Presened by Michael Arad MD, Heart Failure Institute, Leviev Heart Center, Sheba Hospital and Tel Aviv University, Israel
The delicate macular rash which persisted over years on the palms of this 44 years old male is angiokeratoma. Other disease manifestations include postural instability with white matter lesions on brain MRI, proteinuria, peripheral neuropathy, lymphedema but no cardiomyopathy. The patient was diagnosed with Fabry disease at age of 16. Enzyme therapy with Replagal was started at 33 years.
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