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Published on: December 20, 2017
Fabry disease--a primer for cardiologists
Insights
Fabry disease, a genetic disorder, affects multiple organs, especially the heart. Early screening and enzyme replacement therapy are crucial for managing cardiac symptoms and preventing irreversible fibrosis.
Area of Science:
- Genetics and rare diseases
- Cardiology
- Metabolic disorders
Background:
- Fabry disease is an X-linked lysosomal storage disorder resulting from alpha-galactosidase A deficiency.
- It is a systemic condition impacting kidneys, heart, and brain, with cardiac involvement often manifesting as left ventricular hypertrophy.
Purpose of the Study:
- To review the systemic features of Fabry disease.
- To emphasize the importance of early cardiac involvement screening and timely intervention.
Main Methods:
- Literature review focusing on Fabry disease.
- Analysis of clinical presentations, diagnostic considerations, and treatment strategies.
Main Results:
- Cardiac involvement is a significant manifestation requiring cardiologist attention.
- Early screening is vital as treatment benefits diminish with established cardiac fibrosis.
Conclusions:
- Screening for Fabry disease is beneficial in specific populations like ESRD patients or young stroke victims.
- Enzyme replacement therapy can reverse abnormalities and should be initiated for symptomatic patients.
Abstract:
Fabry disease is an X-linked lysosomal storage disorder caused by α-galactosidase A deficiency. It is a systemic disease mostly affecting the kidneys, the heart and the brain. Cardiac involvement often presents as concentric nonobstructive left ventricular hypertrophy and is a differential to be taken into account by cardiologists. This review describes the most important systemic features, but mostly highlights the cardiac involvement. Patients with known Fabry disease should be screened early for cardiac involvement, as treatment benefit may not be seen once cardiac fibrosis has developed. Screening for Fabry can be effective among individuals with end-stage renal disease, unexplained cardiac hypertrophy or strokes in young people with no apparent predisposing factors. Enzyme replacement therapy reverses metabolic and various pathologic abnormalities and should be initiated in all patients with symptomatic Fabry disease.
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