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Intrafamilial phenotypic variability in four families with Anderson-Fabry disease
M Rigoldi1, D Concolino, A Morrone
1Rare Metabolic Diseases Unit, San Gerardo Hospital, Monza, Italy.
Insights
Anderson-Fabry Disease shows significant intrafamilial phenotypic variability. This variability impacts disease progression and organ involvement, complicating prognostic predictions for affected families.
Area of Science:
- Genetics
- Rare Diseases
- Metabolic Disorders
Background:
- Anderson-Fabry Disease is a rare genetic disorder.
- It is caused by mutations in the GLA gene, leading to alpha-galactosidase A deficiency.
- This deficiency results in the accumulation of globotriaosylceramide (Gb3) in various tissues.
Observation:
- A clinical history analysis of 16 hemizygous males from four families with Anderson-Fabry Disease was performed.
- Seven patients died (ages 26-61), while nine are alive (ages 23-55).
- Eleven patients received enzyme replacement therapy (ERT) for 5-10 years.
Findings:
- A wide spectrum of intrafamilial phenotypic variability was observed.
- Variability was noted in terms of target organ involvement and disease severity among family members with the same mutation.
- These findings confirm significant intrafamilial heterogeneity in Anderson-Fabry Disease.
Implications:
- The study highlights the challenge of providing accurate prognostic information during genetic counseling for Anderson-Fabry Disease.
- Prognosis based solely on family history is difficult due to the unpredictable disease course and variable organ involvement.
- Further research is needed to identify factors influencing phenotypic variability and improve patient counseling.
Abstract:
We analysed the clinical history of 16 hemizygous males affected by Anderson-Fabry Disease, from four families, to verify their intrafamilial phenotypic variability. Seven male patients, ranging from 26 to 61 years of age, died, whereas nine (age range 23-55) are alive. Eleven patients have undergone enzyme replacement therapy (ERT) for a period of 5-10 years. We have found a wide range of intrafamilial phenotypic variability in these families, both in terms of target-organs and severity of the disease. Overall, our findings confirm previous data from the literature showing a high degree of intrafamilial phenotypic variability in patients carrying the same mutation. Furthermore, our results underscore the difficulty in giving accurate prognostic information to patients during genetic counselling, both in terms of rate of disease progression and involvement of different organs, when such prognosis is solely based on the patient's family history.
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