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Saudi Journal of Kidney Diseases and Transplantation
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ARTICLES Table of Contents   
Year : 2003  |  Volume : 14  |  Issue : 3  |  Page : 367-377
Fabry Kidney Disease


1 Universidad Panamericana School of Medicine, Mexico City, Mexico, USA
2 Universidad Panamericana School of Medicine, Mexico City, Mexico; Division of Nephrology, New England Medical Center, Boston, Massachusetts, USA
3 Department of Medicine and Renal Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA

Correspondence Address:
Ravi Thadhani
Founders 036, 55 Fruit Street, Massachusetts General Hospital, Boston, MA 02114
USA
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PMID: 17657109

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Fabry disease (FD), the second most common type of lysosomal storage disease (LSD), is one of 41 disorders characterized by accumulation of substances normally degraded within lysosomes. It is an X-linked recessive disorder characterized by a deficiency of lysosomal alpha-galactosidase A (α-Gal A). The locus for human α-Gal A is located on the Xq22 chromosome. Most FD mutations are confined to a single family. Although FD is an X-linked disorder, up to one third of female carriers develop clinical manifestations of the disease. It typically presents during infancy or adolescence with crisis of neuropathic pain (acroparesthesia), angiokeratomas, and asymptomatic corneal lesions. As Gb3 deposition progresses, clinical manifestations occur in other organs. Patients typically die in the fourth or fifth decade of life due to cardiac, renal or cerebrovascular complications. Usually, there is diffuse deposition of glycosphingolipid in the renal glomeruli, tubules, interstitium, and vasculature. Clinically, the renal disease manifests with hypertension, microscopic hematuria (rare), moderate proteinuria, which can be in the nephrotic range, and lipiduria. End-stage renal disease can be treated with either dialysis or transplantation. Thegene for (x-Gal A was cloned and sequenced, which eventually led to production of enzyme for therapeutic use by either recombinant DNA technology or gene activation


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