種田 積子
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Associate Professor
Article types Case report
Language English
Peer review Peer reviewed
Title Renal transplantation between siblings with unrecognized Fabry disease.
Journal Formal name:Transplantation proceedings
Abbreviation:Transplant Proc
ISSN code:(1873-2623)0041-1345(Linking)
Domestic / ForeginForegin
Volume, Issue, Page 45(1),pp.115-8
Author and coauthor Taneda S†, Honda K, Nakajima I, Huchinoue S, Oda H
Authorship Lead author
Publication date 2013
Summary Fabry disease is an X-linked lysosomal storage disease caused by deficiency of the lysosomal hydrolase, α-galactosidase A (α-Gal A). We report a case of a renal transplant recipient with unrecognized Fabry disease who received the allograft from a sibling donor with unrecognized Fabry disease. The recipient began to show a gradual increase of the serum creatinine with mild proteinuria at 3 years after transplantation. Histopathologic examination revealed finely vacuolated podocytes, demonstrated by ultrastructural examination to contain osmophilic myelin bodies. Furthermore, the recipient showed reduced circulating levels of α-Gal A and elevated urinary levels of globotriaosylceramide. These findings indicated that both the recipient and the donor suffered from Fabry disease of the renal variant phenotype. Enzyme replacement therapy (ERT) was initiated in the recipient, which resulted in a slight decrease of serum creatinine. Although mild proteinuria persisted, initiation of ERT in the recipient led to improvement of the renal function.
DOI 10.1016/j.transproceed.2012.10.024
PMID 23375284