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An inherited metabolic disorder that affects the lysosomal degradation of the spinhgolipids. Representative examples include Gaucher disease, Tay-Sachs disease, and Niemann-Pick disease.
No HPO annotations are available for this condition.
Age of onset: later in life.
Fabry disease encompasses a spectrum of phenotypes ranging from the severe classic phenotype to atypical late-onset forms. The late-onset forms are more common than the classic phenotype. However, in registries and publications individuals with the classic phenotype are overrepresented. Individuals with atypical Fabry disease present later in life and are underdiagnosed . Significant diagnostic delays are reported in the Fabry Outcome Survey (FOS) ; they are particularly common in females and may lead to avoidable complications . The FOS and the Fabry Registry, multicenter international initiatives designed to examine the natural history of Fabry disease and the effects of enzyme replacement therapy (ERT), are an important source of long-term data on the disease [, , , ].
Fabry disease typically affects more than one organ system and should be suspected in males and females with the following clinical features, particularly if more than one is present:
Vascular cutaneous lesions (angiokeratomas)
Periodic crises of severe pain in the extremities (acroparesthesia)
No approved treatments are currently available for sphingolipidosis. The disease remains an area of unmet medical need.
Evaluations Following Initial Diagnosis To establish the extent of disease and needs in an individual diagnosed with Fabry disease, the evaluations summarized (if not performed as part of the evaluation that led to the diagnosis) are recommended. Table 6. Recommended Evaluations Following Initial Diagnosis in Individuals with Fabry Disease
The following are general guidelines, and the frequency of evaluations should be adjusted based on disease severity and needs of the affected individual. Individuals receiving ERT are typically evaluated more frequently (e.g., every 6 months). Table 7. Recommended Surveillance for Individuals with Fabry Disease
2 clinical trials registered, 1 recruiting. Interventions under study include drug therapy, other interventions, and biologic therapy. Pipeline includes 1 PHASE2. Research is primarily sponsored by academic and government institutions.
33 publications have been identified in PubMed for sphingolipidosis. Research spans Basic Science / Preclinical (39%), Diagnostic / Biomarker (18%), and Gene Therapy / Novel Therapeutics (12%).
Research Type | Count | % of Total |
|---|---|---|
Laboratory research | 13 |
Data assembled from 5 of 12 sources · Last updated Sep 20, 2026, 12:11 PM UTC
European rare disease database
Genetic and Rare Diseases Info Center
Table 2.
Source: GeneReviews — "Fabry Disease"
Cornea verticillata (characteristic corneal opacity) and lenticular opacities
Unexplained left ventricular hypertrophy or cardiac arrhythmia
Unexplained stroke
Abdominal pain, nausea, and/or diarrhea of unknown etiology in young adulthood consistent with irritable bowel syndrome
Renal insufficiency of unknown etiology including unexplained proteinuria or microalbuminuria
Source: GeneReviews — "Fabry Disease"
Common misdiagnoses in individuals with Fabry disease are summarized in .
Table 3.
Common Misdiagnoses in Individuals with Fabry Disease
Fabry-Related Manifestation / Concern | Common Misdiagnoses
| "Growing pains"
Early-onset stroke1
Juvenile arthritis
Multiple sclerosis2
Petechiae
Raynaud syndrome
Rheumatic fever
Rheumatoid arthritis
Systemic lupus erythematosus
Pain assoc w/low-grade fever erythrocyte sedimentation rate | Erythromelalgia
Neurosis
Rheumatic fever
| Hypertrophic cardiomyopathy
| End-stage kidney disease3
Familial Mediterranean fever (assoc w/both pain renal involvement4
1. ,
2.
3. , ,
4. ,
Source: GeneReviews — "Fabry Disease"
Biomarker and diagnostic research for sphingolipidosis has been reported in the published literature.
