Mild Left Ventricular Hypertrophy Unravels a Novel Nonsense Mutation of the GLA Gene Associated with the Classical Phenotype of Fabry Disease

Cardiology. 2017;137(2):67-73. doi: 10.1159/000455117. Epub 2017 Feb 3.

Abstract

We report on the clinical, biochemical, and genetic findings of a large family with the classical phenotype of Fabry disease due to the novel nonsense mutation c.607G>T (p.E203X) of the GLA gene, which occurs in the active site of the α-galactosidase A enzyme. This report highlights that (i) Fabry disease diagnosis should be considered in all cases of unexplained left ventricular hypertrophy (LVH), even in its milder forms; (ii) a complete evaluation of patients with unexplained LVH is important to find diagnostic red flags of treatable causes of LVH, such as Fabry disease; (iii) cascade family screening is paramount to the earlier diagnosis and treatment of other affected family members; and (iv) the Fabry disease phenotype is highly variable in heterozygote females, even within the same family.

Keywords: Classical phenotype; Fabry disease; GLA gene; Left ventricular hypertrophy; Mutation; Nonsense.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Codon, Nonsense
  • Echocardiography
  • Fabry Disease / genetics*
  • Fabry Disease / physiopathology*
  • Female
  • Heterozygote
  • Humans
  • Hypertrophy, Left Ventricular / diagnostic imaging*
  • Hypertrophy, Left Ventricular / etiology
  • Male
  • Middle Aged
  • Pedigree
  • Phenotype
  • Sex Factors
  • Young Adult
  • alpha-Galactosidase / genetics*

Substances

  • Codon, Nonsense
  • GLA protein, human
  • alpha-Galactosidase