Fabry's disease differential diagnosis: Difference between revisions

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__NOTOC__
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{{Fabry's disease}}
{{Fabry's disease}}
==Differentiating Fabry's disease from other disease==
{| class="wikitable"
|+
!Organ
!Sing/Symptom
!Fabry's disease
!Possible differential diagnosis
!DDx Clues
!Further inf
|-
| rowspan="7" |Skin
| rowspan="3" |Angiokeratoma<br />
| rowspan="3" |
*Mean age: 17 years
*Locations: Mostly [[Hip (anatomy)|Hips]], [[Groin area|Groin]], [[Periumbilical]]
|[[Fucosidosis]]<ref name="pmid33266441">{{cite journal| author=Stepien KM, Ciara E, Jezela-Stanek A| title=Fucosidosis-Clinical Manifestation, Long-Term Outcomes, and Genetic Profile-Review and Case Series. | journal=Genes (Basel) | year= 2020 | volume= 11 | issue= 11 | pages=  | pmid=33266441 | doi=10.3390/genes11111383 | pmc=7700486 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33266441  }}</ref>
|
*Mean age: 2 years, the older patients more likely to have in examination
*Location: Varies involve Hips, Groin, Abdomen, external genitalia


<br />
{{CMG}} {{AE}} {{GhazalS}}
|
*The clinical appearance of the lesions may be indistinguishable.
*The light microscopic findings are indistinguishable.
*Should Investigate accompanying symptoms
|-
|[[Sialidosis]] (Juvenile foem)<ref name="pmid22452439">{{cite journal| author=Zampetti A, Orteu CH, Antuzzi D, Bongiorno MR, Manco S, Gnarra M | display-authors=etal| title=Angiokeratoma: decision-making aid for the diagnosis of Fabry disease. | journal=Br J Dermatol | year= 2012 | volume= 166 | issue= 4 | pages= 712-20 | pmid=22452439 | doi=10.1111/j.1365-2133.2012.10742.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22452439  }}</ref>
|
*Mean age : 2 years
*Location: Diffuse
|
*The clinical appearance of the lesions may be indistinguishable.
*Should Investigate accompanying symptoms
|-
|[[Acral pseudolymphomatous]] angiokeratoma of childhood<ref name="pmid20465644">{{cite journal| author=Chedraoui A, Malek J, Tamraz H, Zaynoun S, Kibbi AG, Ghosn S| title=Acral pseudolymphomatous angiokeratoma of children in an elderly man: report of a case and review of the literature. | journal=Int J Dermatol | year= 2010 | volume= 49 | issue= 2 | pages= 184-8 | pmid=20465644 | doi=10.1111/j.1365-4632.2009.04203.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20465644  }}</ref>
|
*Mainly children
*Location: Trunk and exterimities
|
*Should Investigate accompanying symptoms
|-
| rowspan="4" |[[Hypohidrosis]]/[[Anhidrosis]]
| rowspan="4" |
* Mean age: Mostly in the 20s <ref name="pmid17573884">{{cite journal| author=Orteu CH, Jansen T, Lidove O, Jaussaud R, Hughes DA, Pintos-Morell G | display-authors=etal| title=Fabry disease and the skin: data from FOS, the Fabry outcome survey. | journal=Br J Dermatol | year= 2007 | volume= 157 | issue= 2 | pages= 331-7 | pmid=17573884 | doi=10.1111/j.1365-2133.2007.08002.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17573884  }}</ref>
|[[Horner's syndrome|Horner syndrome]]
|
* Classic signs: Ptosis, Miosis, Anhidrosis
|
* In children and infants [[Harlequin sign]] is more apparent than anhidrosis
|-
|[[Topiramate]] usage
|
* History taking
|
|-
|[[Acetylcholine]] intoxication
|
* History taking
|
|-
|[[Ectodermal dysplasia]]
|
* Accompanying with hair and teeth problems<ref name="pmid34989033">{{cite journal| author=Kohn LL, Braun M, Cordoro KM, McCalmont TH, Shah SD, Frieden IJ | display-authors=etal| title=Skin and Mucosal Manifestations in NEMO Syndrome: A Case Series and Literature Review. | journal=Pediatr Dermatol | year= 2022 | volume= 39 | issue= 1 | pages= 84-90 | pmid=34989033 | doi=10.1111/pde.14905 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=34989033  }}</ref>
|
|}


