Females with Fabry disease frequently have major organ involvement: lessons from the Fabry Registry

W.R. Wilcox, J.P. Oliveira, R.J. Hopkin, A. Ortiz, M. Banikazemi, U. Feldt-Rasmussen, K. Sims, S. Waldek, G.M. Pastores, P. Lee, C.M. Eng, L. Marodi, K.E. Stanford, F. Breunig, C. Wanner, D.G. Warnock, R.M. Lemay, D.P. Germain

    359 Citations (Scopus)

    Abstract

    Fabry disease (FD) is an X-linked lysosomal storage disease caused by alpha-galactosidase A deficiency. The Fabry Registry is a global clinical effort to collect longitudinal data on FD. In the past, most "carrier" females were usually thought to be clinically unaffected. A systematic effort has been made to enroll all FD females, regardless of symptomology. Of the 1077 enrolled females in the Registry, 69.4% had symptoms and signs of FD. The median age at symptom onset among females was 13 years, and even though 84.1% had a positive family history, the diagnosis was not made until a median age of 31 years. Twenty percent experienced major cerebrovascular, cardiac, or renal events, at a median age of 46 years. Among adult females with estimated glomerular filtration rate (eGFR) data (N=638), 62.5% had an eGFR <90 ml/min/1.73 m2 and 19.0% had eGFR <60 ml/min/1.73 m2. Proteinuria 300 mg/day was present in 39.0% of females, and 22.2% had >1 gram/day. Quality of life (QoL), as measured by the SF-36((R)) survey, was impaired at a later age than in males, but both genders experience significantly impaired QoL from the third decade of life onward. Thus, females with FD have a significant risk for major organ involvement and decreased QoL. Females should be regularly monitored for signs and symptoms of FD, and considered for enzyme replacement therapy
    Udgivelsesdato: 2008/2
    Original languageEnglish
    JournalMolecular Genetics and Metabolism
    Volume93
    Issue number2
    Pages (from-to)112-128
    Number of pages16
    ISSN1096-7192
    Publication statusPublished - 2008

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