An asymptomatic heterozygous female with fabry disease: implications for enzyme replacement therapy.
We report an asymptomatic female with Fabry disease immunohistochemically diagnosed by renal biopsy. She was initially diagnosed as having nephrotic syndrome, and renal biopsy was performed for pathological diagnosis. The renal specimen revealed non-specific findings (minor glomerular abnormalities) for nephrotic syndrome. Numerous laminated bodies in glomerular epithelial cells in electron microscopic findings and accumulations of ceramidetrihexoside immunohistochemically were observed and she was diagnosed with Fabry disease. However, no other laboratory data or clinical findings supported the diagnosis of Fabry disease. Since the efficacy of recombinant human alpha-galactosidase replacement therapy in this disease has been reported, whether enzyme replacement therapy for subclinical Fabry female patients is indicated or not is an important issue.
Inagaki
Shin-ichiro
S
Department of Pediatrics, Nippon Medical School, Tokyo, Japan.
Migita
Makoto
M
Hayakawa
Mari
M
Fujita
Atushi
A
Yoshida
Junko
J
Ishizaki
Masamichi
M
Kotani
Masaharu
M
Sakuraba
Hitoshi
H
Shimada
Takashi
T
Murakami
Mutsumi
M
Fukunaga
Yoshitaka
Y
D000293:Adolescent; D001706:Biopsy; D000795:Fabry Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics; D005260:Female; D002517:Galactosylgalactosylglucosylceramidase / Q000652:urine; D006579:Heterozygote; D006801:Humans; D007668:Kidney / Q000473:pathology; D000519:alpha-Galactosidase / Q000627:therapeutic use*
D000519:alpha-Galactosidase; D002517:Galactosylgalactosylglucosylceramidase