skip to main content

Fabry disease stroke — SCE Neurology MCQ

Instant feedback + full explanation. One question, done properly.

HardNeurogeneticsFabry disease strokeSCE Neurology

A man has burning acroparesthesias, angiokeratomas, reduced sweating, renal impairment and a premature posterior-circulation stroke. Several maternally related male relatives had renal or cardiac disease. What is the best diagnostic test?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: AAlpha-galactosidase A activity with confirmatory GLA testing

The best answer is “Alpha-galactosidase A activity with confirmatory GLA testing”. The multisystem X-linked phenotype is Fabry disease; low alpha-galactosidase A activity is informative in an affected man and GLA analysis confirms the diagnosis and supports cascade testing. “NOTCH3 sequencing for an inherited small-vessel disorder” is less appropriate because CADASIL does not explain angiokeratomas, hypohidrosis and renal disease “Serum copper and caeruloplasmin with urinary copper testing” is less appropriate because copper testing addresses Wilson disease rather than this X-linked lysosomal phenotype “HTT CAG-repeat analysis for an inherited movement disorder” is less appropriate because Huntington disease causes chorea and neuropsychiatric decline “Serum AQP4-IgG using a validated cell-based assay” is less appropriate because AQP4 autoimmunity causes inflammatory optic-spinal attacks rather than lifelong systemic storage disease

Reference: GeneReviews: Fabry Disease. https://www.ncbi.nlm.nih.gov/books/NBK1292/