Repeat Cardiac Transplant Indicated by Severe Cardiac Allograft Vasculopathy in a Patient With Danon Disease

Rev Cardiovasc Med. 2018 Jun 30;19(2):69-71. doi: 10.31083/j.rcm.2018.02.903.

Abstract

Danon disease is a rare, X-linked dominant, lysosomal storage disorder, presenting with cardiomyopathy mostly in adolescent men. Male patients face a high mortality rate and rarely live to the age of 25 years unless they receive a heart transplant. Because they generally undergo heart transplantation at a young age, many patients ultimately face both short- and long-term complications. We present a 32-year-old man diagnosed with Danon disease; a nonsense mutation in the LAMP-2 gene. Progressive heart failure symptoms resulted in initial heart transplant at age 27 years. He subsequently developed severe cardiac allograft vasculopathy that led to graft failure requiring a redo orthotopic heart transplant. This is one of only two reported Danon disease cases described to date surviving repeat orthotopic heart transplants. We present this case to highlight the importance of heart transplantation in the management of Danon disease, to emphasize the risk of cardiac allograft vasculopathy post-transplant, and to discuss management strategies.

Keywords: Danon disease; cardiac allograft vasculopathy; cardiac transplantation.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / etiology
  • Coronary Artery Disease / surgery*
  • Genetic Predisposition to Disease
  • Glycogen Storage Disease Type IIb / diagnosis
  • Glycogen Storage Disease Type IIb / genetics
  • Glycogen Storage Disease Type IIb / surgery*
  • Heart Failure / diagnosis
  • Heart Failure / genetics
  • Heart Failure / surgery*
  • Heart Transplantation / adverse effects*
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Lysosomal-Associated Membrane Protein 2 / genetics
  • Male
  • Mutation, Missense
  • Phenotype
  • Reoperation
  • Severity of Illness Index
  • Treatment Failure
  • Ultrasonography, Interventional

Substances

  • Immunosuppressive Agents
  • LAMP2 protein, human
  • Lysosomal-Associated Membrane Protein 2