Intravenous Thrombolysis for Acute Ischemic Stroke in Fabry Disease

Odysseas Kargiotis, Klearchos Psychogios, Apostolos Safouris, Pericles Kalyvas, Georgios Magoufis, Eleftherios Stamboulis, Georgios Tsivgoulis

Research output: Contribution to journalArticle

Abstract

Introduction:Fabry is a rare X-linked recessive genetic disease caused by galactosidase A deficiency. Cerebrovascular events occur in ∼13% of patients, whereas stroke may be the presenting clinical manifestation. There are very limited case reports of tissue plasminogen activator administration for acute ischemic stroke in patients with Fabry disease.Case report:A 46-year-old man presented with right-sided hemiparesis with a National Institutes of Health Stroke Scale score of 3. Brain computed tomography showed a hyperdense lesion resembling carvenous angioma. The patient received intravenous thrombolysis 265 minutes after symptom onset, with clinical improvement (discharge National Institutes of Health Stroke Scale score of 1). Brain magnetic resonance imaging disclosed acute thalamic infarction, cavernous angioma, and multiple cerebral microbleeds. The presence of skin angiokeratomas and cardiac hypertrophy prompted further positive investigation for Fabry disease (nondetectable galactosidase activity, excessively elevated lyso-Gb3, and pathogenic deletion in the GLA gene).Conclusion:The present case supports the scarce data underscoring the safety of intravenous thrombolysis for acute ischemic stroke in Fabry disease patients even when cerebral microbleeds are present.

Original languageEnglish (US)
Pages (from-to)146-149
Number of pages4
JournalNeurologist
Volume24
Issue number5
DOIs
StatePublished - Sep 1 2019

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Fabry Disease
Stroke
National Institutes of Health (U.S.)
X-Linked Genetic Diseases
Angiokeratoma
alpha-Galactosidase
Cavernous Hemangioma
Brain
Cardiomegaly
Paresis
Tissue Plasminogen Activator
Hemangioma
Infarction
Tomography
Magnetic Resonance Imaging
Safety
Skin
Genes

All Science Journal Classification (ASJC) codes

  • Clinical Neurology

Cite this

Kargiotis, O., Psychogios, K., Safouris, A., Kalyvas, P., Magoufis, G., Stamboulis, E., & Tsivgoulis, G. (2019). Intravenous Thrombolysis for Acute Ischemic Stroke in Fabry Disease. Neurologist, 24(5), 146-149. https://doi.org/10.1097/NRL.0000000000000241

Intravenous Thrombolysis for Acute Ischemic Stroke in Fabry Disease. / Kargiotis, Odysseas; Psychogios, Klearchos; Safouris, Apostolos; Kalyvas, Pericles; Magoufis, Georgios; Stamboulis, Eleftherios; Tsivgoulis, Georgios.

In: Neurologist, Vol. 24, No. 5, 01.09.2019, p. 146-149.

Research output: Contribution to journalArticle

Kargiotis, O, Psychogios, K, Safouris, A, Kalyvas, P, Magoufis, G, Stamboulis, E & Tsivgoulis, G 2019, 'Intravenous Thrombolysis for Acute Ischemic Stroke in Fabry Disease', Neurologist, vol. 24, no. 5, pp. 146-149. https://doi.org/10.1097/NRL.0000000000000241
Kargiotis O, Psychogios K, Safouris A, Kalyvas P, Magoufis G, Stamboulis E et al. Intravenous Thrombolysis for Acute Ischemic Stroke in Fabry Disease. Neurologist. 2019 Sep 1;24(5):146-149. https://doi.org/10.1097/NRL.0000000000000241
Kargiotis, Odysseas ; Psychogios, Klearchos ; Safouris, Apostolos ; Kalyvas, Pericles ; Magoufis, Georgios ; Stamboulis, Eleftherios ; Tsivgoulis, Georgios. / Intravenous Thrombolysis for Acute Ischemic Stroke in Fabry Disease. In: Neurologist. 2019 ; Vol. 24, No. 5. pp. 146-149.
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