System/Concern |
|---|
Evaluation |
|---|
Comment |
|---|
General | Assess for angiokeratomas, acroparesthesia, sweating abnormalities, abdominal pain, other GI symptoms, pulmonary vascular manifestations. | — |
Eyes | Ophthalmologic eval for ocular manifestations of Fabry disease | Cardiac |
Neurologic | Neurologic assessment | Brain MRI/MRA |
Renal | Renal function studies incl BUN, creatinine, urinalysis | — |
Hearing | Formal audiologic assessment | — |
Psychiatric | Assess for mood disturbance, anxiety, depression (using hospital anxiety depression scale). | Genetic |
counseling | By genetics professionals1 | To inform affected persons families re nature, MOI, implications of Fabry disease to facilitate medical personal decision making BUN = blood urea nitrogen; GI = gastrointestinal; MOI = mode of inheritance 1. |
Source: GeneReviews — "Fabry Disease"
The obstructive lung disease that has been documented in older hemizygous males and heterozygous females is more severe in smokers; therefore, affected individuals should be discouraged from smoking. Amiodarone has been reported to induce cellular and biochemical changes resulting in a phenocopy in particular of the keratopathy of Fabry disease . Given potential effects on cellular levels of -Gal A enzyme activity, it has been contraindicated in persons with Fabry disease. However, little evidence of a detrimental effect in this specific group exists and the relative benefit in individuals with cardiac arrhythmia should be considered.
Source: GeneReviews — "Fabry Disease"
Gene replacement therapy has been investigated in the mouse model of Fabry disease . Trials of ex vivo gene therapy via autologous stem cell transplantation and in vivo gene therapy using adeno-associated virus vectors are being studied in Europe and elsewhere . Systemic mRNA therapy is also being investigated . Alternative enzyme therapy. A PEGylated version of recombinant -Gal A with a longer circulating half-life is currently in a Phase III trial. A Phase II study of 16 individuals revealed an extended plasma half-life, reduction in peritubular capillary Gb3 inclusions, and stable renal function. Three individuals who initially developed anti-drug antibodies did not have detectable antibodies by one year of therapy .
Source: GeneReviews — "Fabry Disease"
2 trials found
System/Concern
Evaluation |
|---|
Frequency |
|---|
General | Assess for angiokeratomas, acroparesthesia, sweating abnormalities, gastrointestinal manifestations. | Annually starting by age ~7 yrs or earlier if symptomatic Assess for pulmonary vascular manifestations. |
Neurologic | Neurologic assessment | Annually Brain MRI/MRA |
Renal | Renal function studies incl BUN, creatinine, urinalysis | Annually beginning at age 18 yrs or more frequently as needed |
Hearing | Audiologic eval | Annually in males beginning at age 18 yrs; 2x/yr in females from age 18 to 35 yrs (more frequently if symptomatic) |
Psychiatric | Psychologic assessment | Annually beginning at age 18 yrs (or more frequently as needed) BUN = blood urea nitrogen |
Source: GeneReviews — "Fabry Disease"
Testing and diagnosis research | 6 | 18% |
New treatment approaches | 4 | 12% |
Research summaries | 3 | 9% |
Patient case studies | 3 | 9% |
Disease patterns and progression | 3 | 9% |
Clinical study results | 1 | 3% |
Mattern N (2026). [PMID: 41932416](https://pubmed.ncbi.nlm.nih.gov/41932416/). *Bone*. [Basic Science / Preclinical]
Tsutsumi N (2026). [PMID: 41783478](https://pubmed.ncbi.nlm.nih.gov/41783478/). *American journal of ophthalmology case reports*. [Case Report / Case Series]
Jovanovic VM (2026). [PMID: 41795546](https://pubmed.ncbi.nlm.nih.gov/41795546/). *Stem cell research*. [Case Report / Case Series]
Van Baelen A (2025). [PMID: 40806768](https://pubmed.ncbi.nlm.nih.gov/40806768/). *International journal of molecular sciences*. [Epidemiology / Natural History]
Omar A (2025). [PMID: 40883240](https://pubmed.ncbi.nlm.nih.gov/40883240/). *The Malaysian journal of pathology*. [Epidemiology / Natural History]
Zelada D (2025). [PMID: 41430252](https://pubmed.ncbi.nlm.nih.gov/41430252/). *Cell communication and signaling : CCS*. [Diagnostic / Biomarker]
Ducatez F (2025). [PMID: 39727194](https://pubmed.ncbi.nlm.nih.gov/39727194/). *Journal of clinical laboratory analysis*. [Gene Therapy / Novel Therapeutics]
Ludlaim AM (2025). [PMID: 39822020](https://pubmed.ncbi.nlm.nih.gov/39822020/). *Journal of inherited metabolic disease*. [Basic Science / Preclinical]
Guerra J (2025). [PMID: 40305757](https://pubmed.ncbi.nlm.nih.gov/40305757/). *Brain : a journal of neurology*. [Basic Science / Preclinical]
Dubot P (2025). [PMID: 38706107](https://pubmed.ncbi.nlm.nih.gov/38706107/). *Journal of inherited metabolic disease*. [Basic Science / Preclinical]