Case Report: Precision COVID-19 Immunization Strategy to Overcome Individual Fragility: A Case of Generalized Lipodystrophy Type 4

Front Immunol. 2022 Apr 6:13:869042. doi: 10.3389/fimmu.2022.869042. eCollection 2022.


A 48-year-old patient affected with congenital generalized lipodystrophy type 4 failed to respond to two doses of the BNT162b2 vaccine, consisting of lipid nanoparticle encapsulated mRNA. As the disease is caused by biallelic variants of CAVIN1, a molecule indispensable for lipid endocytosis and regulation, we complemented the vaccination cycle with a single dose of the Ad26.COV2 vaccine. Adenovirus-based vaccine entry is mediated by the interaction with adenovirus receptors and transport occurs in clathrin-coated pits. Ten days after Ad26.COV2 administration, S- and RBD-specific antibodies and high-affinity memory B cells increased significantly to values close to those observed in Health Care Worker controls.

Keywords: CAVIN1; SARS-CoV-2 vaccine; case report; congenital generalized lipodystrophy type 4; memory B cells.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenovirus Vaccines*
  • BNT162 Vaccine
  • COVID-19 Vaccines / adverse effects
  • COVID-19*
  • Humans
  • Lipodystrophy, Congenital Generalized*
  • Liposomes
  • Middle Aged
  • Nanoparticles
  • SARS-CoV-2
  • Vaccination


  • Adenovirus Vaccines
  • COVID-19 Vaccines
  • Lipid Nanoparticles
  • Liposomes
  • BNT162 Vaccine