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[法布里病的神经学表现。综述]

[The neurological manifestations of Fabry disease. A review].

作者信息

Firsov K V, Kotov A S

机构信息

Vladimirsky Moscow Regional Research Institute, Moscow, Russia.

出版信息

Zh Nevrol Psikhiatr Im S S Korsakova. 2016;116(9):98-105. doi: 10.17116/jnevro20161169198-105.

Abstract

Fabry disease (Anderson-Fabry disease) is an X-linked recessive lysosomal storage disorder resulting from deficient activity of lysosomal hydrolase, alpha-galactosidase A (alpha-Gal A), which leads to progressive accumulation of globotriaosylceramide (Gb3) in various cells, predominantly endothelial and vascular smooth muscle cells, with clinical manifestations affecting major organs including the central nervous system. Manifestations of Fabry disease include progressive renal and cardiac insufficiency, neuropathic pain, stroke and cerebral disease, skin and gastrointestinal symptoms. Clinical onset usually occurs in childhood, but many severe patients are diagnosed in adulthood. Females may be severely affected as males and both may die prematurely due to stroke, heart disease and renal failure. Early recognition of symptoms, enzyme activity levels, concentration of Gb3 levels in the blood, urine and skin biopsies, as well as genetic testing (GLA gene) enable establishment of early diagnosis and therapeutic intervention with enzyme replacement therapy. Enzyme replacement therapy can stabilize or reduce the progression of the disease. Early therapy may prevent complications of the disease.

摘要

法布里病(安德森 - 法布里病)是一种X连锁隐性溶酶体贮积症,由溶酶体水解酶α - 半乳糖苷酶A(α - Gal A)活性不足引起,导致球三糖神经酰胺(Gb3)在各种细胞中进行性蓄积,主要是内皮细胞和血管平滑肌细胞,临床表现累及包括中枢神经系统在内的主要器官。法布里病的表现包括进行性肾和心脏功能不全、神经性疼痛、中风和脑部疾病、皮肤和胃肠道症状。临床发病通常发生在儿童期,但许多重症患者在成年期才被诊断出来。女性可能与男性一样受到严重影响,两者都可能因中风、心脏病和肾衰竭而过早死亡。对症状、酶活性水平、血液、尿液和皮肤活检中Gb3水平的浓度以及基因检测(GLA基因)的早期识别有助于早期诊断并通过酶替代疗法进行治疗干预。酶替代疗法可以稳定或减缓疾病的进展。早期治疗可能预防疾病的并发症。

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