title: Characteristics of Cerebral Microbleeds in Patients with Fabry Disease.
abstract: OBJECTIVE
  Fabry disease (FD) is an X-linked lysosomal storage disorder frequently associated with the central nervous system manifestations. Although white matter hyperintensity (WMH) on MRI has been previously reported, little is known about cerebral microbleeds (CMBs) in patients with FD. Our aim is to investigate the clinical characteristics of CMBs in patients with FD.
  
  
  METHODS
  All patients with FD were diagnosed by enzyme activity and/or gene analysis at Jikei University Hospital. We retrospectively enrolled consecutive patients with FD who underwent MRI study, including fluid-attenuated inversion recovery and susceptibility-weighted imaging, between July 2008 and September 2013. After categorizing the patients into CMB-positive and CMB-negative groups, we compared the clinical characteristics between the 2 groups.
  
  
  RESULTS
  We enrolled 54 patients (males, 24; median age 39 years, interquartile range; 29-50 years). The CMB-positive group included 16 (30%) patients. The number of males was significantly higher in the CMB-positive group than in the CMB-negative group (75% versus 32%, P = .003). The prevalence rates of chronic kidney disease (CKD) (estimated glomerular filtration rate < 60 mL/min/1.73 m(2)) and WMH were higher in the CMB-positive group than in the CMB-negative group (CKD: 44% versus 13%, P = .013; WMH: 88% versus 58%, P = .035). No significant differences in the number of vascular risk factors were observed between the 2 groups.
  
  
  CONCLUSIONS
  The distinct characteristics of FD patients with CMBs were male sex, presence of CKD, and WMH. These factors may play an important role in the mechanism of hemorrhagic stroke in FD.
authors.affiliation: Department of Neurology, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan. Electronic address: yu1028@jikei.ac.jp.
authors.forename: Yu
authors.initials: Y
authors.lastname: Kono
authors.affiliation: Department of Pediatrics, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan; Division of Gene Therapy, Research Center for Medical Sciences, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan.
authors.forename: Taichi
authors.initials: T
authors.lastname: Wakabayashi
authors.affiliation: Department of Pediatrics, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan.
authors.forename: Masahisa
authors.initials: M
authors.lastname: Kobayashi
authors.affiliation: Department of Pediatrics, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan; Division of Gene Therapy, Research Center for Medical Sciences, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan.
authors.forename: Toya
authors.initials: T
authors.lastname: Ohashi
authors.affiliation: Advanced Clinical Research Center, Institute of Neurological Disorders, Kanagawa, Japan.
authors.forename: Yoshikatsu
authors.initials: Y
authors.lastname: Eto
authors.affiliation: Department of Pediatrics, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan; Division of Gene Therapy, Research Center for Medical Sciences, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ida
authors.affiliation: Department of Neurology, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Iguchi
mesh_terms: D000328:Adult; D017668:Age of Onset; D000368:Aged; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000453:epidemiology*; D015897:Comorbidity; D000795:Fabry Disease / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D056784:Leukoencephalopathies / Q000000981:diagnostic imaging / Q000453:epidemiology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000453:epidemiology; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors
keywords: Fabry disease; cerebral microbleeds; chronic kidney disease; susceptibility-weighted imaging; white matter hyperintensity