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Myocardial fibrosis as the first sign of cardiac involvement in a male patient with Fabry disease: report of a clinical case and discussion on the utility of the magnetic resonance in Fabry pathology.
[fabry disease]
Cardiovascular
magnetic
resonance
(
CMR
)
with
late
gadolinium
enhancement
(
LGE
)
imaging
is
increasingly
used
to
assess
myocardial
involvement
in
patients
with
Fabry
disease
,
an
X
linked
lipid
storage
disorder
.
However
,
it
is
often
proposed
as
an
optional
tool
.
A
different
cardiomyopathic
disease
progression
between
male
and
female
patients
was
hypothesised
in
previous
studies
,
as
in
female
myocardial
fibrosis
was
found
without
left
ventricular
(
LV
)
hypertrophy
,
while
myocardial
fibrosis
was
always
detected
in
association
to
LV
hypertrophy
in
men
.
A
male
Caucasian
patient
,
19
years
old
,
diagnosed
through
a
family-based
molecular
screening
,
presented
with
LGE
of
the
LV
inferolateral
wall
evidenced
at
the
CMR
,
without
LV
hypertrophy
,
or
other
clinical
signs
of
the
disease
.
This
is
the
first
report
of
cardiac
fibrosis
as
the
first
sign
of
organ
involvement
in
a
male
patient
with
Fabry
disease
.
This
finding
stresses
the
importance
of
performing
CMR
with
LGE
imaging
for
the
initial
staging
and
monitoring
of
Fabry
patients
of
both
genders
.
Diseases
Validation
Diseases presenting
"hypertrophy in men"
symptom
fabry disease
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