Evidence map›Paper›PMID 32397962›Full record

ArticleBMC neurology2020

Fabry disease presenting as bilateral medial medullary infarction with a "heart appearance" sign: a case report.

Shuai Jiang, Lei Wang, Yuying Yan, Qiange Zhu, Jincheng Wan, Jiayu Sun, Bo Wu

Open access · goldAbstract readCase Reports
In one paragraph

Article in BMC neurology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.2field-weighted citation impact, top 46% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 5 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Shuai JiangDepartment of Neurology, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Chengdu, 610041, China.
Lei WangDepartment of Neurology, The Third People's Hospital of Chengdu, Chengdu, China.
Yuying YanDepartment of Neurology, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Chengdu, 610041, China.
Qiange ZhuDepartment of Neurology, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Chengdu, 610041, China.
Jincheng WanDepartment of Neurology, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Chengdu, 610041, China.
Jiayu SunDepartment of Radiology, West China Hospital, Sichuan University, Chengdu, China.
Bo WuDepartment of Neurology, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Chengdu, 610041, China. dragonwb@126.com.ORCID http://orcid.org/0000-0003-2067-9965
Sichuan University · CNThird People's Hospital of Chengdu · CN

Funding

National Natural Science Foundation of China 81671146National Natural Science Foundation of China 81870937
6 · The paper itself

Abstract

backgroundThe etiologic determinants of cryptogenic stroke remain a diagnostic challenge in clinical practice. Fabry disease (FD) is one of the monogenic causes of stroke that may remain unrecognized as a potential contributing causative factor, because of its rarity and difficulty in diagnosis. We report a case with rare bilateral medial medullary infarction manifesting as "heart appearance" who was diagnosed with FD. CASE PRESENTATION: A 51-year-old Chinese man presented with acute dysarthria and mild tetraparesis. In the 24 h following admission, the patient rapidly developed progressive flaccid quadriplegia and tongue weakness, necessitating ventilator support. Immediate magnetic resonance imaging of the brain showed heart-shaped appearance of bilateral medial medullary infarction. The patient suffered two new subcortical infarcts 40 days after the first. Detailed Family history and physical examination indicated symptoms consistent with FD, which was confirmed by very low alpha galactosidase A levels and a missense mutation of the alpha-galactosidase A gene.

conclusionsWe report what appears to be the first case of FD manifesting as bilateral medial medullary infarction. Our case suggests that clinicians should consider the possibility of FD in patients with cryptogenic stroke, especially when combined with infarction in the vertebrobasilar artery system, renal insufficiency, or cardiomyopathy. A detailed analysis of subtle historical clues and performing a complete physical examination on stroke patients would help promote earlier diagnosis of FD.

Indexed as

Fabry DiseaseHumansMagnetic Resonance ImagingMaleMedulla OblongataMiddle AgedStrokeBilateral medial medullary infarctionCase reportCryptogenic strokeFabry disease

Identifiers

PMID32397962
PMCPMC7216630
OpenAlexW3026154363

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.