Farber disease is an extremely rare genetic disorder first described by Farber in 1957. It is also known as Farber's lipogranulomatosis, ceramidase deficiency, fibrocytic dysmucopolysaccharidosis and lipogranulomatosis. It is characterised by the deficiency of ceramidase, an enzyme that normally breaks down fatty material in our body’s cells.
Farber disease is a genetic disease that arises due to a mutation in the ASAH1 gene responsible for making an enzyme called ceramidase. This leads to an increased accumulation of ceramide, a lipid molecule normally digested by ceramidase, in several organs and tissues. Abnormal accumulation leads to the clinical features of the disease. The severity and the extent of organ involvement may vary from person to person.
The disease passes down through families in an autosomal recessive pattern, i.e. two copies of the abnormal gene must be present for the disease to develop.
Joints, liver, throat, tissues and central nervous system are affected. The usual onset of the disease is before the age of one year.
Children with serious nervous system involvement may die early in infancy. Others may survive up to the third or fourth decade of life with abnormalities. No specific treatment is available as yet.
References:1. Case report: Farber's disease (lysosomal acid ceramidase deficiency) R A JAMESON, P J L HOLT, AND J H KEEN From Booth Hall Children's Hospital, Manchester, Annals of the Rheumatic Diseases, 1987; 46, 559-561
2. Farber S: A lipid metabolic disorder: disseminated lipogranulomatosis: a syndrome with similarity to, and important difference from, Niemann-Pick and Hand-Schüller-Christian disease. American Journal of Diseases in Childhood 1952, 84(4):499-500
3. Farber S, Cohen J, Uzman LL: Lipogranulomatosis: a new lipo-glycoprotein storage disease. Journal of Mt Sinai Hospital N Y 1957, 24(6):816-837.
4. Farber disease: clinical presentation, pathogenesis and a new approach to treatment. Karoline Ehlert, Michael Frosch, Natalja Fehse, Axel Zander, Johannes Roth and Josef Vormoor Pediatric Rheumatology 2007, 5:15
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