Fabry Disease (α-Galactosidase A Deficiency): Renal Involvement and Enzyme Replacement Therapy

2001 ◽  
pp. 174-192 ◽  
Author(s):  
R.J. Desnick ◽  
M.P. Wasserstein ◽  
M. Banikazemi
Keyword(s):  
Enzyme Replacement Therapy ◽  
Fabry Disease ◽  
Replacement Therapy ◽  
Renal Involvement ◽  
Enzyme Replacement ◽  
Alpha Galactosidase

scholarly journals Rare causes of stroke in young people

2018 ◽  
pp. 27-30
Author(s):  
S. Borzenkov ◽  
N. Svyrydova ◽  
L. Borzenkova
Keyword(s):  
Young People ◽  
Enzyme Replacement Therapy ◽  
Fabry Disease ◽  
Replacement Therapy ◽  
Symptomatic Therapy ◽  
Fabry’S Disease ◽  
Fabry's Disease ◽  
Enzyme Replacement ◽  
Alpha Galactosidase ◽  
Stroke In Young

One of the reasons that can lead to a stroke in young people is Fabry’s disease. This is one of the rare, genetically determined diseases of the X – linked type of inheritance, belonging to the group of lysosomal diseases of accumulation (synonyms: diffuse universal angiokeratoma, hereditary dystonic lipidosis, deficiency of alpha galactosidase A). The genetics of Fabry disease is due to mutations in the GLA gene characterized by a significant decrease in the activity or absence of the enzyme α-galactosidase A. These deviations result in the accumulation of glycosphingolipids, namely, ceramide accumulated in the cytoplasm or lysosomes of cells of various organs and tissues, disrupting their function, causing ischemia and tissue fibrosis. A specific laboratory diagnosis is the determination of the activity of alpha-galactosidase A. In Fabry’s disease, the activity of alpha-galactosidase A in men in men is always reduced, and in women, the activity of GLA may be near the lower limit of norm, or slightly lower, or normal. In Fabry disease symptomatic therapy and enzyme replacement therapy are used to reduce the severity and prevent the symptoms of Fabry disease. Antiplatelet therapy should be the basis of treatment. With timely access to enzyme replacement therapy, the prognosis is favorable.

scholarly journals Variable clinical features of patients with Fabry disease and outcome of enzyme replacement therapy

2021 ◽  
Vol 132 (2) ◽  
pp. S36
Author(s):  
Marina Dutra-Clarke ◽  
Daisy Tapia ◽  
Emily Curtin ◽  
Dennis Ruenger ◽  
Anita Lakatos ◽  
...  
Keyword(s):  
Enzyme Replacement Therapy ◽  
Fabry Disease ◽  
Replacement Therapy ◽  
Clinical Features ◽  
Enzyme Replacement

scholarly journals Variable clinical features of patients with Fabry disease and outcome of enzyme replacement therapy

2021 ◽  
Vol 26 ◽  
pp. 100700
Author(s):  
Marina Dutra-Clarke ◽  
Daisy Tapia ◽  
Emily Curtin ◽  
Dennis Rünger ◽  
Grace K. Lee ◽  
...  
Keyword(s):  
Enzyme Replacement Therapy ◽  
Fabry Disease ◽  
Replacement Therapy ◽  
Clinical Features ◽  
Enzyme Replacement

MO061IS THE PM290I MUTATION RELATED TO ORGAN INVOLVEMENT OF FABRY DISEASE?

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Francisca Silva ◽  
Nicole Pestana ◽  
José Durães ◽  
Nuno Guimarães Rosa ◽  
Gil Silva
Keyword(s):  
Enzyme Replacement Therapy ◽  
Fabry Disease ◽  
Replacement Therapy ◽  
Genetic Variant ◽  
Clinical Manifestations ◽  
Mutant Enzyme ◽  
Enzyme Replacement ◽  
Screening Study ◽  
Gla Gene

