testing and diagnosis

 

An early diagnosis of Fabry disease is useful for many reasons, including starting symptom management, reducing the risk of further problems happening as well as early identification of other family members who may be affected.

Initially, a combination of the signs and symptoms may lead your doctor to think you may have Fabry disease. Your doctor may then refer you to a specialist centre for a diagnosis of Fabry disease to be confirmed and for any treatment to be initiated.

Anyone who is thought to have Fabry disease can have the diagnosis confirmed through laboratory testing. This test, called an enzyme assay, measures the amount of alpha-GAL enzyme activity in the blood.

In males this can be done by taking a blood sample which is then tested to check the level of the a-Gal A enzyme. If the level of the enzyme is very low a diagnosis of Fabry disease can be made.

This test can also be used to confirm the diagnosis of Fabry disease in females, although a laboratory genetic test in which DNA is analysed is a more effective test for confirming the diagnosis in women especially where there is a family history of Fabry disease.

Prenatal diagnosis is possible by measuring the a-Gal A activity in tissue or fluid taken from around the foetus. This test may be offered to expectant mothers who have Fabry disease. Specialist support and advice are available for such testing.

An examination of your family history may indicate the presence of Fabry disease, particularly if a male relative suffered from kidney failure, heart disease or stroke early in life. To help identify whether there is the possibility of you or any of your relatives having Fabry disease, you can complete a medical family tree.

 

Family Testing

If you or a family member has been diagnosed, others in your immediate and extended family may also have Fabry disease. You do need to speak with your doctor or a genetic counsellor about Fabry testing.

The National Referral Laboratory for Lysosomal Disorders

(http://www.wch.sa.gov.au/services/az/divisions/labs/geneticmed/nrl.html)

 

 

Tests

Specimens

Postnatal

Prenatal

Fabry disease

Biochemical testing:

  • a-Galactosidase ($);
  • Trihexosylceramidase (a-galactosidase) ($);
  • In female patients, we recommend that 20mL of urine (random collection, sent frozen) be sent for inclusion in our developmental lipid profiling studies. This may enable us to give a better prediction regarding disease status.

Molecular testing:

Prenatal testing: ($)

Prenatal testing is available and can be performed by:

  • mutation analysis, where the mutation within the family is known (TAT 1 week);
  • analysis of a-galactosidase activity in cultured CV cells or amniocytes (TAT 2-3 weeks).

Note that it is very important that the laboratory is contacted prior to any prenatal testing as samples from the proband and/or parents are routinely required before any prenatal analysis.

Further information on prenatal testing can be obtained on the Prenatal diagnoses page.

Biochemical testing:
EDTA blood (10mL), leucocytes, cultured cells (skin fibroblasts, chorionic villus or amniotic cells), fresh frozen tissue, skin biopsy (prep $);
Urine (10-20mL, sent
frozen or freeze-dried).

Molecular testing:
DNA, EDTA blood or any tissue/source from which DNA can be extracted for mutation studies.
(prep $).

Prenatal testing:
Require
dissected CVS, whole amniotic fluid or cultured CV cells or amniocytes;
For mutation analysis, we can also receive DNA extracted from any of the above tissues (less preferred option).

95

6
(1 aff)

 

Lysosomal Diseases Research Unit - Adelaide

The Lysosomal Diseases Research Unit (LDRU) is an acknowledged world leader in research into lysosomal storage disorders. The Unit supports a multidisciplinary team of about 40 scientists, technicians and students working towards the goal of EARLY DIAGNOSIS AND EFFECTIVE THERAPY for these disorders. It maintains an annual competitively-won research budget of approximately $1.5 million.

Lysosomal storage disorders are inherited and result in severe clinical symptoms that worsen with age. Lysosomal storage disorders result from a deficiency or absence in the functional activity of a specific enzyme (protein) in each of the body's billions of cells. These enzymes are important in the removal of waste from each cell. Where the function of these enzymes is impaired, the waste cannot be removed effectively and begins to store within the cell. As more waste stores, it begins to interfere with the cell's ability to carry out its normal functions. Symptoms include bone deformities and very short stature, heart and respiratory difficulties, coarse facial features, an enlarged head, tongue, liver and spleen, and, in two-thirds of patients, brain degeneration. Very severely affected patients die within the first five or 10-years of life. In Australia the estimated incidence of lysosomal storage disorders is about 1 in 5,000 births (compared with disorders such as cystic fibrosis, incidence 1 in 2,500 births), making them a considerable health burden.

Dr Michael Fietz, Head, National Referral Laboratory for Lysosomal, Peroxisomal & Related Genetic Disorders phone (08) 8161 8062

Public Officer, Lysosomal Diseases Australia phone (08) 8161 7393

19-Jul-2010

Dear Fabry Community Letter from Genzyme

A Dear Fabry Community Letter giving an update on the supply of Fabrazyme

06-Jun-2010

Invitation to Dr S Waldek

FSGA is very fortunate to have international speaker Dr Stephen Waldek present to Australian Fabry patients in 5 states.

This section of the website contains published articles from the following sources:

  • Newspapers 
  • Magazines
  • Research Papers
  • Videos
  • Television

There are some great you tube sites suitable for educating young Fabry patients.

Watch the recent Fabry disease episode of House on FOX TV...

Fabry Australia gratefully acknowledges the generous support of the following organisations that are helping to make a difference to people and families affected by Fabry disease.
 
   
               
Fabry Support Group Australia         ABN 70 053 079 595        Reg Charity A0029817E