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A random Abstract
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Fabry disease presenting as apical left ventricular hypertrophy in a patient carrying the missense mutation R118C.
[fabry disease]
Anderson-
Fabry
disease
is
an
X-
linked
lysosomal
storage
disorder
caused
by
abnormalities
of
the
GLA
gene
,
which
encodes
the
enzyme
α-galactosidase
A
.
A
deficiency
of
this
enzyme
leads
to
the
lysosomal
accumulation
of
glycosphingolipids
,
which
may
cause
left
ventricular
hypertrophy
that
is
typically
concentric
and
symmetric
.
We
present
the
case
of
a
60
-
year
-old
woman
with
symptoms
of
dyspnea
,
atypical
chest
pain
and
palpitations
,
in
whom
a
transthoracic
echocardiogram
revealed
an
apical
variant
of
hypertrophic
cardiomyopathy
.
Analysis
of
specific
sarcomeric
genetic
mutations
was
negative
.
The
patient
underwent
a
screening
protocol
for
Anderson-
Fabry
disease
,
using
a
dried
blood
spot
test
,
which
was
standard
at
our
institution
for
patients
with
left
ventricular
hypertrophy
.
The
enzymatic
activity
assay
revealed
reduced
α-galactosidase
A
enzymatic
activity
.
Molecular
analysis
identified
a
missense
point
mutation
in
the
GLA
gene
(
p
.
R
118
C
)
.
This
case
report
shows
that
Anderson-
Fabry
disease
may
cause
an
apical
form
of
left
ventricular
hypertrophy
.
The
diagnosis
was
only
achieved
because
of
systematic
screening
,
which
highlights
the
importance
of
screening
for
Anderson-
Fabry
disease
in
patients
with
unexplained
left
ventricular
hypertrophy
,
including
those
presenting
with
more
unusual
patterns
,
such
as
apical
variants
of
left
ventricular
hypertrophy
.
This
case
also
supports
the
idea
that
the
missense
mutation
R
118
C
is
indeed
a
true
pathogenic
mutation
of
Anderson-
Fabry
disease
.
Diseases
Validation
Diseases presenting
"dyspnea"
symptom
acute rheumatic fever
allergic bronchopulmonary aspergillosis
carcinoma of the gallbladder
congenital diaphragmatic hernia
cushing syndrome
cutaneous mastocytosis
dedifferentiated liposarcoma
erdheim-chester disease
esophageal carcinoma
fabry disease
familial mediterranean fever
inclusion body myositis
liposarcoma
lymphangioleiomyomatosis
neuralgic amyotrophy
pleomorphic liposarcoma
primary effusion lymphoma
scrub typhus
systemic capillary leak syndrome
thoracic outlet syndrome
well-differentiated liposarcoma
This symptom has already been validated