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法布里病——一种由基因决定的极其罕见的疾病,病程非常特殊。

Fabry disease - a genetically conditioned extremely rare disease with a very unusual course.

作者信息

Śnit Mirosław, Przyłudzka Marcela, Grzeszczak Władysław

机构信息

Department of Internal Medicine, Diabetology and Nephrology, Medical University of Silesia, Katowice, Poland.

出版信息

Intractable Rare Dis Res. 2022 Feb;11(1):34-36. doi: 10.5582/irdr.2021.01132.

Abstract

Fabry disease (FD) is a rare lysosomal storage disease. FD is caused by the presence of a deleterious mutation in the GLA gene encoding the enzyme alpha galactosidase A (αGAL A) on the X chromosome. The accumulation of Gb3 and lyso-GL-3 in nerve fiber cells, endothelium, vascular muscle cells, mesangial cells, podocytes, renal tubular epithelial cells and cardiomyocytes is the most important pathogenetic factor. The rate of disease progression depends on residual conserved enzymatic activity. In this article we present an example of a 25-year-old patient with FD with an initial asymptomatic course. The first manifestation of FD developed in the third decade of life. These include high blood pressure, urinary changes and grade V renal failure, requiring renal replacement therapy. The diagnosis was made very late, when renal failure and cerebro-cardiac complications occurred, including stroke and dangerous cardiac tamponade.

摘要

法布里病(FD)是一种罕见的溶酶体贮积病。FD是由位于X染色体上编码α-半乳糖苷酶A(αGAL A)的GLA基因存在有害突变所致。神经纤维细胞、内皮细胞、血管平滑肌细胞、系膜细胞、足细胞、肾小管上皮细胞和心肌细胞中Gb3和溶酶-GL-3的蓄积是最重要的致病因素。疾病进展速度取决于残余的保守酶活性。在本文中,我们展示了一名25岁法布里病患者的病例,其最初病程无症状。法布里病的首发症状出现在生命的第三个十年。这些症状包括高血压、尿液改变和V级肾衰竭,需要进行肾脏替代治疗。诊断很晚才做出,当时已经出现肾衰竭和心脑血管并发症,包括中风和危险的心包填塞。

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