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- Title
Immune-complex glomerulonephritis with a membranoproliferative pattern in Frasier syndrome: a case report and review of the literature.
- Authors
Matsuoka, Daisuke; Noda, Shunsuke; Kamiya, Motoko; Hidaka, Yoshihiko; Shimojo, Hisashi; Yamada, Yasushi; Miyamoto, Tsutomu; Nozu, Kandai; Iijima, Kazumoto; Tsukaguchi, Hiroyasu
- Abstract
<bold>Background: </bold>Mutations in the Wilms tumor 1 gene cause a spectrum of podocytopathy ranging from diffuse mesangial sclerosis to focal segmental glomerulosclerosis. In a considerable fraction of patients with Wilms tumor 1 mutations, the distinctive histology of immune-complex-type glomerulonephritis has been reported. However, the clinical relevance and etiologic mechanisms remain unknown.<bold>Case Presentation: </bold>A 5-year-old child presented with steroid-resistant nephrotic range proteinuria. Initial renal biopsy revealed predominant diffuse mesangial proliferation with a double-contour and coexisting milder changes of focal segmental glomerulosclerosis. Immunofluorescence and electron microscopy revealed a full-house-pattern deposition of immune complexes in the subendothelial and paramesangial areas. Serial biopsies at 6 and 8 years of age revealed that more remarkable changes of focal segmental glomerulosclerosis had developed on top of the initial proliferative glomerulonephritis. Identification of a de novo Wilms tumor 1 splice donor-site mutation in intron 9 (NM_024426.6:c.1447 + 4C > T) and 46,XY-gonadal dysgenesis led to the diagnosis of Frasier syndrome.<bold>Conclusions: </bold>Our findings, together with those of others, point to the importance of heterogeneity in clinicopathological phenotypes caused by Wilms tumor 1 mutations and suggest that immune-complex-mediated membranoproliferative glomerulopathy should be considered as a histological variant.
- Subjects
FOCAL segmental glomerulosclerosis; GLOMERULONEPHRITIS; NEPHROBLASTOMA; LITERATURE reviews; SYNDROMES; RENAL biopsy
- Publication
BMC Nephrology, 2020, Vol 21, Issue 1, pN.PAG
- ISSN
1471-2369
- Publication type
journal article
- DOI
10.1186/s12882-020-02007-0