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{{Fabry's disease}}
{{Fabry's disease}}
{{CMG}} {{AE}} {{GhazalS}}


* Various screening methods have been identified but to be suitable for use in the general population it should meet the criteria of being cost effective along with its use thereby causing a significant reduction in morbidity and morality.
==Overview==
* Ideally all screening tests should be implemented in a population with high PPV which includes individuals with a family history of FD.  
According to National Society of Genetic Counselors, screening for [[Fabry's disease]] in the patient's family members is recommended. The early [[prenatal]] and [[newborn screening]] can be done by [[α-Gal A enzyme]] and ''[[GLA deficiency|GLA]]'' mutation analyses. Based on the American Heart Failure Society, [[Fabry's disease]] screening should be done in males with unexplained [[cardiac hypertrophy]].
* Measurement of the accumulated urinary Gb3 has been proposed but its reliability as a biomarker of FD, particularly in females is yet to be proven [1]
 
* Screening of patients in high risk groups who may be exhibiting late-onset symptoms of FD but have not yet been diagnosed may be the key to optimising the management of disease in such patients. It can be conducted by measuring plasma galactosidase A activity which documented lower sensitivity and failure in identifying all clinical cases of FD. [2]
* Another screening method of identifying deficient enzyme activity in dried blood spots (DBS) has demonstrated increased reliability and gained validation in diagnosing FD in males but fails to detect about one third of heterozygous females [3] [4]


== References ==
==Screening==
[1] Auray-Blais C, Cyr D, Mills K, Giguere R, Drouin R. Development of a filter paper method potentially applicable to mass and high-risk urinary screenings for Fabry disease. J Inherit Metab Dis. 2007;30:106. doi: 10.1007/s10545-006-0444-3.
[2] Andrade J, Waters PJ, Singh RS, Levin A, Toh BC, Vallance HD, Sirrs S. Screening for Fabry disease in patients with chronic kidney disease: limitations of plasma alpha-galactosidase assay as a screening test. Clin J Am Soc Nephrol. 2008;3:139–145. doi: 10.2215/CJN.02490607.


[3]Linthorst GE, Vedder AC, Aerts JM, Hollak CE. Screening for Fabry disease using whole blood spots fails to identify one-third of female carriers. Clin Chim Acta. 2005;353:201–203. doi: 10.1016/j.cccn.2004.10.019. [PubMed]
*There is insufficient evidence to recommend routine newborn screening for [https://www.wikidoc.org/index.php/Fabry's%20disease Fabry's disease] in the general population.


