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Clinical, histological and molecular characteristics of Mexican patients with Fabry disease and significant renal involvement.
[fabry disease]
Fabry
's
disease
(
FD
)
is
an
X-
linked
lysosomal
disorder
caused
by
a
deficiency
of
the
enzyme
α-galactosidase
A
that
produces
accumulation
of
glycosphingolipids
with
clinical
abnormalities
of
skin
,
eye
,
kidney
,
heart
,
brain
,
and
peripheral
nervous
system
.
We
undertook
this
study
to
describe
the
molecular
characteristics
of
the
first
four
Mexican
patients
with
diagnosis
of
FD
with
significant
renal
involvement
,
correlating
these
molecular
characteristics
with
clinical
,
pathological
and
biochemical
findings
.
Genomic
DNA
from
Mexican
nonrelated
patients
with
presumptive
diagnosis
of
FD
was
sequenced
by
polymerase
chain
reaction
(
PCR
)
.
DNA
sequences
were
compared
against
sequences
in
world
data
bank
gene
for
alpha-galactosidase
A
(
α-
GLA
,
ENSG
00000102393
)
using
the
BLAST
database
.
Three
patients
were
confirmed
as
having
FD
by
displaying
mutations
in
the
α-
GLA
gene
.
The
mutations
found
are
a
substitution
(
p
.
L
243
F
)
in
patient
1
,
and
a
substitution
(
p
.
A
156
V
)
in
patient
3
.
These
two
mutations
had
been
previously
reported
.
The
new
mutation
was
in
patient
2
who
displayed
a
deletion
(
c
.
260
delA
)
changing
the
open
reading
frame
from
codon
86
and
a
stop
codon
at
the
105
th
residue
of
the
protein
,
(
instead
of
429
AA
)
.
The
fourth
patient
had
lack
of
mutations
in
any
of
the
seven
exons
of
α-
GLA
or
25
base-pair
flanking
regions
;
had
mild
manifestations
with
kidney
histopathological
diagnosis
of
FD
that
gave
us
a
final
diagnosis
of
atypical
phenotype
of
FD
.
A
lthough
the
sample
is
small
,
it
gives
a
first
idea
of
the
molecular
and
clinical
heterogeneity
of
FD
in
a
Mexican
population
.
Diseases
Validation
Diseases presenting
"peripheral nervous system"
symptom
adrenomyeloneuropathy
alexander disease
canavan disease
fabry disease
hirschsprung disease
legionellosis
neuralgic amyotrophy
sneddon syndrome
waldenström macroglobulinemia
x-linked adrenoleukodystrophy
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