Details

Autor(en) / Beteiligte

• Romani, Ilaria
• Sarti, Cristina
• Nencini, Patrizia
• Pracucci, Giovanni
• Zedde, Marialuisa
• Cianci, Vittoria
• Nucera, Antonia
• Moller, Jessica
• Orsucci, Daniele
• Toni, Danilo
• Palumbo, Pasquale
• Casella, Carmela
• Pinto, Vincenza
• Barbarini, Leonardo
• Bella, Rita
• Scoditti, Umberto
• Ragno, Michele
• Mezzapesa, Domenico Maria
• Tassi, Rossana
• Volpi, Gino
• Diomedi, Marina
• Bigliardi, Guido
• Cavallini, Anna Maria
• Chiti, Alberto
• Ricci, Stefano
• Cecconi, Emanuela
• Linoli, Giovanni
• Sacco, Simona
• Rasura, Maurizia
• Giordano, Antonello
• Bonetti, Bruno
• Melis, Marta
• Cariddi, Lucia Princiotta
• Dossi, Roberto Currò
• Grisendi, Ilaria
• Aguglia, Umberto
• Di Ruzza, Maria Rita
• Melis, Maurizio
• Sbardella, Emilia
• Vista, Marco
• Valenti, Raffaella
• Musolino, Rosa Fortunata
• Passarella, Bruno
• Direnzo, Vita
• Pennisi, Giovanni
• Genovese, Antonio
• Di Marzio, Fabio
• Sgobio, Rossana
• Acampa, Maurizio
• Nannucci, Serena
• Dagostino, Federica
• Dell'Acqua, Maria Luisa
• Cuzzoni, Maria Giovanna
• Picchioni, Antonella
• Calchetti, Benedetta
• Notturno, Francesca
• Di Lisi, Filomena
• Forlivesi, Stefano
• Delodovici, Maria Luisa
• Buechner, Susanne Christiane
• Biagini, Silvia
• Accavone, Donatella
• Manna, Raffaele
• Morrone, Amelia
• Inzitari, Domenico

Titel

Prevalence of Fabry disease and GLA variants in young patients with acute stroke: The challenge to widen the screening. The Fabry-Stroke Italian Registry

Ist Teil von

• Journal of the neurological sciences, 2024-02, Vol.457, p.122905-122905, Article 122905

Ort / Verlag

Netherlands: Elsevier B.V

Erscheinungsjahr

2024

Quelle

MEDLINE

Beschreibungen/Notizen

• Fabry disease (FD) is a treatable X-linked lysosomal storage disorder caused by GLA gene variants leading to alpha-galactosidase A deficiency. FD is a rare cause of stroke, and it is still controversial whether in stroke patients FD should be searched from the beginning or at the end of the diagnostic workup (in cryptogenic strokes). Fabry-Stroke Italian Registry is a prospective, multicentric screening involving 33 stroke units. FD was sought by measuring α-galactosidase A activity (males) and by genetic tests (males with reduced enzyme activity and females) in patients aged 18–60 years hospitalized for TIA, ischemic stroke, or intracerebral hemorrhage. We diagnosed FD in patients with 1) already known pathogenic GLA variants; 2) novel GLA variants if additional clinical, laboratory, or family-derived criteria were present. Out of 1906 patients, we found a GLA variant in 15 (0.79%; 95%CI 0.44–1.29) with a certain FD diagnosis in 3 (0.16%; 95%CI 0.03–0.46) patients, none of whom had hemorrhage. We identified 1 novel pathogenic GLA variant. Ischemic stroke etiologies in carriers of GLA variants were: cardioaortic embolism (33%), small artery occlusion (27%), other causes (20%), and undetermined (20%). Mild severity, recurrence, previous TIA, acroparesthesias, hearing loss, and small artery occlusion were predictors of GLA variant. In this large multicenter cohort the frequency of FD and GLA variants was consistent with previous reports. Limiting the screening for GLA variants to patients with cryptogenic stroke may miss up to 80% of diagnoses. Some easily recognizable clinical features could help select patients for FD screening. [Display omitted] •GLA variants are identified in 0.9% of Italian adults with TIA/ischemic strokes.•Screening for Fabry disease should be widened to all stroke pathogenesis.•Mild recurrent strokes and small vessel occlusion may hide a GLA variant.•Acroparesthesias and hearing loss in a stroke patient should suggest GLA variants.