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A Classical Phenotype of Fabry Disease with Novel Mutation Found by Kidney Biopsy, A Case Report
Keiichiro Matsumoto1, Marina Ishii1, Masato Mizuta1
1Department of Nephrology, Saga-ken Medical Centre Koseikan, Saga City, Saga, Japan
Insights
Fabry disease (FD) is a rare genetic disorder affecting multiple organs. Early diagnosis and treatment are crucial for managing its complex symptoms and improving patient outcomes.
Area of Science:
- Genetics and rare diseases
- Metabolic disorders
- Cardiovascular medicine
Background:
- Fabry disease (FD) is a lysosomal storage disorder caused by deficiency of the enzyme alpha-galactosidase A.
- This deficiency leads to the accumulation of globotriaosylceramide (Gb3) in various tissues, causing multi-organ damage.
- FD presents with a wide spectrum of clinical manifestations, affecting the heart, kidneys, nervous system, and skin.
Abstract:
Fabry disease (FD) is a multi-organ disorder caused by a deficiency of alpha-galactosidase (α-GLA) or reduced activity of the enzyme due to mutations in the GLA gene on the X chromosome, making it an X-linked hereditary disease. A 37-year-old man previously diagnosed with sudden deafness and cardiac hypertrophy was referred to our department after an abnormal urine finding during a public health checkup. A renal biopsy revealed characteristic findings, and he was diagnosed with FD with a novel GLA abnormality (c.714dupT (p.I239Yfs*11)). We are currently administering enzyme replacement therapy (ERT) with agalsidase α. This case shows that a novel genetic abnormality in FD can be overlooked for 37 years, even in the presence of typical symptoms. The significance of a renal biopsy in diagnosing FD is emphasized, highlighting the crucial role of nephrologists.
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