[4] Chamoles NA, Blanco M, Gaggioli D. Fabry disease: enzymatic diagnosis in dried blood spots on filter paper. Clin Chim Acta. 2001;308:195–196. doi: 10.1016/S0009-8981(01)00478-8. [PubMed]
*According to the National Society of Genetic Counselors, screening for Fabry's disease for family members of the affected individual is recommended by:<span> </span>
**Measuring [https://www.wikidoc.org/index.php/Alpha-galactosidase alpha-galactosidase] activity in men
**Sequencing the GLA [https://www.wikidoc.org/index.php/Gene gene] in females
**[https://www.wikidoc.org/index.php/Prenatal Prenatal] and [[Preimplantation genetic diagnosis|preimplantation]] testing
***Early prenatal diagnosis:
****10 weeks: [[α-Gal A enzyme]] and ''[[GLA deficiency|GLA]]'' mutation analyses by [[Chorionic villus sampling|chorionic villus]] sampling
****15 weeks: α-Gal A enzyme activity by [[amniocentesis]]<ref name="pmid3035532">{{cite journal| author=Kleijer WJ, Hussaarts-Odijk LM, Sachs ES, Jahoda MG, Niermeijer MF| title=Prenatal diagnosis of Fabry's disease by direct analysis of chorionic villi. | journal=Prenat Diagn | year= 1987 | volume= 7 | issue= 4 | pages= 283-7 | pmid=3035532 | doi=10.1002/pd.1970070409 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3035532  }}</ref>
**Newborn screening
***In males: α-Gal A activity and ''GLA'' gene sequencing in blood spots<ref name="pmid16773563">{{cite journal| author=Spada M, Pagliardini S, Yasuda M, Tukel T, Thiagarajan G, Sakuraba H | display-authors=etal| title=High incidence of later-onset fabry disease revealed by newborn screening. | journal=Am J Hum Genet | year= 2006 | volume= 79 | issue= 1 | pages= 31-40 | pmid=16773563 | doi=10.1086/504601 | pmc=1474133 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16773563  }}</ref><ref name="pmid29143201">{{cite journal| author=Burlina AB, Polo G, Salviati L, Duro G, Zizzo C, Dardis A | display-authors=etal| title=Newborn screening for lysosomal storage disorders by tandem mass spectrometry in North East Italy. | journal=J Inherit Metab Dis | year= 2018 | volume= 41 | issue= 2 | pages= 209-219 | pmid=29143201 | doi=10.1007/s10545-017-0098-3 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29143201  }}</ref>
*According to the 2009 Heart Failure Society of America, screening for Fabry's disease is recommended for all men with sporadic or non-autosomal transmission of <u>unexplained</u> [[cardiac hypertrophy]].<ref name="pmid19254666">{{cite journal| author=Hershberger RE, Lindenfeld J, Mestroni L, Seidman CE, Taylor MR, Towbin JA | display-authors=etal| title=Genetic evaluation of cardiomyopathy--a Heart Failure Society of America practice guideline. | journal=J Card Fail | year= 2009 | volume= 15 | issue= 2 | pages= 83-97 | pmid=19254666 | doi=10.1016/j.cardfail.2009.01.006 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19254666  }}</ref>
*There is insufficient evidence to recommend routine screening for [https://www.wikidoc.org/index.php/Fabry's%20disease Fabry's disease] in the dialysis population.


[[Category:Needs content]]
==References==
{{Reflist|2}}
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Latest revision as of 18:00, 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

According to National Society of Genetic Counselors, screening for Fabry's disease in the patient's family members is recommended. The early prenatal and newborn screening can be done by α-Gal A enzyme and GLA mutation analyses. Based on the American Heart Failure Society, Fabry's disease screening should be done in males with unexplained cardiac hypertrophy.

Screening

  • There is insufficient evidence to recommend routine newborn screening for Fabry's disease in the general population.
  • According to the National Society of Genetic Counselors, screening for Fabry's disease for family members of the affected individual is recommended by: 
  • According to the 2009 Heart Failure Society of America, screening for Fabry's disease is recommended for all men with sporadic or non-autosomal transmission of unexplained cardiac hypertrophy.[4]
  • There is insufficient evidence to recommend routine screening for Fabry's disease in the dialysis population.

References

  1. Kleijer WJ, Hussaarts-Odijk LM, Sachs ES, Jahoda MG, Niermeijer MF (1987). "Prenatal diagnosis of Fabry's disease by direct analysis of chorionic villi". Prenat Diagn. 7 (4): 283–7. doi:10.1002/pd.1970070409. PMID 3035532.
  2. Spada M, Pagliardini S, Yasuda M, Tukel T, Thiagarajan G, Sakuraba H; et al. (2006). "High incidence of later-onset fabry disease revealed by newborn screening". Am J Hum Genet. 79 (1): 31–40. doi:10.1086/504601. PMC 1474133. PMID 16773563.
  3. Burlina AB, Polo G, Salviati L, Duro G, Zizzo C, Dardis A; et al. (2018). "Newborn screening for lysosomal storage disorders by tandem mass spectrometry in North East Italy". J Inherit Metab Dis. 41 (2): 209–219. doi:10.1007/s10545-017-0098-3. PMID 29143201.
  4. Hershberger RE, Lindenfeld J, Mestroni L, Seidman CE, Taylor MR, Towbin JA; et al. (2009). "Genetic evaluation of cardiomyopathy--a Heart Failure Society of America practice guideline". J Card Fail. 15 (2): 83–97. doi:10.1016/j.cardfail.2009.01.006. PMID 19254666.