Although the number of observations is limited, these data suggest a role of the immune system in the pathogenesis of renal disease in FLD and provides foundation to the anecdotal reports in LCAT-deficient patients of sudden onset or worsening of nephrotic syndrome after flu-like symptoms or infections (24, 50, 57, 58, 59, 60). The gene discussed is LCAT; the disease is nephrotic syndrome.