Cholesteryl Ester Storage Disease (CESD) is a rare inherited disorder caused by a deficiency of the enzyme lysosomal acid lipase (LAL). This enzyme is responsible for breaking down fats (lipids) in the body. When the enzyme is deficient, fats accumulate in the liver, spleen, and other organs, leading to organ damage and other health problems. Symptoms of CESD include abdominal pain, enlarged liver and spleen, jaundice, and high cholesterol levels. Treatment typically involves dietary changes, medications, and enzyme replacement therapy.