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Familial hypobetalipoproteinemia 1(FHBL1)

MedGen UID:
1639219
Concept ID:
C4551990
Disease or Syndrome
Synonyms: Acanthocytosis with hypobetalipoproteinemia; Hypobetalipoproteinemia, normotriglyceridemic
 
Gene (location): APOB (2p24.1)
 
Monarch Initiative: MONDO:0014252
OMIM®: 615558

Authors:

Additional description

From OMIM
Hypobetalipoproteinemia (FHBL) and abetalipoproteinemia (ABL; 200100) are rare diseases characterized by hypocholesterolemia and malabsorption of lipid-soluble vitamins leading to retinal degeneration, neuropathy, and coagulopathy. Hepatic steatosis is also common. The root cause of both disorders is improper packaging and secretion of apolipoprotein B-containing particles. Obligate heterozygous parents of FHBL patients typically have half normal levels of apoB-containing lipoproteins consistent with autosomal codominant inheritance, whereas obligate heterozygous parents of ABL patients usually have normal lipids consistent with autosomal recessive inheritance (summary by Lee and Hegele, 2014). Genetic Heterogeneity of Familial Hypobetalipoproteinemia Familial hypobetalipoproteinemia-2 (FHBL2; 605019) is caused by mutation in the ANGPTL3 gene (604774) on chromosome 1p31.  http://www.omim.org/entry/615558

Clinical features

From HPO
Steatorrhea
MedGen UID:
20948
Concept ID:
C0038238
Finding
Greater than normal amounts of fat in the feces. This is a result of malabsorption of lipids in the small intestine and results in frothy foul-smelling fecal matter that floats.
Cerebellar ataxia
MedGen UID:
849
Concept ID:
C0007758
Disease or Syndrome
Cerebellar ataxia refers to ataxia due to dysfunction of the cerebellum. This causes a variety of elementary neurological deficits including asynergy (lack of coordination between muscles, limbs and joints), dysmetria (lack of ability to judge distances that can lead to under- or overshoot in grasping movements), and dysdiadochokinesia (inability to perform rapid movements requiring antagonizing muscle groups to be switched on and off repeatedly).
Reduced tendon reflexes
MedGen UID:
356648
Concept ID:
C1866934
Finding
Diminution of tendon reflexes, which is an invariable sign of peripheral nerve disease.
Acanthocytosis
MedGen UID:
195801
Concept ID:
C0687751
Disease or Syndrome
Acanthocytosis is a type of poikilocytosis characterized by the presence of spikes on the cell surface. The cells have an irregular shape resembling many-pointed stars.
Decreased HDL cholesterol concentration
MedGen UID:
57731
Concept ID:
C0151691
Finding
An decreased concentration of high-density lipoprotein cholesterol in the blood.
Hypocholesterolemia
MedGen UID:
57479
Concept ID:
C0151718
Disease or Syndrome
An decreased concentration of cholesterol in the blood.
Elevated circulating aspartate aminotransferase concentration
MedGen UID:
57497
Concept ID:
C0151904
Finding
The concentration of aspartate aminotransferase (AST) in the blood circulation is above the upper limit of normal.
Elevated circulating alanine aminotransferase concentration
MedGen UID:
57740
Concept ID:
C0151905
Finding
An abnormally high concentration in the circulation of alanine aminotransferase (ALT).
Hypertriglyceridemia
MedGen UID:
167238
Concept ID:
C0813230
Finding
An abnormal increase in the level of triglycerides in the blood.
Decreased LDL cholesterol concentration
MedGen UID:
776554
Concept ID:
C0853085
Finding
An decreased concentration of low-density lipoprotein cholesterol in the blood.
Decreased circulating vitamin E concentration
MedGen UID:
1853278
Concept ID:
C5779643
Finding
A reduced concentration of vitamin E in the blood circulation. Vitamin E is a lipophilic vitamin that is also known as alpha-tocopherol.
Reduced circulating vitamin A concentration
MedGen UID:
1853267
Concept ID:
C5848160
Finding
Concentration of vitamin A below the lower limit of normal in the blood circulation.
Retinal degeneration
MedGen UID:
48432
Concept ID:
C0035304
Finding
A nonspecific term denoting degeneration of the retinal pigment epithelium and/or retinal photoreceptor cells.
Rod-cone dystrophy
MedGen UID:
1632921
Concept ID:
C4551714
Disease or Syndrome
An inherited retinal disease subtype in which the rod photoreceptors appear to be more severely affected than the cone photoreceptors. Typical presentation is with nyctalopia (due to rod dysfunction) followed by loss of mid-peripheral field of vision, which gradually extends and leaves many patients with a small central island of vision due to the preservation of macular cones.

