GUIDELINES FOR DIAGNOSIS, THERAPY AND FOLLOW UP OF ANDERSON-FABRY DISEASE

Fabryjeva bolest (Anderson-Fabryjeva bolest) jedna je od najčešćih lizosomskih bolesti nakupljanja (nakon Gaucherove bolesti) uzrokovana smanjenom aktivnošću enzima α-galaktosidaze A (α -Gal A) uz posljedično nakupljanje globotriaozilceramida u različitim stanicama, ponajprije u endotelnim i vaskularnim glatkim mišićnim stanicama uz posljedične multisistemske manifestacije. Pojavnost bolesti u muškaraca je 1:40.000-60.000, dok je u općoj populaciji oko 1 : 117.000. Bol je najčešće prvi simptom bolesti u 60-80 % djece, kao i simptomi probavnog sustava, oftalmološki simptomi, gubitak sluha. Smanjenje bubrežne funkcije, hipertrofična miokardiopatija ili moždani udar mogu se iskazati kao izolirani simptomi bolesti. U bolesnika s Fabryjevom bolešću skraćuje se očekivani životni vijek i to u muškaraca za oko 20 godina, a u žena za 10-15 godina, pa je stoga uvođenje nadomjesne enzimske terapije nužno u svih bolesnika koji zadovoljavaju kriterije za terapiju ove bolesti bez obzira na dob i spol.Fabry disease (Anderson-Fabry disease) is one of the most common lysosomal storage diseases (after Gaucher disease) caused by deficient activity of the α-galactosidase A (α-Gal A) enzyme, which leads to progressive accumulation of globotriaosylceramide in various cells, predominantly in endothelium and vascular smooth muscles, with multisystem clinical manifestations. Estimates of the incidence range from one per 40,000 to 60,000 in males, and 1:117,000 in the general population. Pain is usually the first symptom and is present in 60%-80% of affected children, as well as gastrointestinal disturbances, ophthalmologic abnormalities and hearing loss. Renal failure, hypertrophic cardiomyopathy, or stroke as the presenting symptom may also be found even as isolated symptoms of the disease. Life expectancy is reduced by approximately 20 years in males and 10-15 years in females, therefore enzyme replacement therapy should be introduced in patients of any age and either sex, who meet treatment criteria for Anderson-Fabry disease