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Fabry disease simulating Crohn's ileitis.
[fabry disease]
Fabry
disease
is
an
inherited
(
X-
linked
)
lysosomal
storage
disorder
caused
by
deficiency
of
α-galactosidase
A
,
leading
to
accumulation
of
globotriaosylceramide
in
various
tissues
.
A
57
-
year
-old
male
with
a
family
history
and
laboratory
findings
of
Fabry
disease
,
was
consulted
for
severe
abdominal
pain
,
undulating
pyrexia
,
weight
loss
and
diarrhea
.
The
tentative
clinical
diagnosis
of
Crohn
's
ileitis
was
supported
at
computed
tomographic
examination
,
at
laparotomy
and
at
inspection
of
the
resected
ileal
segment
.
Histology
revealed
chronic
and
acute
inflammation
,
thick
-walled
occluded
vessels
,
fibrosis
and
characteristic
bi
-refringent
lamellar
deposits
of
globotriaosylceramide
and
calcifications
.
Multi-nucleated
giant
cells
contained
phagocytized
bi
-refringent
material
.
Transmission
electron
microscopy
showed
cells
with
irregular
cytoplasmic
bodies
displaying
distinctive
zebra-like
lamellar
structures
.
It
is
submitted
that
the
gastrointestinal
phenotype
of
Fabry
disease
may
concur
with
symptoms
resembling
abdominal
Crohn
's
disease
.
Diseases
Validation
Diseases presenting
"giant cells"
symptom
alpha-thalassemia
carcinoma of the gallbladder
erdheim-chester disease
fabry disease
pleomorphic liposarcoma
pyruvate dehydrogenase deficiency
well-differentiated liposarcoma
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