Cardiocyte storage and hypertrophy as a sole manifestation of Fabry's disease. Report on a case simulating hypertrophic non-obstructive cardiomyopathy
Jazyk angličtina Země Německo Médium print
Typ dokumentu kazuistiky, časopisecké články
PubMed
2173254
DOI
10.1007/bf01606034
Knihovny.cz E-zdroje
- MeSH
- elektronová mikroskopie MeSH
- Fabryho nemoc komplikace metabolismus patologie MeSH
- glykolipidy analýza MeSH
- hmotnostní spektrometrie MeSH
- kardiomegalie komplikace patologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční spektroskopie MeSH
- myokard metabolismus patologie MeSH
- trihexosylceramidy metabolismus MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- Názvy látek
- globotriaosylceramide MeSH Prohlížeč
- glykolipidy MeSH
- trihexosylceramidy MeSH
Fabry's disease was diagnosed in an adult patient as a lipid storage-induced non-obstructive hypertrophic cardiomyopathy. Stable angina pectoris started 15 years before death, was followed by slowly progressive heart failure and repeated pulmonary thromboembolism with death at 63 years. Autopsy disclosed enormous cardiomegaly (1100 g), cardiac storage of ceramide trihexoside (CTH) of the same intensity as in classical cases of generalized Fabry's disease (11 mg lipid/g wet weight) restricted to cardiocytes. Other tissues (liver, kidney, brain, pancreas, pulmonary artery, coronary arteries) were free of storage. Using proton magnetic resonance analysis on formaldehyde-fixed tissue the stored CTH was identified as globotriaosylceramide. It was enzymatically degradable by control cell cultures but left uncleaved by mutant reference Fabry cells. Alpha-galactosidase activities in peripheral leucocytes of all four of the patient's daughters were in the heterozygous range. The diagnostic difficulties in this monosymptomatic novel variant of Fabry's disease are stressed.
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