Niemann-Pick disease type-B: a unique case report with compound heterozygosity and complicated lipid management

BMC Med Genet. 2020 May 6;21(1):94. doi: 10.1186/s12881-020-01027-9.

Abstract

Background: Niemann-Pick disease (NPD) is a rare autosomal recessive hereditary disease characterized by deficient activity of acid sphingomyelinase.

Case presentation: We present a case of NPD type B with a unique compound heterozygosity for SMPD1 (NM_000543.4:c.[84delC];[96G > A]) in which both mutations that induce an early stop codon are located before the second in-frame initiation codon. The clinical presentation of the patient is compatible with NPD type B. She was initially diagnosed of Gaucher Disease, but her altered lipid profile led to a clinical suspicion of NPD. Combined high doses of atorvastatin and ezetimibe were given to treat the severe hypercholesterolemia.

Conclusions: The pharmacological management of the lipid profile in these patients is important. A unique compound mutation in SMPD1 gene is described.

Keywords: Genetics; Low HDL cholesterol; Niemann-Pick disease, type B; Sphingomyelin phosphodiesterase.

Publication types

  • Case Reports

MeSH terms

  • Atorvastatin / administration & dosage
  • Codon, Terminator / genetics
  • Female
  • Humans
  • Lipid Metabolism / genetics
  • Lipids / genetics*
  • Male
  • Mutation / genetics
  • Niemann-Pick Disease, Type B / drug therapy
  • Niemann-Pick Disease, Type B / genetics*
  • Niemann-Pick Disease, Type B / metabolism
  • Niemann-Pick Disease, Type B / pathology
  • Sphingomyelin Phosphodiesterase / genetics*

Substances

  • Codon, Terminator
  • Lipids
  • Atorvastatin
  • SMPD1 protein, human
  • Sphingomyelin Phosphodiesterase