Abstract Background and Aims Fabry disease (FD) is an X-linked hereditary disease. It results from mutations in the GLA gene, leading to deficient activity of the enzyme alpha-galactosidase A and progressive accumulation of undegraded glycosphingolipids in cell lysosomes. Enzyme replacement therapy improved the natural course of this disease, but an early diagnosis is crucial for a successful treatment. Method A screening study for GLA gene mutations was conducted for all patients under dialysis, from a single centre. All the probands with a detectable mutation were analysed individually. Data on the patient's family and personal pathological history were retrospectively collected, by consulting the clinical file. Results 35 years-old female diagnosed with chronic proteinuric kidney disease in the postpartum period. Despite optimal medical treatment the disease progressed, and she started renal replacement therapy with peritoneal dialysis. Five years later she was enrolled in a pilot screening study for FD and the heterozygous mutation c.870G>C (p.Met290Ile; M290I) in exon 6 of the GLA gene was found. The proband didn’t meet the criteria for a definitive FD diagnosis, but she remained under follow-up at our nephrology metabolic diseases consultation, as the mutation was described as pathogenic and associated with a classic FD phenotype. Later that same year, reassessment exams revealed a worsening left ventricle mass index, a new ischemic cerebral lesion and a substantial increase in serum globotriaosylsphingosine (LysoGb3) levels. These clinical changes led to the decision to initiate enzyme replacement therapy. Until now there are only a few descriptions of this genetic variant in the scientific literature. A Portuguese study analysed a total of 11 FD patients and described 2 patients with p.M290I mutation, without detectable Gb3 accumulation. Another study was designed to evaluate the genotype-phenotype relationship in 73 Chinese FD patients. Contrary to other reports, the p.M290I mutation was not associated to the classic FD phenotype. A Swiss investigation with a similar design analysed 69 FD patients during their routine annual examinations. M290I mutant enzyme was found in a 48-year-old heterozygous female with a classic FD phenotype but with a low serum LysoGb3. A Spanish newborn screening identified one male patient with FD and the p.M290I genetic variant but was unable to provide any information about the clinical expression of this mutation, since the diagnosis was made between the third and fifth days of life. The study describing the most patients carrying the M290I mutant enzyme is Brazilian and screened a total of 25,223 dialysis patients. Among 89 FD-positive patients, the p.M290I mutation was present in 22. However, the authors did not provide detailed information about the clinical manifestations or α-Gal A activity and LysoGb3 levels of these patients. Finally, a recent Portuguese screening of 150 hypertrophic cardiomyopathy patients found 25 patients with FD. Of these, one female carried the GLA gene variant p.M290I, with a non-detectable LysoGb3 plasma level. Conclusion We describe a case of FD due to a previously known but still poorly described GLA mutation, which offers strong evidence of its pathogenicity. To our knowledge, this is the first report of p.M290I mutation-associated disease activity evidenced by elevated levels of serum LysoGb3. Despite the absence of classic FD symptoms such as neuropathic pain, cornea verticillata and angiokeratoma, the presence of severe multiple organ evolvement, characterized by renal failure, cardiac disease and ischaemic stroke, strongly suggests a classic phenotype. Consequently, it is our opinion that the presence of a p.M290I GLA mutation should require a strict ongoing patient follow-up, as it may cause clinically significant disease.

scholarly journals Long-Term Effects of Enzyme Replacement Therapy for Anderson-Fabry Disease

2019 ◽  
Vol 60 (1) ◽  
pp. 208-214
Author(s):  
Miki Tsujiuchi ◽  
Mio Ebato ◽  
Hideyuki Maezawa ◽  
Takuya Mizukami ◽  
Ayaka Nogi ◽  
...  
Keyword(s):  
Enzyme Replacement Therapy ◽  
Fabry Disease ◽  
Replacement Therapy ◽  
Long Term Effects ◽  
Enzyme Replacement

scholarly journals Use of a Modified α-N-Acetylgalactosaminidase in the Development of Enzyme Replacement Therapy for Fabry Disease

2009 ◽  
Vol 85 (5) ◽  
pp. 569-580 ◽  
Author(s):  
Youichi Tajima ◽  
Ikuo Kawashima ◽  
Takahiro Tsukimura ◽  
Kanako Sugawara ◽  
Mayuko Kuroda ◽  
...  
Keyword(s):  
Enzyme Replacement Therapy ◽  
Fabry Disease ◽  
Replacement Therapy ◽  
Enzyme Replacement
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