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- W2073058993 abstract "Case presentation A 63-year-old woman was referred to hospital for investigation of a systolic murmur. Echocardiography suggested mitral regurgitation with non-concentric left-ventricular hypertrophy, but no other abnormalities. She was normotensive, and subsequent coronary angiography did not show any evidence of coronary artery disease. The patient was referred to the department of internal medicine for further investigation because of widespread telangiectatic spots on her torso and limbs and a 10–12 year history of episodic pain in her hands and feet. There was no family history of cardiovascular, renal, neurological, or dermatological disorders, and no other abnormalities were apparent on routine examination (figure 1). However, formal ophthalmological examination showed the presence of corneal opacities and atypical tordation of retinal vessels. Abnormalities were not detected on routine biochemical screening, but examination of urine by polarisation microscopy showed birefringent lipid molecules, with a Maltese cross appearance. Skin biopsy samples showed dilatation of superficial capillaries and lipid deposition in endothelial cells (figure 2). Renal biopsy and electron microscopy were not done. Diagnosis of non-classical, heterozygous Fabry's disease was suggested by the decreased activity of α-galactosidase A in serum samples (42; normal 50–150 nmol/h/mg protein). A point mutation in exon two of Arg 112 Cys of allele one of the α-galactosidase A gene was shown by sequence analysis of exons one to seven after PCR amplification. The patient was given symptomatic treatment for her acroparaesthesiae. Figure 2Skin biopsy sample showing dilatation of superficial dermal capillaries Show full caption Lipid deposition in endothelium (unfilled arrow) and pericyte (filled arrow). Frozen section, PAS diastase. Original magnification ×340. View Large Image Figure Viewer Download Hi-res image Case presentation A 63-year-old woman was referred to hospital for investigation of a systolic murmur. Echocardiography suggested mitral regurgitation with non-concentric left-ventricular hypertrophy, but no other abnormalities. She was normotensive, and subsequent coronary angiography did not show any evidence of coronary artery disease. The patient was referred to the department of internal medicine for further investigation because of widespread telangiectatic spots on her torso and limbs and a 10–12 year history of episodic pain in her hands and feet. There was no family history of cardiovascular, renal, neurological, or dermatological disorders, and no other abnormalities were apparent on routine examination (figure 1). However, formal ophthalmological examination showed the presence of corneal opacities and atypical tordation of retinal vessels. Abnormalities were not detected on routine biochemical screening, but examination of urine by polarisation microscopy showed birefringent lipid molecules, with a Maltese cross appearance. Skin biopsy samples showed dilatation of superficial capillaries and lipid deposition in endothelial cells (figure 2). Renal biopsy and electron microscopy were not done. Diagnosis of non-classical, heterozygous Fabry's disease was suggested by the decreased activity of α-galactosidase A in serum samples (42; normal 50–150 nmol/h/mg protein). A point mutation in exon two of Arg 112 Cys of allele one of the α-galactosidase A gene was shown by sequence analysis of exons one to seven after PCR amplification. The patient was given symptomatic treatment for her acroparaesthesiae." @default.
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- W2073058993 date "2001-01-01" @default.
- W2073058993 modified "2023-10-06" @default.
- W2073058993 title "Anderson-Fabry's disease: α galactosidase deficiency" @default.
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- W2073058993 doi "https://doi.org/10.1016/s0140-6736(00)03554-6" @default.
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