CEN Case Reports

, Volume 6, Issue 2, pp 148–151 | Cite as

Urinary mulberry cells and mulberry bodies are useful tool to detect late-onset Fabry disease

  • Homare ShimohataEmail author
  • Hiroshi Maruyama
  • Yasunori Miyamoto
  • Mamiko Takayasu
  • Kouichi Hirayama
  • Masaki Kobayashi
Case report


Fabry disease is an X-linked lysosomal storage disorder caused by a lack of α-galactosidase A activity, which leads to the accumulation of globotriaosylceramide in various organs. A complete lack of α-galactosidase A activity in a hemizygous male is the classical phenotype, and some hemizygous males show primarily cardiac and/or renal symptoms that appear in adulthood; this is called the variant type or the late-onset type. The kidney and heart are the major target organs, with damage to these organs related to mortality. Thus, in Fabry patients, early detection and early treatment are critical to longevity. Here, we present a 55-year-old Japanese male patient who was diagnosed with late-onset Fabry nephropathy with cardiomyopathy but with no abnormal urinary findings except for urinary mulberry cells and mulberry bodies. In spite of the absence of abnormal urinary findings, the light microscopic and electron microscopic pathological findings showed extensive deposition of globotriaosylceramide to podocytes. In this paper, we propose that the presence of mulberry cells and mulberry bodies can be used for the earlier detection of Fabry nephropathy, especially the late-onset type.


Fabry nephropathy Late-onset Mulberry bodies Mulberry cells 


Compliance with ethical standards

Conflict of interest

The authors have declared that no conflict of interest exists.

Human and animal rights

This article does not contain any studies with human participants performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Japanese Society of Nephrology 2017

Authors and Affiliations

  1. 1.Department of NephrologyTokyo Medical University Ibaraki Medical CenterInashikiJapan

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