The involvement of the aorta in Fabry disease (FD) is not uncommon, but the need for a surgical intervention and description of its potential results are rare. Pathology of the affected aortic wall is still unavailable. We report severe aortopathy caused by FD refractory to long-term (16-year agalsidase alpha) enzyme replacement therapy and progressing to a large aneurysm (56 mm) of the aortic root requiring surgical repair. We describe the pathology of the aortic wall, including globotriaosylceramide (Gb3) accumulation in the smooth muscle cells, large areas of fatty infiltration, and foci of lymphocytic inflammation as an immune-mediated reaction to Gb3 secretion.

Severe Aortopathy Caused by Fabry Disease

Russo, Matteo Antonio;Sansone, Luigi;Belli, Manuel;
2025-01-01

Abstract

The involvement of the aorta in Fabry disease (FD) is not uncommon, but the need for a surgical intervention and description of its potential results are rare. Pathology of the affected aortic wall is still unavailable. We report severe aortopathy caused by FD refractory to long-term (16-year agalsidase alpha) enzyme replacement therapy and progressing to a large aneurysm (56 mm) of the aortic root requiring surgical repair. We describe the pathology of the aortic wall, including globotriaosylceramide (Gb3) accumulation in the smooth muscle cells, large areas of fatty infiltration, and foci of lymphocytic inflammation as an immune-mediated reaction to Gb3 secretion.
2025
Aneurysms
Aorta
Aortopathy
Cardiomyocytes
Clinical pathology
Enzyme replacement therapy
Fabry disease
Inflammation
Left ventricle
Smooth muscle cells
Surgical pathology
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.12078/33867
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