A familial dyslipidemia panel was notable only for her known bilallelic LIPA pathogenic variants (panel genes: ABCA1, ABCG5, ABCG8, ANGPTL3, APOA1, APOA5, APOB, APOC2, APOC3, APOE, CETP, CYP27A1, CYP7A1, GCKR, GPD1, GPIHBP1, LCAT, LDLR, LDLRAP1, LIPA, LIPC, LMF1, LPL, MTTP, PCSK9, SAR1B, SCARB1, and STAP1). The gene discussed is PCSK9; the disease is metabolic syndrome.