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An intronic haplotype in α galactosidase A is associated with reduced mRNA expression in males with cryptogenic stroke.
[fabry disease]
Persons
with
unexplained
early
-onset
stroke
have
been
targeted
for
screening
surveys
for
Fabry
disease
,
the
most
common
of
the
three
X-
linked
lysosomal
disorders
,
because
Fabry
patients
with
stroke
are
more
likely
to
have
the
life-threatening
progressive
cardiac
and
renal
manifestations
and
would
therefore
most
benefit
from
early
diagnosis
and
intervention
with
enzyme
replacement
therapy
(
ERT
)
.
Among
175
Israeli
patients
with
unexplained
cryptogenic
stroke
screened
for
mutations
in
the
Fabry
α
galactosidase
A
(
GLA
)
gene
,
sequencing
identified
six
with
2
-
4
GLA
intronic
variants
,
one
of
whose
father
and
three
sisters
had
the
same
variants
.
Two
variants
,
c
.
640
-
16
A
>
G
(
g
.
10115
A
>
G
)
in
intron
4
and
c
.
1000
-
22
C
>
T
(
g
.
10956
C
>
T
)
in
intron
6
,
were
common
to
all
patients
.
However
,
three
males
with
a
common
four
variant
intronic
haplotype
had
low
residual
enzyme
activity
and
~
50
%
reduced
mRNA
expression
.
Transcript
splice-site
defects
were
not
identified
in
any
of
the
index
cases
and
X-
chromosome
inactivation
was
not
highly
skewed
in
the
six
females
.
These
data
do
not
suggest
that
GLA
intronic
variants
,
per
se
,
are
pathogenic
.
Nonetheless
,
it
is
clear
that
a
certain
intronic
haplotype
in
males
with
cryptogenic
stroke
is
associated
with
reduced
GLA
expression
and
function
.
Diseases
Validation
Diseases presenting
"renal manifestations"
symptom
fabry disease
lymphangioleiomyomatosis
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