==Overview==
[[Fabry's disease]] is often misdiagnosed due to its rarity and wide range of non-specific clinical manifestations. [[Fabry's disease]] be differentiated from various kind of condition based on the [[symptoms]] and organ involvement. 
==Differentiating Fabry's disease from other diseases==
===[[Skin]] manifestation===
*[[Angiokeratoma]]: [[Fucosidosis]]<ref name="pmid33266441">{{cite journal| author=Stepien KM, Ciara E, Jezela-Stanek A| title=Fucosidosis-Clinical Manifestation, Long-Term Outcomes, and Genetic Profile-Review and Case Series. | journal=Genes (Basel) | year= 2020 | volume= 11 | issue= 11 | pages=  | pmid=33266441 | doi=10.3390/genes11111383 | pmc=7700486 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33266441  }}</ref>,[[Sialidosis]] (Juvenile form)<ref name="pmid22452439">{{cite journal| author=Zampetti A, Orteu CH, Antuzzi D, Bongiorno MR, Manco S, Gnarra M | display-authors=etal| title=Angiokeratoma: decision-making aid for the diagnosis of Fabry disease. | journal=Br J Dermatol | year= 2012 | volume= 166 | issue= 4 | pages= 712-20 | pmid=22452439 | doi=10.1111/j.1365-2133.2012.10742.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22452439  }}</ref>, [[Acral pseudolymphomatous]] angiokeratoma of childhood<ref name="pmid20465644">{{cite journal| author=Chedraoui A, Malek J, Tamraz H, Zaynoun S, Kibbi AG, Ghosn S| title=Acral pseudolymphomatous angiokeratoma of children in an elderly man: report of a case and review of the literature. | journal=Int J Dermatol | year= 2010 | volume= 49 | issue= 2 | pages= 184-8 | pmid=20465644 | doi=10.1111/j.1365-4632.2009.04203.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20465644  }}</ref>
*[[Hypohidrosis]]/[[Anhidrosis]]<span> </span>:[[Horner syndrome|Horner syndrome,]] [[Topiramate]] usage, [[Acetylcholine]] intoxication, [[Ectodermal dysplasia]]
*[[Hyperhidrosis]]: [[Primary hyperhidrosis]]<ref name="pmid32726555">{{cite journal| author=Gorelick J, Friedman A| title=Diagnosis and Management of Primary Hyperhidrosis: Practical Guidance and Current Therapy Update. | journal=J Drugs Dermatol | year= 2020 | volume= 19 | issue= 7 | pages= 704-710 | pmid=32726555 | doi=10.36849/JDD.2020.5162 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32726555  }}</ref>
*[[Lymphedema]]: [[Chronic Venus insufficiency]], [[Rheumatic disorders]]
===[[Peripheral nervous system]]===
*[[Pain]] ([[neuropathic]]): [[rheumatic disorders]], [[fibromyalgia]], [[headache]] ([[Cluster headache|Cluster]]), [[migraine]], [[diabetic neuropathy]], recurrent fever syndromes, [[porphyria]], [[uremic neuropathy]] , [[Guillain-Barré syndrome|Guillain-Barre]]' syndrome, hereditary [[neuropathy]]
===[[Gastrointestinal]] symptoms===
*[[Abdominal pain]], [[diarrhea]], [[constipation]]: [[Gastritis]], [[duodenal ulcer]], [[celiac disease]], [[gastrointestinal hemorrhage]], [[Crohn's disease|Crohn’s disease]], [[ulcerative colitis]], [[diverticulitis]], functional [[Dyspepsia, functional|dyspepsia]], [[irritable bowel syndrome]], [[Familial mediterranean fever|familial Mediterranean fever]]
===[[Eyes]]===
*[[Cornea verticillate]]<span> </span>:Therapy with amiodarone, [[flecainide]], [[tamoxifen]]; [[fucosidosis]]
*[[Tortuositas vasorum]]: [[Diabetes mellitus]], [[Hypertension|arterial hypertension]], [[nephrotic syndrome]], [[neurofibromatosis type 1]], [[fibromuscular dysplasia]], [[Rendu-Osler-Weber disease]], [[Velocardiofacial syndrome]]
*[[Uveitis]]: [[Rheumatic disorders]], [[tubulointerstitial nephritis and uveitis syndrome (TINU)]], [[Bechet's disease]], [[sarcoidosis]], [[Crohn’s disease]]
*[[Conjunctival aneurysms]]: [[Kawasaki syndrome|Kawasaki syndrome]], [[Diabetes mellitus]]
===[[Ears]]===
*Acute/chronic [[hearing loss]]: [[apoplexy]], [[multiple sclerosis]], [[leopard syndrome]]
*[[tinnitus]]: [[otosclerosis]], [[borreliosis]], [[sudden deafness]], [[Meniere's disease]], [[acoustic neurinoma]]
*[[Dizziness]]: [[benign paroxysmal positional vertigo]], [[Meniere's disease]], [[vestibular neuritis]], [[cerebellar/brain stem infarction]]
===[[Heart]]===
*[[Angina pectoris]], [[myocardial infarction]]: [[Atherosclerosis]]
*[[Palpitations]]: [[atrial fibrillation]], [[Wolf-Parkinson-White syndrome]], [[hyperthyroidism]], [[drug induced palpitations]]
*[[Cardiomyopathy|Cardiomyopathy:]] Mitochondriopathies, [[Long QT syndrome]], [[myocarditis]], [[Pompe disease]], [[Niemann-Pick disease]], hemochromatosis, [[Duchenne muscular dystrophy|Duchenne]]/[[Becker's muscular dystrophy|Becker]] muscular dystrophy, [[neurofibromatosis type 1]], [[systemic lupus erythematosus]], [[rheumatoid arthritis]], [[dermatomyositis]]
*[[Valvular heart disease|Valvular]] disorders: [[Endocarditis]], [[rheumatic disorders]], [[mucopolysaccharidoses]]
*Impaired variability of cardiac frequency<span> </span>:[[Arterial hypertension]], [[mitral valve prolapse]], [[diabetes mellitus]], [[Sjogren syndrome]], [[MELAS syndrome]], [[obstructive sleep apnea]]
===[[Kidneys]]===
*[[Proteinuria]]/[[progressive renal failure]]: [[Diabetes mellitus]], [[arterial hypertension]], [[glomerulonephritis]], systemic [[Systemic lupus erythematosus|lupus]] erythematosus, [[hemolytic-uremic syndrome]], [[gout]], [[amyloidosis]], [[diabetes mellitus]], [[Henoch-Schonlein purpura]]
===[[Central nervous system]]===
*[[TIA]], [[apoplexy]], white matter lesions: [[Atherosclerosis]], [[multiple sclerosis]], [[mitochondriopathies]], [[CADASIL]]<ref name="pmid19623315">{{cite journal| author=Hoffmann B, Mayatepek E| title=Fabry disease-often seen, rarely diagnosed. | journal=Dtsch Arztebl Int | year= 2009 | volume= 106 | issue= 26 | pages= 440-7 | pmid=19623315 | doi=10.3238/arztebl.2009.0440 | pmc=2704393 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19623315  }}</ref>


