Contributing to the late diagnosis is the low awareness of LCAT deficiency as a monogenic cause of nephrotic syndrome, possibly because of its rarity, because most studies focus on pediatric or young adult cohorts (21, 22), who are likely still asymptomatic for FLD-induced renal disease, and because the LCAT gene may not have sufficient coverage in the platforms used (23). Here, LCAT is linked to nephrotic syndrome.