GLA and Nager acrofacial dysostosis: When a challenging interpretation of GLA mutations or starting therapy is controversial, an endomyocardial biopsy (EMB) may be required [75,76], providing definitive evidence of AFD by showing fine-granulated vacuolization through Sudan-black staining, concentric lamellar bodies formed by Gb3, and typical lysosomal inclusions or “zebra” bodies via electron microscopy.