title: Prevalence of Fabry disease in stroke patients--a systematic review and meta-analysis.
abstract: BACKGROUND
  Fabry disease is an uncommon but treatable cause of stroke. Enzyme replacement therapy helps improve neurologic symptoms. We conducted a systematic review and meta-analysis to evaluate the prevalence of Fabry disease in stroke patients.
  
  
  METHODS
  We searched MEDLINE and EMBASE databases for relevant articles published in English up to February 2013. Studies that reported incidence or prevalence of Fabry disease in stroke patients were included. Two reviewers independently assessed studies to determine eligibility, validity, and quality. Meta-analysis was performed to calculate the prevalence of Fabry disease by etiology and gender.
  
  
  RESULTS
  Nine studies (n = 8302 patients) met the inclusion criteria. Eight studies (n = 8148) examined the prevalence of Fabry disease in young stroke patients. Overall qualities of included studies were moderate to high. The prevalence of Fabry disease ranged from .4% to 2.6% on strokes of any etiologies. In cryptogenic stroke, the prevalence ranged from .6% to 11.1%, 4.5% in men (95% confidence interval [CI] = 3.2%-6.3%) and 3.4% in women (95% CI = 1.0%-10.7%). The prevalence of Fabry disease in patients with all etiologies was similar in men (.9% [95% CI = .3%-2.3%]) and (1.4% [95% CI = .7%-2.7%]) in women.
  
  
  CONCLUSIONS
  Fabry disease may explain approximately 1% of all strokes in the young, including 3%-5% of cryptogenic strokes. The confirmation of Fabry disease may be challenging as there are different criteria for men and women. Early recognition of Fabry disease may help initiate the appropriate treatment to decrease the risk of subsequent complications.
authors.affiliation: Health and Rehabilitation Sciences, Western University, Elborn College, London, Ontario; Stroke Outcomes Research Center, Department of Medicine, St Michael's Hospital, University of Toronto, Toronto. Electronic address: qshi26@uwo.ca.
authors.forename: Qiyun
authors.initials: Q
authors.lastname: Shi
authors.affiliation: Division of Endocrinology, Diabetes and Nutrition, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Junji
authors.initials: J
authors.lastname: Chen
authors.affiliation: Stroke Outcomes Research Center, Department of Medicine, St Michael's Hospital, University of Toronto, Toronto.
authors.forename: Jitphapa
authors.initials: J
authors.lastname: Pongmoragot
authors.affiliation: Division of Neurology, Centre hospitalier de l'Université de Montréal, Faculty of Medicine, Université de Montréal, Montreal, Quebec.
authors.forename: Sylvain
authors.initials: S
authors.lastname: Lanthier
authors.affiliation: Stroke Outcomes Research Center, Department of Medicine, St Michael's Hospital, University of Toronto, Toronto; Department of Medicine, Li Ka Shing Knowledge Institute, St Michael's Hospital, University of Toronto, Toronto, Canada.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Saposnik
mesh_terms: D056947:Enzyme Replacement Therapy; D000795:Fabry Disease / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology*
keywords: Fabry disease; meta-analysis; prevalence; stroke; youth