Sitosterolemia carrying both ABCG5 and HBA gene mutations: a case report and review of the literature

作者：Xiaobing Sun, Jiong Wu, Pu Chen, Ruiqing He, Ting Li, Qingtao Zeng, Qi Hou · 发表于：Journal of Medical Case Reports · 年份：2025 · DOI：10.1186/s13256-025-05439-0 · 被引用次数：2 · 研究领域：Cholesterol and Lipid Metabolism、Peroxisome Proliferator-Activated Receptors、Cancer, Lipids, and Metabolism

BACKGROUND: Mutations in the ABCG5 gene can cause sitosterolemia, which is a rare lipid metabolism disorder characterized by impaired regulation of phytosterols, leading to their excessive accumulation in tissues and organs, which triggers various complications. If left untreated, it may cause serious issues, often presenting first as xanthomas on the skin and other tissues. CASE PRESENTATION: A 9-year-old female Chinese Zhuang patient developed her first xanthomas on her knees at the age of 4, which progressively spread across her body over the years. Initial blood tests revealed elevated plasma cholesterol and low-density lipoprotein, and she was misdiagnosed with familial hypercholesterolemia, leading to ineffective treatment. Despite visiting several hospitals, the underlying cause remained unidentified, and the patient was eventually admitted to our hospital for further evaluation. The complete blood count showed mild hypochromic microcytic anemia and blood smears showed microcytic hypochromic anemia and the presence of giant platelets in the peripheral blood. Plasma phytosterol profiling revealed significantly elevated phytosterol levels, and whole exome sequencing detected a homozygous mutation in the ABCG5 gene (c.751C > T, p.Q251*). On the basis of these findings, the patient was diagnosed with sitosterolemia. Her parents and younger brother were found to carry the heterozygous mutation but exhibited no clinical symptoms. In addition, iron metabolism tests and DNA co...