Tangier disease is a rare autosomal recessive condition characterized by low levels of high density lipoprotein cholesterol (HDL-C) in the blood, accumulation of cholesterol in many organs of the body, and an increased risk of arteriosclerosis.
TD is caused by mutations in the ABCA1 (ATP-binding cassette) gene on chromosome 9q31. ABCA1 codes for a protein that helps rid cells of excess cholesterol. This cholesterol is then picked up by HDL particles in the blood and carried to the liver, which processes the cholesterol to be reused in cells throughout the body. Individuals with TD are unable to eliminate cholesterol from cells, leading to its buildup in the tonsils and other organs.
The symptoms of Tangier disease are quite variable but the most common symptoms of Tangier disease are enlarged, yellow-colored tonsils, an enlarged spleen, accumulation of cholesterol in the mucous membranes of the intestines, abnormalities in the nervous system (neuropathy), and an increased risk of arteriosclerosis. Less commonly seen symptoms are an enlarged liver, lymph nodes and thymus, and hemolytic anemia. Cholesterol accumulation has been seen in other organs such as the bone marrow, gall bladder, skin, kidneys, heart valves, ureters, testicles, and the cornea of the eye.
Tangier disease is also known as A-alphalipoprotein Neuropathy.
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