A Single Lung Transplant in a Patient with Fabry Disease: Causality or Far-Fetched? A Case Report

Introduction. Fabry disease is a rare X-linked lysosomal storage disorder, characterized by an α-galactosidase A deficiency resulting in globotriaosylceramide storage within cells. Subsequently, various organ systems are involved, clinically the most important are kidneys, the heart, and the periph...

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Main Authors: Martina Gaggl, Renate Kain, Peter Jaksch, Dominik Haider, Gerald Mundigler, Till Voigtländer, Raute Sunder-Plassmann, Paulus Rommer, Walter Klepetko, Gere Sunder-Plassmann
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:Case Reports in Transplantation
Online Access:http://dx.doi.org/10.1155/2013/905743
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author Martina Gaggl
Renate Kain
Peter Jaksch
Dominik Haider
Gerald Mundigler
Till Voigtländer
Raute Sunder-Plassmann
Paulus Rommer
Walter Klepetko
Gere Sunder-Plassmann
author_facet Martina Gaggl
Renate Kain
Peter Jaksch
Dominik Haider
Gerald Mundigler
Till Voigtländer
Raute Sunder-Plassmann
Paulus Rommer
Walter Klepetko
Gere Sunder-Plassmann
author_sort Martina Gaggl
collection DOAJ
description Introduction. Fabry disease is a rare X-linked lysosomal storage disorder, characterized by an α-galactosidase A deficiency resulting in globotriaosylceramide storage within cells. Subsequently, various organ systems are involved, clinically the most important are kidneys, the heart, and the peripheral and central nervous systems. Although obstructive lung disease is a common pathological finding in Fabry disease, pulmonary involvement is a clinically disregarded feature. Case Presentation. We report a patient with a diagnosis of chronic obstructive pulmonary disease (COPD) who received a single lung transplant in 2007. Later, a kidney biopsy revealed the diagnosis of Fabry disease, which was confirmed by enzymatic and genetic testing. Ultrastructural changes in a native lung biopsy were consistent with the diagnosis. Although the association of a lung transplant and Fabry disease appears far-fetched on first sight, respiratory impairment cannot be denied in Fabry disease. Conclusion. With this case presentation, we would like to stimulate discussion about rare differential diagnoses hidden beneath widespread disease and that a correct diagnosis is the base of an optimal treatment strategy for each patient. Overall, the patient might have benefited from specific enzyme replacement therapy, especially in view of the chronic kidney disease.
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spelling doaj-art-c659973842f743db95d2fcaa6916afab2025-02-03T01:03:20ZengWileyCase Reports in Transplantation2090-69432090-69512013-01-01201310.1155/2013/905743905743A Single Lung Transplant in a Patient with Fabry Disease: Causality or Far-Fetched? A Case ReportMartina Gaggl0Renate Kain1Peter Jaksch2Dominik Haider3Gerald Mundigler4Till Voigtländer5Raute Sunder-Plassmann6Paulus Rommer7Walter Klepetko8Gere Sunder-Plassmann9Department of Medicine III, Division of Nephrology and Dialysis, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, AustriaDepartment of Pathology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, AustriaDepartment of Surgery, Division of Thoracic Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, AustriaDepartment of Medicine III, Division of Nephrology and Dialysis, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, AustriaDepartment of Medicine II, Division of Cardiology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, AustriaInstitute of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, AustriaDepartment of Laboratory Medicine, Laboratory for Molecular Diagnostics, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, AustriaDeparment of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, AustriaDepartment of Surgery, Division of Thoracic Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, AustriaDepartment of Medicine III, Division of Nephrology and Dialysis, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, AustriaIntroduction. Fabry disease is a rare X-linked lysosomal storage disorder, characterized by an α-galactosidase A deficiency resulting in globotriaosylceramide storage within cells. Subsequently, various organ systems are involved, clinically the most important are kidneys, the heart, and the peripheral and central nervous systems. Although obstructive lung disease is a common pathological finding in Fabry disease, pulmonary involvement is a clinically disregarded feature. Case Presentation. We report a patient with a diagnosis of chronic obstructive pulmonary disease (COPD) who received a single lung transplant in 2007. Later, a kidney biopsy revealed the diagnosis of Fabry disease, which was confirmed by enzymatic and genetic testing. Ultrastructural changes in a native lung biopsy were consistent with the diagnosis. Although the association of a lung transplant and Fabry disease appears far-fetched on first sight, respiratory impairment cannot be denied in Fabry disease. Conclusion. With this case presentation, we would like to stimulate discussion about rare differential diagnoses hidden beneath widespread disease and that a correct diagnosis is the base of an optimal treatment strategy for each patient. Overall, the patient might have benefited from specific enzyme replacement therapy, especially in view of the chronic kidney disease.http://dx.doi.org/10.1155/2013/905743
spellingShingle Martina Gaggl
Renate Kain
Peter Jaksch
Dominik Haider
Gerald Mundigler
Till Voigtländer
Raute Sunder-Plassmann
Paulus Rommer
Walter Klepetko
Gere Sunder-Plassmann
A Single Lung Transplant in a Patient with Fabry Disease: Causality or Far-Fetched? A Case Report
Case Reports in Transplantation
title A Single Lung Transplant in a Patient with Fabry Disease: Causality or Far-Fetched? A Case Report
title_full A Single Lung Transplant in a Patient with Fabry Disease: Causality or Far-Fetched? A Case Report
title_fullStr A Single Lung Transplant in a Patient with Fabry Disease: Causality or Far-Fetched? A Case Report
title_full_unstemmed A Single Lung Transplant in a Patient with Fabry Disease: Causality or Far-Fetched? A Case Report
title_short A Single Lung Transplant in a Patient with Fabry Disease: Causality or Far-Fetched? A Case Report
title_sort single lung transplant in a patient with fabry disease causality or far fetched a case report
url http://dx.doi.org/10.1155/2013/905743
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