Tse Kai-Chung, Chan Kwok-Wah, Tin Vicky Pui-Chi, Yip Pok-Siu, Tang Sydney, Li Fu-Keung, Ho Yiu-Wing, Lai Kar-Neng, Chan Tak-Mao
Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, People's Republic of China.
Nephrol Dial Transplant. 2003 Jan;18(1):182-6. doi: 10.1093/ndt/18.1.182.
Fabry's disease is an X-linked recessive inborn error of glycosphingolipid catabolism resulting from deficient activity of lysosomal enzyme alpha-galactosidase A causing occlusive microvascular diseases affecting the kidney, heart, peripheral nerves and brain. It is an uncommon disease in the Oriental population.
We report a Chinese kindred of Fabry's disease and the relevant clinical features are discussed. The diagnosis of Fabry's disease was based on serum alpha-galactosidase A activity and typical histological features from renal biopsy in the index patient. Genetic analysis of two hemizygous male patients revealed a missense mutation predicting a leucine to proline substitution (L14P) in the alpha-galactosidase gene causing classical Fabry's disease in this family. This is a novel point mutation not described previously in the literature and the second report describing novel genetic mutations for Fabry's disease in Chinese patients.
Fabry's disease is rare in Chinese patients but this diagnosis should be considered in patients with positive family history of kidney disease and relevant clinical features.
法布里病是一种X连锁隐性遗传性鞘糖脂分解代谢障碍疾病,由溶酶体酶α-半乳糖苷酶A活性缺乏所致,可引起闭塞性微血管疾病,累及肾脏、心脏、周围神经和大脑。在东方人群中,这是一种罕见疾病。
我们报告了一个中国法布里病家系,并对相关临床特征进行了讨论。法布里病的诊断基于先证者的血清α-半乳糖苷酶A活性及肾活检典型组织学特征。对两名半合子男性患者的基因分析显示,α-半乳糖苷酶基因存在一个错义突变,预测亮氨酸被脯氨酸取代(L14P),导致该家族出现典型的法布里病。这是一个文献中此前未描述过的新的点突变,也是第二篇描述中国患者法布里病新基因突变的报告。
法布里病在中国患者中较为罕见,但对于有肾病家族史及相关临床特征的患者应考虑该诊断。