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土耳其慢性肾病患者人群中法布里病的患病率。

The prevalence of Fabry disease in a Turkish population with chronic kidney patients.

作者信息

Tomar Özdem Kavraz, Bal Ayşe Zeynep, Şirali Semahat Karahisar, Duranay Murat, Korucu Berfu, Güz Galip, Akdağ Seyit İbrahim

机构信息

Department of Nephrology, Ankara Training and Research Hospital, 06104, Ankara, Turkey.

Department of Nephrology, Faculty of Medicine, Gazi University, 06104, Ankara, Turkey.

出版信息

Int Urol Nephrol. 2023 Jun;55(6):1629-1634. doi: 10.1007/s11255-023-03488-2. Epub 2023 Feb 1.

Abstract

BACKGROUND AND OBJECTIVES

Fabry disease (FD) is an X-linked lysosomal storage disease with various clinical symptoms due to a deficiency of an enzyme called alpha-galactosidase A. The likelihood of nephropathy increases with age and the severity of the mutation in Fabry patients. Fabry disease is difficult to diagnose. The exact incidence and prevalence of Fabry disease are unknown due to its atypical or oligosymptomatic forms.

DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: GLA gene mutations were examined in patients over the age of 18 who were followed up on with a diagnosis of chronic kidney disease and who had or did not receive renal replacement therapy from October 2017 to December 2019.

RESULTS

A total of 18 sites in 8 locations around Turkey volunteered to participate in the study, including people aged 18 and older with stages 1-5 of chronic kidney disease (CKD) or getting renal replacement therapy. 1904 patients were screened in total. In 13 cases, a D313Y pseudo mutation in the GLA gene was discovered. GLA gene mutations were found and pathologically assessed in four of the tested cases.

CONCLUSIONS

The range of clinical symptoms of Fabry disease, as well as the frequent delays in diagnosis, result in treatment being too late. We believe that screening chronic renal patients at high risk for Fabry disease is warranted.

摘要

背景与目的

法布里病(FD)是一种X连锁溶酶体贮积病,因缺乏一种名为α-半乳糖苷酶A的酶而出现各种临床症状。法布里病患者发生肾病的可能性随年龄增长及突变严重程度增加。法布里病难以诊断。由于其非典型或症状较少的形式,法布里病的确切发病率和患病率尚不清楚。

设计、地点、参与者及测量:对2017年10月至2019年12月期间接受随访诊断为慢性肾脏病且已接受或未接受肾脏替代治疗的18岁以上患者进行GLA基因突变检测。

结果

土耳其各地8个地点的共18个机构自愿参与该研究,包括患有1 - 5期慢性肾脏病(CKD)或正在接受肾脏替代治疗的18岁及以上人群。总共筛查了1904例患者。在13例中发现了GLA基因的D313Y假突变。在4例检测病例中发现了GLA基因突变并进行了病理评估。

结论

法布里病的临床症状范围以及诊断时常出现的延误导致治疗过晚。我们认为对法布里病高危慢性肾病患者进行筛查是有必要的。

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