What is LAL-D?

Lysosomal acid lipase deficiency (LAL-D) is a rare, progressive and inherited condition caused by mutations in the LIPA gene which is responsible for the production of the lysosomal acid lipase (LAL) enzyme.1 LAL-D is characterised by problems with the breakdown and use of fats and cholesterol in the body.


When a child is diagnosed with LAL-D, the parents (who are carriers of the disease) should undergo genetic testing, as the risk for their next child to be affected is 25%.1

In patients with LAL-D, mutations in the LIPA gene cause reduced or absent LAL activity, resulting in the disruption of the lipid and cholesterol metabolism.1,3

What are the signs and symptoms

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The LAL enzyme plays a central role in breaking down certain fats and cholesterol. When there is a decrease or loss of the LAL enzyme, lipids and cholesterol do not get processed and get deposited...

Managing LAL-D

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LAL-D can be diagnosed by demonstrating deficient LAL activity or mutations in the LIPA gene.1 The level of LAL-D activity is determined using an enzyme-based blood test.1 Genetic testing enables characterisation...

Complications associated with LAL-D

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LAL-D affects many vital organs, such as the liver, cardiovascular system, spleen and the gastrointestinal tract. In fact, most people with LAL-D experience complications in more than one organ system: Liver LAL-D is a...

LAL, lysosomal acid lipase; LAL-D, lysosomal acid lipase deficiency; LIPA, lipase A.
Reiner Ž, Guardamagna O, Nair D, et al. Lysosomal acid lipase deficiency — an under-recognized cause of dyslipidaemia and liver dysfunction. Atherosclerosis. 2014;235(1):21-30. Hoffman EP, Barr ML, Giovanni MA, et al. Lysosomal Acid Lipase Deficiency. 2015 Jul 30 [Updated 2016 Sep 1]. In: Adam MP, Feldman J, Mirzaa GM, et al., editors. GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2024. Available at: https://www.ncbi.nlm.nih.gov/books/NBK305870/. Lewis H, Adamson J, Atherton K, Bailey D, Birtwistle J, Bosanquet K, et al. CollAborative care and active surveillance for Screen-Positive EldeRs with subthreshold depression (CASPER): a multicentred randomised controlled trial of clinical effectiveness and cost-effectiveness. Health Technol Assess 2017;21(8). Bernstein DL, Hülkova H, Bialer MG, et al. Cholesteryl ester storage disease: review of the findings in 135 reported patients with an underdiagnosed disease. J Hepatol. 2013;58(6):1230-1243.