Patients with symptoms of haemolytic anaemia and thrombocytopenia revealed by genetic testing as sitosterolemia

Abstract Background Sitosterolemia is a rare, inherited, autosomal recessive disorder of lipid metabolism. Patients with sitosterolemia may exhibit diverse, distinct clinical characteristics. Methods and results We report cases of sitosterolemia with haematological abnormalities as primary initial s...

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Main Authors: Mengjia Qian, Pu Chen, Yanxia Zhan, Bijun Zhu, Lingyan Wang, Miaomiao Zhang, Yujie Zhou, Hao Chen, Lili Ji, Yunfeng Cheng
Format: Article
Language:English
Published: Wiley 2025-08-01
Series:Clinical and Translational Discovery
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Online Access:https://doi.org/10.1002/ctd2.70071
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author Mengjia Qian
Pu Chen
Yanxia Zhan
Bijun Zhu
Lingyan Wang
Miaomiao Zhang
Yujie Zhou
Hao Chen
Lili Ji
Yunfeng Cheng
author_facet Mengjia Qian
Pu Chen
Yanxia Zhan
Bijun Zhu
Lingyan Wang
Miaomiao Zhang
Yujie Zhou
Hao Chen
Lili Ji
Yunfeng Cheng
author_sort Mengjia Qian
collection DOAJ
description Abstract Background Sitosterolemia is a rare, inherited, autosomal recessive disorder of lipid metabolism. Patients with sitosterolemia may exhibit diverse, distinct clinical characteristics. Methods and results We report cases of sitosterolemia with haematological abnormalities as primary initial symptoms. Both patients were seen with symptoms of haemolytic anaemia and thrombocytopenia. Their plasma levels of low‐density lipoprotein‐cholesterol were normal. Genetic tests were arranged as stomatocytes were found in their peripheral blood smears. Three heterozygous mutations in adenosine triphosphate‐binding cassette subfamily G member 5 (ABCG5) were identified in case 1. A mutation in integrin beta 3 was discovered in case 2, while no mutations were found in ABCG5 or ABCG8. Sitosterolemia was considered for both cases, and Ezetimibe was used for treatment, with quick curative responses. Conclusion For patients with unexplained haemolytic anaemia, thrombocytopenia, especially with stomatocytes present in peripheral blood, the diagnosis of sitosterolemia should be considered, and genetic testing is recommended.
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institution Kabale University
issn 2768-0622
language English
publishDate 2025-08-01
publisher Wiley
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series Clinical and Translational Discovery
spelling doaj-art-e0f26f2dd8b043aea4c2a43fc09e40b82025-08-25T18:28:39ZengWileyClinical and Translational Discovery2768-06222025-08-0154n/an/a10.1002/ctd2.70071Patients with symptoms of haemolytic anaemia and thrombocytopenia revealed by genetic testing as sitosterolemiaMengjia Qian0Pu Chen1Yanxia Zhan2Bijun Zhu3Lingyan Wang4Miaomiao Zhang5Yujie Zhou6Hao Chen7Lili Ji8Yunfeng Cheng9Institute of Clinical Science Zhongshan Hospital, Fudan University Shanghai ChinaDepartment of Laboratory Medicine Zhongshan Hospital, Fudan University Shanghai ChinaDepartment of Haematology Zhongshan Hospital, Fudan University Shanghai ChinaInstitute of Clinical Science Zhongshan Hospital, Fudan University Shanghai ChinaInstitute of Clinical Science Zhongshan Hospital, Fudan University Shanghai ChinaInstitute of Clinical Science Zhongshan Hospital, Fudan University Shanghai ChinaInstitute of Clinical Science Zhongshan Hospital, Fudan University Shanghai ChinaDepartment of Thoracic Surgery Zhongshan‐Xuhui Hospital, Fudan University Shanghai ChinaDepartment of Haematology Zhongshan Hospital, Fudan University Shanghai ChinaInstitute of Clinical Science Zhongshan Hospital, Fudan University Shanghai ChinaAbstract Background Sitosterolemia is a rare, inherited, autosomal recessive disorder of lipid metabolism. Patients with sitosterolemia may exhibit diverse, distinct clinical characteristics. Methods and results We report cases of sitosterolemia with haematological abnormalities as primary initial symptoms. Both patients were seen with symptoms of haemolytic anaemia and thrombocytopenia. Their plasma levels of low‐density lipoprotein‐cholesterol were normal. Genetic tests were arranged as stomatocytes were found in their peripheral blood smears. Three heterozygous mutations in adenosine triphosphate‐binding cassette subfamily G member 5 (ABCG5) were identified in case 1. A mutation in integrin beta 3 was discovered in case 2, while no mutations were found in ABCG5 or ABCG8. Sitosterolemia was considered for both cases, and Ezetimibe was used for treatment, with quick curative responses. Conclusion For patients with unexplained haemolytic anaemia, thrombocytopenia, especially with stomatocytes present in peripheral blood, the diagnosis of sitosterolemia should be considered, and genetic testing is recommended.https://doi.org/10.1002/ctd2.70071ABCG5haematological abnormalitiesITGB3sitosterolemia
spellingShingle Mengjia Qian
Pu Chen
Yanxia Zhan
Bijun Zhu
Lingyan Wang
Miaomiao Zhang
Yujie Zhou
Hao Chen
Lili Ji
Yunfeng Cheng
Patients with symptoms of haemolytic anaemia and thrombocytopenia revealed by genetic testing as sitosterolemia
Clinical and Translational Discovery
ABCG5
haematological abnormalities
ITGB3
sitosterolemia
title Patients with symptoms of haemolytic anaemia and thrombocytopenia revealed by genetic testing as sitosterolemia
title_full Patients with symptoms of haemolytic anaemia and thrombocytopenia revealed by genetic testing as sitosterolemia
title_fullStr Patients with symptoms of haemolytic anaemia and thrombocytopenia revealed by genetic testing as sitosterolemia
title_full_unstemmed Patients with symptoms of haemolytic anaemia and thrombocytopenia revealed by genetic testing as sitosterolemia
title_short Patients with symptoms of haemolytic anaemia and thrombocytopenia revealed by genetic testing as sitosterolemia
title_sort patients with symptoms of haemolytic anaemia and thrombocytopenia revealed by genetic testing as sitosterolemia
topic ABCG5
haematological abnormalities
ITGB3
sitosterolemia
url https://doi.org/10.1002/ctd2.70071
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