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A case of lipoprotein glomerulopathy with a rare apolipoprotein E isoform combined with neurofibromatosis type I

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Abstract

Lipoprotein glomerulopathy (LPG) is a rare inherited disease characterized by histopathological features of lipoprotein thrombi in dilated glomerular capillaries and type III like hyperlipoproteinemia with heterozygous mutation of the apolipoprotein (apo) E gene. We herein present the case of a 50-year-old woman with LPG complicated by neurofibromatosis type 1 (NF1). To the best of our knowledge, this is the first report of a case of LPG complicated by NF1. On the other hand, she had not only a heterozygous apoE-Sendai mutation, which is one of the most frequent apoE variants in LPG patients, but also a rare isoform of ApoE5 (Glu3Lys). Although apoE mutation has been recognized as having a principal role in the pathogenesis of LPG, some other factors are assumed to be present in the pathogenesis of LPG, because many asymptomatic carriers of apoE variants are recognized. The coexistence of NF1 or apoE5 (Glu3Lys) allele might play a role as an additional factor in the development of LPG.

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References

  1. Saito T, Sato H, Kudo K, et al. Lipoprotein glomerulopathy: glomerular lipoprotein thrombi in a patient with hyperlipoproteinemia. Am J Kidney Dis. 1989;13:148–53.

    Article  CAS  PubMed  Google Scholar 

  2. Oikawa S, Matsunaga A, Saito T, et al. Apolipoprotein E Sendai (arginine 145 ⟶ proline): a new variant associated with lipoprotein glomerulopathy. J Am Soc Nephrol. 1997;8:820–3.

    CAS  PubMed  Google Scholar 

  3. Matsunaga A, Sasaki J, Komatsu T, et al. A novel apolipoprotein E mutation, E2 (Arg25Cys), in lipoprotein glomerulopathy. Kidney Int. 1999;56:421–7.

    Article  CAS  PubMed  Google Scholar 

  4. Saito T, Matsunaga A, Ito K, Nakashima H. Topics in lipoprotein glomerulopathy: an overview. Clin Exp Nephrol. 2014;18:214–7.

    Article  CAS  PubMed  Google Scholar 

  5. Kodera H, Mizutani Y, Sugiyama S, et al. A case of lipoprotein glomerulopathy with ApoE Chicago and ApoE (Glu3Lys) treated with fenofibrate. Case Rep Nephrol Dial. 2017;7:112–20.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Miyata T, Sugiyama S, Nangaku M, et al. Apolipoprotein E2/E5 variants in lipoprotein glomerulopathy recurred in transplanted kidney. J Am Soc Nephrol. 1999;10:1590–5.

    CAS  PubMed  Google Scholar 

  7. Sam R, Wu H, Yue L, et al. Lipoprotein glomerulopathy: a new apolipoprotein E mutation with enhanced glomerular binding. Am J Kidney Dis. 2006;47:539–48.

    Article  PubMed  Google Scholar 

  8. Ordovas JM, Litwack-Klein L, Wilson PW, Schaefer MM, Schaefer EJ. Apolipoprotein E isoform phenotyping methodology and population frequency with identification of ApoE1 and ApoE5 isoforms. J Lipid Res. 1987;28:371–80.

    CAS  PubMed  Google Scholar 

  9. Feussner G, Scharnagl H, Scherbaum C, et al. Apolipoprotein E5 (Glu212 ⟶ Lys): increased binding to cell surface proteoglycans but decreased uptake and lysosomal degradation in cultured fibroblasts. J Lipid Res. 1996;37:1632–45.

    CAS  PubMed  Google Scholar 

  10. Dong LM, Yamamura T, Yamamoto A. Enhanced binding activity of an apolipoprotein E mutant, APO E5, to LDL receptors on human fibroblasts. Biochem Biophys Res Commun. 1990;168:409–14.

    Article  CAS  PubMed  Google Scholar 

  11. Wardell MR, Rall SC Jr, Schaefer EJ, Kane JP, Weisgraber KH. Two apolipoprotein E5 variants illustrate the importance of the position of additional positive charge on receptor-binding activity. J Lipid Res. 1991;32:521–8.

    CAS  PubMed  Google Scholar 

  12. Van-Gils J, Harambat J, Jubert C, et al. Atypical hematologic and renal manifestations in neurofibromatosis type I: coincidence or pathophysiological link? Eur J Med Genet. 2014;57:639–42.

    Article  PubMed  Google Scholar 

  13. Hyun JI, Min JW, Lee HM, Kim YK, Choi EJ, Song HC. Minimal change nephrotic syndrome showing complete remission after resection of a neurofibroma in a type I neurofibromatosis patient. Korean J Intern Med. 2017;32:186–9.

    Article  PubMed  Google Scholar 

  14. Afshinnia F, Vega-Warner V, Killen P. Focal segmental glomerulosclerosis in association with neurofibromatosis type 1: a case report and proposed molecular pathways. Clin Kidney J. 2013;6:208–10.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Koshikawa M, Mukoyama M, Mori K, et al. Role of p38 mitogen-activated protein kinase activation in podocyte injury and proteinuria in experimental nephrotic syndrome. J Am Soc Nephrol. 2005;16:2690–701.

    Article  CAS  PubMed  Google Scholar 

  16. Gödel M, Hartleben B, Herbach N, et al. Role of mTOR in podocyte function and diabetic nephropathy in humans and mice. J Clin Invest. 2011;121:2197–209.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Ito K, Nakashima H, Watanabe M, et al. Macrophage impairment produced by Fc receptor gamma deficiency plays a principal role in the development of lipoprotein glomerulopathy in concert with apoE abnormalities. Nephrol Dial Transplant. 2012;27:3899–907.

    Article  CAS  PubMed  Google Scholar 

  18. Koga T, Iwasaki H, Ishiguro M, Matsuzaki A, Kikuchi M. Losses in chromosomes 17, 19, and 22q in neurofibromatosis type 1 and sporadic neurofibromas: a comparative genomic hybridization analysis. Cancer Genet Cytogenet. 2002;15:113–20.

    Article  Google Scholar 

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Correspondence to Satoshi Takasaki.

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All the authors have declared no competing interest.

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This article does not contain any studies with human participants performed by any of the authors.

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Written informed consent was obtained from the patient before the commencement of phenotype and gene analyses for apoE.

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Takasaki, S., Matsunaga, A., Joh, K. et al. A case of lipoprotein glomerulopathy with a rare apolipoprotein E isoform combined with neurofibromatosis type I. CEN Case Rep 7, 127–131 (2018). https://doi.org/10.1007/s13730-018-0309-2

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  • DOI: https://doi.org/10.1007/s13730-018-0309-2

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