Acid Lipase Disease (Cholesterol Ester Storage Disease, Wolman’s Disease)

What is Acid Lipase Disease?

Acid lipase disease occurs when the enzyme needed to break down certain fats that are normally digested by the body is lacking or missing, resulting in the toxic buildup of these fats in the body’s cells and tissues.  These fatty substances, called lipids, include waxes, oils, and cholesterol.  Two rare lipid storage diseases are caused by the deficiency of the enzyme lysosomal acid lipase:

Wolman’s disease is an autosomal recessive disorder marked by the buildup of cholesteryl esters (normally a tranport form of cholesterol that brings nutrients into the cells and carries out waste) and triglycerides (a chemical form in which fats exist in the body).  Infants with the disorder appear normal at birth but quickly develop progressive mental deterioration, low muscle tone, jaundice, anaemia, vomiting, malnourishment, gastrointestinal problems, and calcium deposits in the adrenal glands, causing them to harden.  Affected children also develop an enlarged liver and grossly enlarged spleen, and the abdomen is distended.  Both male and female infants are affected by the disorder.

Cholesteryl ester storage disease (CESD) is an extremely rare disorder that results from storage of cholesteryl esters and triglycerides in cells in the blood and lymph and lymphoid tissue.  CESD is a less severe variant of Wolman’s disease, with later onset.  Children develop an enlarged liver, leading to cirrhosis and chronic liver failure before adulthood.  Children may also develop calcium deposits in the adrenal glands and jaundice.  Onset varies, and the disorder may not be diagnosed until adulthood.

Is there any treatment?

What is the prognosis?

Infants with Wolman’s disease usually die by age 1 from malnutrition.  The onset and course of CESD varies, and individuals may live into adulthood.