Professional guidelines

PubMed

Wakabayashi T, Takahashi M, Okazaki H, Okazaki S, Yokote K, Tada H, Ogura M, Ishigaki Y, Yamashita S, Harada-Shiba M; Committee on Primary Dyslipidemia under the Research Program on Rare and Intractable Disease of the Ministry of Health, Labour and Welfare of Japan
J Atheroscler Thromb 2024 Jul 1;31(7):1005-1023. Epub 2024 May 3 doi: 10.5551/jat.RV22018. PMID: 38710625Free PMC Article

Recent clinical studies

Etiology

Long MT, Noureddin M, Lim JK
Gastroenterology 2022 Sep;163(3):764-774.e1. Epub 2022 Jul 14 doi: 10.1053/j.gastro.2022.06.023. PMID: 35842345Free PMC Article
Rimbert A, Vanhoye X, Coulibaly D, Marrec M, Pichelin M, Charrière S, Peretti N, Valéro R, Wargny M, Carrié A, Lindenbaum P, Deleuze JF, Genin E, Redon R, Rollat-Farnier PA, Goxe D, Degraef G, Marmontel O, Divry E, Bigot-Corbel E, Moulin P, Cariou B, Di Filippo M
Arterioscler Thromb Vasc Biol 2021 Jan;41(1):e63-e71. Epub 2020 Nov 19 doi: 10.1161/ATVBAHA.120.315491. PMID: 33207932
Lima Pessoa E, Costa Vilella Dos Reis M, Sayuri Yamamoto T, Ribeiro Neto M, Ferraro O, Alves MJ, Guedes Coelho Lopes R
Breast J 2019 Jul;25(4):763-765. Epub 2019 May 20 doi: 10.1111/tbj.13341. PMID: 31111608
Jung HH, Danek A, Walker RH
Orphanet J Rare Dis 2011 Oct 25;6:68. doi: 10.1186/1750-1172-6-68. PMID: 22027213Free PMC Article
Laskarzewski PM, Khoury P, Morrison JA, Kelly K, Mellies MJ, Glueck CJ
Metabolism 1982 Jun;31(6):558-77. doi: 10.1016/0026-0495(82)90095-6. PMID: 7078433

Diagnosis

Wakabayashi T, Takahashi M, Okazaki H, Okazaki S, Yokote K, Tada H, Ogura M, Ishigaki Y, Yamashita S, Harada-Shiba M; Committee on Primary Dyslipidemia under the Research Program on Rare and Intractable Disease of the Ministry of Health, Labour and Welfare of Japan
J Atheroscler Thromb 2024 Jul 1;31(7):1005-1023. Epub 2024 May 3 doi: 10.5551/jat.RV22018. PMID: 38710625Free PMC Article
Long MT, Noureddin M, Lim JK
Gastroenterology 2022 Sep;163(3):764-774.e1. Epub 2022 Jul 14 doi: 10.1053/j.gastro.2022.06.023. PMID: 35842345Free PMC Article
Jung HH, Danek A, Walker RH
Orphanet J Rare Dis 2011 Oct 25;6:68. doi: 10.1186/1750-1172-6-68. PMID: 22027213Free PMC Article
Assmann G, Menzel HJ
Ric Clin Lab 1982 Jan-Mar;12(1):63-81. doi: 10.1007/BF02909310. PMID: 6806887
Gerrard JW, Lubos MC
Pediatr Clin North Am 1967 Feb;14(1):73-91. doi: 10.1016/s0031-3955(16)31944-7. PMID: 5334379

