Renal involvement in a patient with the chronic visceral subtype of acid sphingomyelinase deficiency resembles Fabry disease. Issue 1 (26th July 2021)

• Record Type: Journal Article
• Authors: Eskes, Eline C. B.; van der Lienden, Martijn J. C.; Roelofs, Joris J. T. H.; Vogt, Liffert; Aerts, Johannes M. F. G.; Aten, Jan; Hollak, Carla E. M.
• Is Part Of: JIMD reports. Volume 62:Issue 1(2021)
• Page Start: 15
• Page End: 21
• Publication Date: 2021-07-26
• Subjects: acid sphingomyelinase deficiency -- Fabry disease -- Gaucher disease -- histopathology -- Niemann‐Pick disease -- renal manifestations; Metabolism, Inborn errors of -- Periodicals; Metabolism -- Disorders -- Periodicals; 616.39042
• DOI: 10.1002/jmd2.12242
• Languages: English
• ISSNs: 2192-8304

Abstract

Abstract: Acid sphingomyelinase deficiency (ASMD) is a lysosomal storage disease (LSD) in which sphingomyelin accumulates due to deficient acid sphingomyelinase. In the chronic visceral subtype, organ manifestations are generally limited to the spleen, liver, and lungs. We report a male patient with the chronic visceral subtype who developed proteinuria and renal insufficiency at the age of 49. In renal tissue, foam cells were observed in the glomeruli as well as sphingomyelin accumulation within podocytes, mesangial cells, endothelial cells, and tubular epithelial cells. Although macrophages are the primary storage cells in both ASMD and Gaucher disease, comparison to the histopathological findings in Gaucher and Fabry disease revealed a diffuse storage pattern in multiple renal cell types, closer resembling the pattern found in Fabry disease.