A case report and literature study on Alport syndrome featuring nephrotic syndrome as its primary manifestation.

Alport syndrome COL4A5 gene Children Kidney failure Nephrotic syndrome

Journal

Transplant immunology
ISSN: 1878-5492
Titre abrégé: Transpl Immunol
Pays: Netherlands
ID NLM: 9309923

Informations de publication

Date de publication:
Dec 2023
Historique:
received: 06 07 2023
revised: 07 10 2023
accepted: 19 10 2023
pubmed: 23 10 2023
medline: 23 10 2023
entrez: 22 10 2023
Statut: ppublish

Résumé

Historically, due to the lack of distinct clinical symptoms, Alport syndrome, a hereditary kidney disease prevalent in children and a leading cause of kidney failure, has often been misdiagnosed as other kidney conditions. This article presents a comprehensive review and analysis of clinical data concerning a child diagnosed with Alport syndrome, where nephrotic syndrome served as the primary manifestation. The male child in this case exhibited symptoms starting at the age of 6, initially diagnosed as nephrotic syndrome. Consequently, oral steroid medication was administered, proving ineffective. Due to persistent proteinuria and microscopic hematuria, a renal biopsy was performed. Immunofluorescence staining revealed no abnormal expression of the α3, α4, and α5 chains of type IV collagen. Notably, electron microscopy revealed the basement membrane to be partially torn and arachnoid. Genetic testing indicated a hemizygous COL4A5 acceptor-splice-site mutation c.4707-1(IVS50)G > A, inherited from his mother. This specific mutated locus, being the first of its kind reported, adds valuable information to the existing gene mutation spectrum of Alport syndrome. Consequently, it emphasizes the importance for clinicians to deepen their understanding of rare kidney diseases, contributing to enhanced diagnostic accuracy and improved patient care.

Sections du résumé

BACKGROUND BACKGROUND
Historically, due to the lack of distinct clinical symptoms, Alport syndrome, a hereditary kidney disease prevalent in children and a leading cause of kidney failure, has often been misdiagnosed as other kidney conditions.
CASE DESCRIPTION METHODS
This article presents a comprehensive review and analysis of clinical data concerning a child diagnosed with Alport syndrome, where nephrotic syndrome served as the primary manifestation. The male child in this case exhibited symptoms starting at the age of 6, initially diagnosed as nephrotic syndrome. Consequently, oral steroid medication was administered, proving ineffective. Due to persistent proteinuria and microscopic hematuria, a renal biopsy was performed. Immunofluorescence staining revealed no abnormal expression of the α3, α4, and α5 chains of type IV collagen. Notably, electron microscopy revealed the basement membrane to be partially torn and arachnoid. Genetic testing indicated a hemizygous COL4A5 acceptor-splice-site mutation c.4707-1(IVS50)G > A, inherited from his mother.
CONCLUSION CONCLUSIONS
This specific mutated locus, being the first of its kind reported, adds valuable information to the existing gene mutation spectrum of Alport syndrome. Consequently, it emphasizes the importance for clinicians to deepen their understanding of rare kidney diseases, contributing to enhanced diagnostic accuracy and improved patient care.

Identifiants

pubmed: 37866673
pii: S0966-3274(23)00158-2
doi: 10.1016/j.trim.2023.101941
pii:
doi:

Types de publication

Case Reports

Langues

eng

Sous-ensembles de citation

IM

Pagination

101941

Informations de copyright

Copyright © 2023. Published by Elsevier B.V.

Auteurs

Zhuo Deng (Z)

Department of Pediatrics, the Affiliated Hospital of Southwest Medical University, Luzhou 646000, China.

Qi Zhou (Q)

Department of Pediatrics, the Affiliated Hospital of Southwest Medical University, Luzhou 646000, China.

Tai-Guang Zhou (TG)

Department of Pediatrics, the Affiliated Hospital of Southwest Medical University, Luzhou 646000, China. Electronic address: zhoutaiguangzz8@126.com.

Classifications MeSH