[Fabry's disease: new therapeutic options for this lysosomal storage disorder]

Nervenarzt. 2003 Jun;74(6):489-96. doi: 10.1007/s00115-003-1513-6. Epub 2003 May 20.
[Article in German]

Abstract

Fabry's disease is an x-linked, recessive, lysosomal storage disorder that results from deficient alpha-galactosidase A activity with pathological sphingolipid deposition mainly in endothelium, smooth muscle cells, kidneys, central and peripheral nervous system, and myocardium. Clinical manifestation mostly occurs during childhood and adolescence with severe pain attacks or chronic pain mainly in hands and feet, hypohydrosis, and skin lesions (angiokeratoma). In more advanced disease stages, renal and cerebrovascular complications develop with proteinuria and later renal failure and cerebral ischemia caused by cerebral microangiopathy, dilatative arteriopathy, or cardiac embolism. Heterozygote female carriers are severely affected more often than was previously considered. The diagnosis is based on the detection of deficient alpha-galactosidase A activity in leukocytes, fibroblasts, or tissue biopsies. Two randomised placebo-controlled studies showed that enzyme replacement is effective by demonstrating either reduced pain or reduced tissue sphingolipid deposition. Early diagnosis of Fabry's disease is important in view of these new causal therapeutic options.

MeSH terms

  • Adult
  • Aged
  • Analgesics / administration & dosage
  • Analgesics / adverse effects
  • Brain Diseases, Metabolic, Inborn / diagnosis*
  • Brain Diseases, Metabolic, Inborn / genetics
  • Brain Diseases, Metabolic, Inborn / psychology
  • Codon, Nonsense
  • Combined Modality Therapy
  • Fabry Disease / genetics
  • Fabry Disease / psychology
  • Fabry Disease / therapy*
  • Female
  • Genetic Carrier Screening
  • Humans
  • Male
  • Middle Aged
  • Patient Care Team
  • Peripheral Nervous System Diseases / diagnosis*
  • Peripheral Nervous System Diseases / genetics
  • Peripheral Nervous System Diseases / psychology
  • Phenotype
  • Quality of Life / psychology
  • Recombinant Proteins / administration & dosage
  • alpha-Galactosidase / administration & dosage
  • alpha-Galactosidase / genetics

Substances

  • Analgesics
  • Codon, Nonsense
  • Recombinant Proteins
  • alpha-Galactosidase