Therapy

Liu Y, Liu ZY, Wan XH, Guo Y
Chin Med Sci J 2018 Mar 30;33(1):53-59. doi: 10.24920/21802. PMID: 29620515
Turner PR, Tuomilehto J, Happonen P, La Ville AE, Shaikh M, Lewis B
Atherosclerosis 1990 Mar;81(2):145-50. doi: 10.1016/0021-9150(90)90021-a. PMID: 2157450
Muller DP, Lloyd JK, Wolff OH
Lancet 1983 Jan 29;1(8318):225-8. doi: 10.1016/s0140-6736(83)92598-9. PMID: 6130255
Romem M, Yaniv I, Hanukoglu A, Fried D, Goodman RM
Metab Pediatr Ophthalmol 1981;5(1):29-31. PMID: 6973052
Illingworth DR, Connor WE, Lin DS, Diliberti J
Gastroenterology 1980 Jan;78(1):68-75. PMID: 7350037

Prognosis

Long MT, Noureddin M, Lim JK
Gastroenterology 2022 Sep;163(3):764-774.e1. Epub 2022 Jul 14 doi: 10.1053/j.gastro.2022.06.023. PMID: 35842345Free PMC Article
Takahashi M, Okazaki H, Ohashi K, Ogura M, Ishibashi S, Okazaki S, Hirayama S, Hori M, Matsuki K, Yokoyama S, Harada-Shiba M
J Atheroscler Thromb 2021 Oct 1;28(10):1009-1019. Epub 2021 May 16 doi: 10.5551/jat.RV17056. PMID: 33994405Free PMC Article
Simone ML, Rabacchi C, Kuloglu Z, Kansu A, Ensari A, Demir AM, Hizal G, Di Leo E, Bertolini S, Calandra S, Tarugi P
J Clin Lipidol 2019 Jul-Aug;13(4):554-562. Epub 2019 May 30 doi: 10.1016/j.jacl.2019.05.013. PMID: 31253576
Jung HH, Danek A, Walker RH
Orphanet J Rare Dis 2011 Oct 25;6:68. doi: 10.1186/1750-1172-6-68. PMID: 22027213Free PMC Article
Linton MF, Pierotti V, Young SG
Proc Natl Acad Sci U S A 1992 Dec 1;89(23):11431-5. doi: 10.1073/pnas.89.23.11431. PMID: 1454832Free PMC Article

Clinical prediction guides

Long MT, Noureddin M, Lim JK
Gastroenterology 2022 Sep;163(3):764-774.e1. Epub 2022 Jul 14 doi: 10.1053/j.gastro.2022.06.023. PMID: 35842345Free PMC Article
Rimbert A, Vanhoye X, Coulibaly D, Marrec M, Pichelin M, Charrière S, Peretti N, Valéro R, Wargny M, Carrié A, Lindenbaum P, Deleuze JF, Genin E, Redon R, Rollat-Farnier PA, Goxe D, Degraef G, Marmontel O, Divry E, Bigot-Corbel E, Moulin P, Cariou B, Di Filippo M
Arterioscler Thromb Vasc Biol 2021 Jan;41(1):e63-e71. Epub 2020 Nov 19 doi: 10.1161/ATVBAHA.120.315491. PMID: 33207932
Gordon DA, Jamil H
Biochim Biophys Acta 2000 Jun 26;1486(1):72-83. doi: 10.1016/s1388-1981(00)00049-4. PMID: 10856714
Linton MF, Pierotti V, Young SG
Proc Natl Acad Sci U S A 1992 Dec 1;89(23):11431-5. doi: 10.1073/pnas.89.23.11431. PMID: 1454832Free PMC Article
Muller DP, Lloyd JK, Wolff OH
Lancet 1983 Jan 29;1(8318):225-8. doi: 10.1016/s0140-6736(83)92598-9. PMID: 6130255

Recent systematic reviews

Lima Pessoa E, Costa Vilella Dos Reis M, Sayuri Yamamoto T, Ribeiro Neto M, Ferraro O, Alves MJ, Guedes Coelho Lopes R
Breast J 2019 Jul;25(4):763-765. Epub 2019 May 20 doi: 10.1111/tbj.13341. PMID: 31111608

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