4.Multidisciplinary treatment in the long-term management of Fabry disease.
Chinese Journal of Internal Medicine 2023;62(8):949-955
Fabry disease is a rare X-linked hereditary condition caused by mutations in the α-galactosidase A (GLA) gene, resulting in decreased α-GAL A enzyme activity. The clinical manifestations of Fabry disease are diverse, which leads to delays in diagnosis and treatment, thereby increasing the disease burden for patients and their families. Given its characteristics, multidisciplinary treatment (MDT) is critical for the long-term management of Fabry disease, and should include nephrology departments, cardiovascular departments, neurology departments, and pediatric department, among others. This study focuses on early screening for Fabry disease, the indication for initiating enzyme replacement therapy, pre-treatment evaluation, and monitoring to provide practical guidance for Chinese clinicians.
Child
;
Humans
;
Fabry Disease/drug therapy*
;
alpha-Galactosidase/therapeutic use*
;
Mutation
;
Enzyme Replacement Therapy
6.Monitoring globotriaosylsphingosine in a Korean male patient with Fabry disease
Heejoon JANG ; Kwon Wook JOO ; Seung Seok HAN
Kidney Research and Clinical Practice 2019;38(2):250-252
No abstract available.
Fabry Disease
;
Humans
;
Male
7.Fabry Disease that Phenocopies Hypertrophic Cardiomyopathy: a thorough Genetic ‘Detective’ Identifies the ‘Rogue’ Hidden in the GLA Gene
Soonil KWON ; Seung Pyo LEE ; Seung Shin PARK ; Beom Joon KIM ; Hyung Kwan KIM ; Hyun Jai CHO ; Moon Woo SEONG ; Dae Won SOHN
Korean Circulation Journal 2019;49(5):461-464
No abstract available.
Cardiomyopathy, Hypertrophic
;
Fabry Disease
8.Prevalence of Fabry Disease in Korean Men with Left Ventricular Hypertrophy
Woo Shik KIM ; Hyun Soo KIM ; Jinho SHIN ; Jong Chun PARK ; Han Wook YOO ; Toshihiro TAKENAKA ; Chuwa TEI
Journal of Korean Medical Science 2019;34(7):e63-
BACKGROUND: Fabry disease is an X-linked recessive disorder caused by deficiency of the lysosomal enzyme α-galactosidase A (α-Gal A). Previous studies identified many cases of Fabry disease among men with left ventricular hypertrophy (LVH). The purpose of this study was to define the frequency of Fabry disease among Korean men with LVH. METHODS: In this national prospective multicenter study, we screened Fabry disease in men with LVH on echocardiography. The criterion for LVH diagnosis was a maximum LV wall thickness 13 mm or greater. We screened 988 men with LVH for plasma α-Gal A activity. In patients with low α-Gal A activity (< 3 nmol/hr/mL), we searched for mutations in the α-galactosidase gene. RESULTS: In seven men, α-Gal A activity was low. Three had previously identified mutations; Gly328Arg, Arg301Gln, and His46Arg. Two unrelated men had the E66Q variant associated with functional polymorphism. In two patients, we did not detect GLA mutations, although α-Gal A activity was low on repeated assessment. CONCLUSION: We identified three patients (0.3%) with Fabry disease among unselected Korean men with LVH. Although the prevalence of Fabry disease was low in our study, early treatment of Fabry disease can result in a good prognosis. Therefore, in men with unexplained LVH, differential diagnosis of Fabry disease should be considered.
Diagnosis
;
Diagnosis, Differential
;
Echocardiography
;
Fabry Disease
;
Humans
;
Hypertrophy, Left Ventricular
;
Male
;
Plasma
;
Prevalence
;
Prognosis
;
Prospective Studies
9.A novel GLA mutation in a Korean boy with an early cardiac manifestation of Fabry disease.
Soonhak KWON ; Jin Sung PARK ; Jae Hun JUNG ; Su Kyeong HWANG ; Yeo Hyang KIM ; Yun Jeong LEE
Journal of Genetic Medicine 2018;15(1):28-33
Fabry disease (FD) is a rare X-linked lysosomal storage disorder caused by the deficiency of α-galactosidase A. Patients with classical FD present acroparesthesia, hypohidrosis, cornea verticillata, disseminated angiokeratoma, and microalbuminuria in childhood, and develop life-threatening renal, cardiac, and cerebrovascular complications typically after the fourth decade of life. To date, more than 700 mutations responsible for FD have been identified in the human GLA gene. Herein, we report a novel GLA mutation, c.1117_1141del25 (p.Gly373Profs*10), identified in an 11-year-old Korean boy with FD presenting early cardiac and neurologic manifestation and in other affected family members. The boy had acroparesthesia, hypohidrosis, cornea verticillata, and left ventricular hypertrophy. His mother and sister also had acroparesthesia. Two males on the mother's side had similar pain and died of unknown causes. The plasma α-galactosidase A activity (4.1 nmol/hr/mg protein) of the patient was markedly lower than the mean value of the controls. The plasma level of globotriaosylsphingosine was elevated in the patient and all the carriers. We concluded the novel GLA mutation c.1117_1141del25 is a pathogenic mutation for FD, probably related to the early cardiac manifestation of FD.
Angiokeratoma
;
Child
;
Cornea
;
Fabry Disease*
;
Humans
;
Hypertrophy, Left Ventricular
;
Hypohidrosis
;
Lysosomal Storage Diseases
;
Male*
;
Mothers
;
Neurologic Manifestations
;
Plasma
;
Siblings
10.Ocular manifestations in a patient with de novo Fabry disease
You Hyun LEE ; Kyu Young SHIM ; Sung Bae PARK ; Yu Cheol KIM
Yeungnam University Journal of Medicine 2018;35(2):232-235
Fabry disease (FD) is an X-linked, recessively inherited, rare, progressive, disorder of glycosphingolipid metabolism affecting multiple organs resulting in organ dysfunction. It is rare to find only one FD affected subject with a de novo mutation. Here we report a case of a 41-year-old Asian male diagnosed with de novo FD. Comprehensive ophthalmological evaluation was performed using slit lamp, color fundus photography, optical coherence tomography, fluorescein angiography, and indocyanine green angiography. On slit lamp examination, cornea verticillata and slightly tortuous, and aneurysmal dilatation of inferior bulbar conjunctival vessels were observed. Other imaging modalities showed unremarkable findings. Cornea verticillata and inferior bulbar conjunctival vascular abnormalities may be detected earlier than other ocular abnormalities in de novo FDs like hereditary FDs.
Adult
;
Aneurysm
;
Angiography
;
Asian Continental Ancestry Group
;
Cornea
;
Dilatation
;
Fabry Disease
;
Fluorescein Angiography
;
Humans
;
Indocyanine Green
;
Male
;
Metabolism
;
Photography
;
Slit Lamp
;
Tomography, Optical Coherence

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