Chiari type I malformation in four unrelated patients affected with Fabry disease.
Fabry disease (FD) is an X-linked inborn error of metabolism resulting from the deficient activity of alpha-galactosidase A which leads to the widespread deposition of glycosphingolipids in lysosomes, and to ischemic complications involving kidneys, heart and brain. Among neurological symptoms, strokes and transient ischemic attacks (TIA) have been reported. A 30-year-old male patient, with FD, was referred to us for evaluation of a sudden episode of dizziness, with disequilibrium, and diplopia, in agreement with the diagnosis of a TIA. Head magnetic resonance imaging (MRI) showed no cerebrovascular involvement but revealed the presence of Chiari type I malformation (CMI). We subsequently performed head MRI in a cohort of 44 consecutive hemizygous male patients and seven heterozygous females affected with FD, and identified three additional cases (two males and one female) of CMI. Whether the association is coincidental or not will need further studies but our data suggest that CMI should be ruled out in all Fabry patients.
Germain
Dominique P
DP
Assistance Publique - Hôpitaux de Paris, Department of Genetics, Hôpital Européen Georges Pompidou, 20, rue Leblanc, 75015 Paris, France. dominique.germain@egp.aphp.fr
Benistan
Karelle
K
Halimi
Philippe
P
D000328:Adult; D001139:Arnold-Chiari Malformation / Q000145:classification / Q000150:complications* / Q000235:genetics* / Q000473:pathology; D000795:Fabry Disease / Q000150:complications* / Q000235:genetics*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged