Anorexia, weight loss, and diarrhea as presenting symptoms of angiokeratoma corporis diffusum (Fabry-Anderson's disease)

Digestive Diseases and Sciences
G F Nelis, G J Jacobs

Abstract

Fabry-Anderson's disease or angiokeratoma corporis diffusum (ACD) is an X-linked sphingolipidosis with a systemic character and occurs in 2-5 per million births (1-3). The basic defect is the absence of a lysosomal enzyme x-galactosidase A. This enzyme is necessary for the metabolization of ceramide trihexoside (globotriglycosyl ceramide), a breakdown product of cell membranes (4, 5). Clinically the disease is characterized by cutaneous angiokeratoma's and severe pain in the limbs from the second decade, followed by progressive renal insufficiency and cardiovascular and cerebrovascular damage in the third or fourth decade (6-8). In patients with established ACD, gastrointestinal symptoms have been described incidentally, mainly mild diarrhea (9, 10). We describe a kindred with ACD showing two extraordinary clinical features: (1) Anorexia, weight loss, and diarrhea were the presenting symptoms and antedated limb pain by many years, which has not been described before. (2) The disease was associated with another rare X-linked disorder: hypoplastic amelogenesis imperfecta.

References

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Feb 1, 1972·Archives of Disease in Childhood·D M FlynnE P Young
May 25, 1967·The New England Journal of Medicine·R O BradyL Laster
Oct 1, 1963·Archives of Neurology·A N RAHMAN, R LINDENBERG

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Citations

Jan 12, 2002·Kidney International·Ravi ThadhaniGregorio T Obrador
Apr 26, 2001·Journal of Pediatric Gastroenterology and Nutrition·D G FieldT F Hoban
Sep 19, 2006·Genetics in Medicine : Official Journal of the American College of Medical Genetics·Christine M EngWilliam R Wilcox
Dec 20, 2007·Genetics in Medicine : Official Journal of the American College of Medical Genetics·Henriette MersebachUlla Feldt-Rasmussen
Jun 1, 1991·Postgraduate Medical Journal·C I JackN Carroll
Sep 17, 2004·European Journal of Gastroenterology & Hepatology·Björn HoffmannBerthold Koletzko
Mar 30, 2007·Acta Paediatrica. Supplement·Björn Hoffmann, Satish Keshav

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