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}


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Latest revision as of 10:27, 14 July 2022

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ghazal Sanadgol, M.D.[2]

Overview

Fabry's disease is often misdiagnosed due to its rarity and wide range of non-specific clinical manifestations. Fabry's disease be differentiated from various kind of condition based on the symptoms and organ involvement.

Differentiating Fabry's disease from other diseases

Skin manifestation

Peripheral nervous system

Gastrointestinal symptoms

Eyes

Ears

Heart

Kidneys

Central nervous system

References

  1. Stepien KM, Ciara E, Jezela-Stanek A (2020). "Fucosidosis-Clinical Manifestation, Long-Term Outcomes, and Genetic Profile-Review and Case Series". Genes (Basel). 11 (11). doi:10.3390/genes11111383. PMC 7700486 Check |pmc= value (help). PMID 33266441 Check |pmid= value (help).
  2. Zampetti A, Orteu CH, Antuzzi D, Bongiorno MR, Manco S, Gnarra M; et al. (2012). "Angiokeratoma: decision-making aid for the diagnosis of Fabry disease". Br J Dermatol. 166 (4): 712–20. doi:10.1111/j.1365-2133.2012.10742.x. PMID 22452439.
  3. Chedraoui A, Malek J, Tamraz H, Zaynoun S, Kibbi AG, Ghosn S (2010). "Acral pseudolymphomatous angiokeratoma of children in an elderly man: report of a case and review of the literature". Int J Dermatol. 49 (2): 184–8. doi:10.1111/j.1365-4632.2009.04203.x. PMID 20465644.
  4. Gorelick J, Friedman A (2020). "Diagnosis and Management of Primary Hyperhidrosis: Practical Guidance and Current Therapy Update". J Drugs Dermatol. 19 (7): 704–710. doi:10.36849/JDD.2020.5162. PMID 32726555 Check |pmid= value (help).
  5. Hoffmann B, Mayatepek E (2009). "Fabry disease-often seen, rarely diagnosed". Dtsch Arztebl Int. 106 (26): 440–7. doi:10.3238/arztebl.2009.0440. PMC 2704393. PMID 19623315.