Brown et al. [10] studied pulmonary manifestations and pulmonary function test in 25 affected Fabry men. Shortness of breath on mild to moderate exertion was reported by 36% of the subjects and cough and wheezing were present in 24%. Nine patients (36%) had reduced FEV1/FVC ratio consistent with obstructive ventilatory impairment; four of the nine were nonsmokers. Forced expiratory time to deliver the middle half of the FVC (FEF25 – 75) was elevated in eight of these patients. The prevalence of obstructive impairment was strongly age-dependent, in parallel with the relationship found for extra-pulmonary symptoms [11].