title: Left ventricular noncompaction in a patient with fabry disease: overdiagnosis, morphological manifestation of fabry disease or two unrelated rare conditions in the same patient?
abstract: We report a clinical case of a young female with Fabry disease but without left ventricular hypertrophy, which fulfills the diagnostic criteria of left ventricular noncompaction (LVNC). To our knowledge, this is the first report of LVNC in a patient with Fabry disease. The possibility of an overdiagnosis of LVNC is discussed based on the limitations of the current diagnostic criteria. This case was further investigated by genetic analysis, which came to demonstrate the limited usefulness of genetic testing in the diagnosis of LVNC. Assuming a true trabecular pattern of LVNC, the hypothesis that the same patient has two unrelated and rare conditions, although possible, is unlikely. The genetic and clinical heterogeneity of LVNC is discussed and supports, along with this clinical case, the hypothesis that LVNC is a morphological expression of different diseases rather than a distinct cardiomyopathy. Accordingly, LVNC could be a rare cardiac manifestation of Fabry disease.
authors.affiliation: Cardiology Department, Centro Hospitalar do Alto Ave, Guimarães, Portugal. olgazevedo @ yahoo.com.br
authors.forename: Olga
authors.initials: O
authors.lastname: Azevedo
authors.forename: Paulo
authors.initials: P
authors.lastname: Gaspar
authors.forename: Clara
authors.initials: C
authors.lastname: Sá Miranda
authors.forename: Damião
authors.initials: D
authors.lastname: Cunha
authors.forename: Rosa
authors.initials: R
authors.lastname: Medeiros
authors.forename: António
authors.initials: A
authors.lastname: Lourenço
mesh_terms: D000328:Adult; D003951:Diagnostic Errors; D018618:Echocardiography, Doppler, Color / Q000379:methods; D000795:Fabry Disease / Q000175:diagnosis* / Q000235:genetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D056830:Isolated Noncompaction of the Ventricular Myocardium / Q000175:diagnosis* / Q000235:genetics; D008279:Magnetic Resonance Imaging / Q000379:methods; D035583:Rare Diseases; D018570:Risk Assessment; D012680:Sensitivity and Specificity