Mishra Vinayak, Banerjee Amit, Gandhi Arohi B, Kaleem Ifrah, Alexander Josh, Hisbulla Mohamed, Kannichamy Vishmita, Valaiyaduppu Subas Sharathshiva, Hamid Pousette
Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.
General Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.
Cureus. 2020 Dec 14;12(12):e12083. doi: 10.7759/cureus.12083.
Fabry disease is an X-linked lysosomal storage disorder caused by a mutation in the alpha-galactosidase A (GLA) gene, leading to the deficiency of alpha-galactosidase A enzyme. The natural history of the affected patients (both males and females) includes neurovascular complications, such as cerebrovascular disease at a relatively young age. The pathophysiology behind the vascular involvement is primarily attributed to the accumulation of globotriaosylceramide and its derivatives in the vascular endothelium and vascular smooth muscle cells. MRI is the gold standard radiological investigation to detect the white matter lesions characteristic of Fabry disease's neurological involvement. More studies should focus on the utility of universally screening patients with young stroke for Fabry disease and the effectiveness of enzyme replacement therapy to prevent stroke. This review offers a synopsis of the current knowledge of the pathophysiology, neuroradiology, treatment, and prognosis of cerebrovascular disease in Fabry patients.
法布里病是一种X连锁溶酶体贮积症,由α-半乳糖苷酶A(GLA)基因突变引起,导致α-半乳糖苷酶A酶缺乏。受影响患者(包括男性和女性)的自然病史包括神经血管并发症,如在相对年轻时发生的脑血管疾病。血管受累背后的病理生理学主要归因于球三糖神经酰胺及其衍生物在血管内皮和血管平滑肌细胞中的积累。MRI是检测法布里病神经受累特征性白质病变的金标准影像学检查。更多研究应聚焦于对年轻卒中患者进行法布里病普遍筛查的效用以及酶替代疗法预防卒中的有效性。本综述概述了目前关于法布里病患者脑血管疾病的病理生理学、神经放射学、治疗及预后的知识。