Medicina (B Aires). 2010;70(1):37-43.
Fabry disease is an X- linked lysosomal disorder due to deficient activity of the enzyme alpha galactosidase A which leads to multisystemic storage of globotriaosylceramide with neurologic, gastrointestinal, cardiac, renal, skin and ophtalmological involvement. Recent studies indicate that heterozygous females develop symptoms similar to the males, but comparative information regarding the relative frequency of clinical manifestations, age of onset and severity of the disorder between males and females with Fabry disease is not available in Argentina. We identified 59 symptomatic adult patients with Fabry disease: 32 males (mean age 34.8 years) and 27 females (mean age 46.6 years). Diagnosis was made by enzymatic analysis in males and by genetic studies in females. We compared the frequency and severity of the clinical manifestations in females and males with this disease. The most frequent manifestations were: acroparesthesias, angiokeratomas, hypohydrosis (all them were significantly more frequent in males than in females, as well as the severity of symptoms), and cornea verticillata. Proteinuria and ventricular hypertrophy were frequent findings both in males and females. There was a delayed latency between age at onset and age at diagnosis in our group: 14 years for men and 30 years for females. Fabry disease is an underdiagnosed and potentially fatal disorder that affects both sexes. The availability of enzyme replacement therapy should stimulate the identification of signs and symptoms suggestive of this disorder, to allow earlier diagnosis and treatment.
法布里病是一种X连锁溶酶体疾病,由于α-半乳糖苷酶A活性不足,导致球三糖神经酰胺在多系统蓄积,累及神经、胃肠道、心脏、肾脏、皮肤和眼科。最近的研究表明,杂合子女性会出现与男性相似的症状,但在阿根廷,关于法布里病男性和女性临床表现的相对频率、发病年龄和疾病严重程度的比较信息并不存在。我们确定了59例有症状的成年法布里病患者:32例男性(平均年龄34.8岁)和27例女性(平均年龄46.6岁)。男性通过酶分析诊断,女性通过基因研究诊断。我们比较了该疾病男性和女性临床表现的频率和严重程度。最常见的表现为:肢端感觉异常、血管角质瘤、少汗(所有这些在男性中比在女性中更常见,症状严重程度也是如此),以及涡状角膜。蛋白尿和心室肥厚在男性和女性中均为常见表现。在我们的研究组中,发病年龄和诊断年龄之间存在延迟:男性为14年,女性为30年。法布里病是一种诊断不足且可能致命的疾病,影响两性。酶替代疗法的可用性应促使人们识别提示该疾病的体征和症状,以便早期诊断和治疗。