Brain MRI findings in children and adolescents with Fabry disease

• Published in: Journal of the neurological sciences 2018-12, Vol.395, p.131-134
• Main Authors: Marchesoni, C., Cisneros, E., Pfister, P., Yáñez, P., Rollan, C., Romero, C., Kisinovsky, I., Rattagan, L., León Cejas, L., Pardal, A., Sevlever, G., Reisin, R.
• Format: Article
• Language: English
• Subjects: Adolescent; Brain - diagnostic imaging; Cerebral Hemorrhage - diagnostic imaging; Cerebral Hemorrhage - genetics; Child; Childhood; Cohort Studies; Diagnosis, Differential; Fabry Disease - diagnostic imaging; Fabry Disease - genetics; Female; Humans; Lysosomal; Magnetic Resonance Imaging; Male; Stroke; Vascular lesions; White matter; White Matter - diagnostic imaging; Young Adult
• ISSN: 0022-510X; 1878-5883
• DOI: 10.1016/j.jns.2018.10.009

To evaluate the presence of white matter and hemorrhagic lesions in brain MRI of children and adolescents with Fabry disease (FD). Brain MRI studies in 44 consecutive children and teenagers (20 boys, mean age 14.6 years, range 7–21 years) were evaluated using classic sequences as well as, GRE-weighted images, for white matter lesions (WML) and chronic microbleed detection. All patients lacked history of stroke or TIA. Brain MRI findings in 46 consecutive children and adolescents without FD, referred for the evaluation of headaches (36 females, mean age 14.1 years, range 7–21 years) were evaluated as a control group. Additionally, we assessed the clinical manifestations of FD. Seven children (15.9%) with FD had brain MRI evidence of asymptomatic WML (5 girls, mean age 14.8 years, range: 13–20 years) compared with 3 children (6.5%) in the control group (p = 0.01). Brain abnormalities in patients with FD revealed WML, deep gray matter and infratentorial involvement. Three patients presented two lesions each. None of the children showed microbleeds. Regarding clinical manifestations, 90.9% of the patients had signs or symptoms of FD. We identified asymptomatic white matter brain lesions in 15.9% of children with FD without clinical history of stroke. FD is a treatable disorder that should be routinely included in the differential diagnosis of both symptomatic and asymptomatic brain lesions in children and adolescents. The detection of brain lesions may foster earlier treatment. •Young patients with Fabry Disease may present silent vascular brain lesions.•Only non-hemorrhagic white matter and deep gray matter lesions were identified.•Fabry Disease should be considered when white matter lesions are found in children.•Brain lesions in Fabry Disease may foster an earlier treatment.