title: Phospholipid storage in the myocardium of a unique Japanese case of idiopathic cardiomyopathy.
abstract: BACKGROUND
  A unique adult male patient who developed cardiomyopathy was first suspected to have cardiac Fabry disease based on the pathological findings in heart tissues obtained on biopsy, but the alpha-galactosidase activity in his leukocytes was normal and no mutation was detected in the coding region of the alpha-galactosidase gene. We identified accumulated materials in the myocardium of this patient.
  
  
  METHODS
  Pathological and biochemical analyses were performed using the autopsied heart tissues as samples.
  
  
  RESULTS
  Although numerous lamellar and concentric inclusion bodies were ultrastructurally found in the autopsied myocardium, the alpha-galactosidase activity in the heart tissues was not decreased. Lipid analysis revealed the accumulation of phospholipids including phosphatidylethanolamine, phosphatidylcholine, and phosphatidylinositol, but not globotriaosylcereamide or gangliosides.
  
  
  CONCLUSIONS
  We found that a large amount of phospholipids accumulated in the myocardium of a patient with idiopathic cardiomyopathy, and electron microscopic findings of lamellar and concentric inclusion bodies in cardiomyocytes. A cardiac phospholipid storage disorder should be considered as an important candidate disease on differential diagnosis of myocardiac disorders including cardiac Fabry disease.
authors.affiliation: Department of Clinical Genetics, The Tokyo Metropolitan Institute of Medical Science, Tokyo Metropolitan Organization for Medical Research, Bunkyo-ku, Tokyo 113-8613, Japan.
authors.forename: Ikuo
authors.initials: I
authors.lastname: Kawashima
authors.forename: Ichiro
authors.initials: I
authors.lastname: Takeuchi
authors.forename: Mai
authors.initials: M
authors.lastname: Ohsawa
authors.forename: Masaharu
authors.initials: M
authors.lastname: Kotani
authors.forename: Youichi
authors.initials: Y
authors.lastname: Tajima
authors.forename: Takayuki
authors.initials: T
authors.lastname: Inomata
authors.forename: Tohru
authors.initials: T
authors.lastname: Izumi
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Sakuraba
mesh_terms: D001344:Autopsy; D009202:Cardiomyopathies / Q000201:enzymology / Q000378:metabolism* / Q000473:pathology; D002855:Chromatography, Thin Layer; D006801:Humans; D008297:Male; D008875:Middle Aged; D010743:Phospholipids / Q000378:metabolism*; D000519:alpha-Galactosidase / Q000378:metabolism
chemical_list: D010743:Phospholipids; D000519:alpha-Galactosidase