Sometimes when you hear hoof beats, it could be a zebra: consider the diagnosis of Fabry disease

BMC Nephrology

Warren P Pickering¹  Helen E Binns²  John P Dormer⁴  James O Burton³ 

[1] Department of Nephrology, Northampton General Hospital, Northampton, UK;Department of Cardiology, Northampton General Hospital, Northampton, UK;Department of Infection, Immunity & Inflammation, School of Medicine and Biological Sciences, University of Leicester, Leicester, LE1 9HN, UK;Department of Histopathology, University Hospitals of Leicester NHS Trust, Leicester, UK

关键词: Multi-system disease;    Zebra bodies;    Renal biopsy;    Anderson-Fabry disease;   

Others  :  1083140
DOI  :  10.1186/1471-2369-13-73

 received in 2012-05-10, accepted in 2012-07-12,  发布年份 2012

【 摘 要 】

Background

Fabry disease is an X-linked lysosomal storage disorder that results from a deficiency of the enzyme α-galactosidase A. Fabry disease is present in 4–5% of men with unexplained left ventricular hypertrophy or cryptogenic stroke. As enzyme replacement therapy is now more widely available, it is important to recognise the signs and symptoms of the disease and establish the diagnosis so that early treatment can be started before irreversible organ damage occurs.

Case Presentation

A previously fit and well 32-year-old Caucasian male presented with multisystem dysfunction including renal impairment. Although he had no suggestive symptoms, a diagnosis of Fabry disease was first established on a native renal biopsy. This was confirmed by enzymatic testing and subsequent genetic analysis that revealed a potentially new pathogenic variant.

Conclusions

This case highlights the importance both of Fabry disease as a differential diagnosis in patients with renal impairment in the context of multi-system disease and also of adequate tissue sampling for electron microscopy when performing native renal biopsies.

【 授权许可】

   
2012 Burton et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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