Physical Activity, Fukuoka University
Takafumi Nishida
Division of Anti-aging and Vascular Medicine, Department of Internal Medicine, National Defense Medical College
Yasuhiro Endo
Division of Anti-aging and Vascular Medicine, Department of Internal Medicine, National Defense Medical College
Manami Teramoto
Division of Anti-aging and Vascular Medicine, Department of Internal Medicine, National Defense Medical College
Kei Sasaki
Division of Anti-aging and Vascular Medicine, Department of Internal Medicine, National Defense Medical College
Center for Preventive, Anti-aging and Regenerative Medicine, Fukuoka University Hospital
Junko Arakawa
Division of Anti-aging and Vascular Medicine, Department of Internal Medicine, National Defense Medical College
Makoto Sasaki
Division of Anti-aging and Vascular Medicine, Department of Internal Medicine, National Defense Medical College
Natsuko Suzuki
Diabetes Center, Ebina General Hospital
Koji kuwata
Department of Nephrology and Endocrinology, Department of Internal Medicine, National Defense Medical College
Toshihiko Imakiire
Department of Nephrology and Endocrinology, Department of Internal Medicine, National Defense Medical College
Takayuki Miyake
Tokorozawa Heart Center
Masami Sakurada
Tokorozawa Heart Center
Susumu Matsukuma
Department of Pathology and Laboratory Medicine, National Defense Medical College
Tsutomu Hirano
Diabetes Center, Ebina General Hospital
Yoshinari Uehara
Research Institute for Physical Activity, Fukuoka University
Center for Preventive, Anti-aging and Regenerative Medicine, Fukuoka University Hospital
Katsunori Ikewaki
Division of Anti-aging and Vascular Medicine, Department of Internal Medicine, National Defense Medical College

Keywords: High-density lipoprotein, Lecithin–cholesterol acyltransferase, Autoantibody, IgG4 autoimmune disease, Nephrotic syndrome

JOURNAL OPEN ACCESS FULL-TEXT HTML

2023 Volume 30 Issue 8 Pages 1070-1082

DOI https://doi.org/10.5551/jat.63616

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Abstract

Lecithin–cholesterol acyltransferase (LCAT) plays a significant role in the progression from premature to mature high-density lipoprotein (HDL) in circulation. Consequently, primary or secondary LCAT deletion or reduction naturally results in low serum HDL cholesterol levels. Recently, rare cases of acquired HDL deficiency with LCAT autoantibodies have been reported, mainly from Japan, where LCAT autoantibodies of immunoglobulin G (IgG) caused the HDL deficiency. Here to our knowledge, we report for the first time two cases of acquired HDL deficiency caused by IgG4 linked LCAT autoantibodies with or without a high serum IgG4 level. Furthermore, these cases can extend to a new concept of “IgG4 autoimmune disease” from the viewpoint of verifying the serum autoantibody and/or renal histopathology.

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