The CoQ10 enzyme has several vital roles in the human body. CoQ10 deficiency can lead to many clinical manifestations including the steroid-resistant nephrotic syndrome. At least 16 genes work together to facilitate the correct synthesis of CoQ10, one of which is CoQ8B. We report the case of a 14-year-old male with a rare homozygous variant, who presented with late severe nephrotic syndrome and bilateral small dysplastic kidneys. This report will also describe the comprehensive and systemic workup that is needed in these patients. We conclude that physicians need to consider renal causes in their workup of any unexplained oedema in children and that in such cases, screening for rarer genetic causes should be considered in a country such as Saudi Arabia, given the relatively high rates of consanguinity here.

Group B streptococcal (GBS) infection is one of the leading causes of neonatal sepsis worldwide. Despite a significant decline in early-onset (EOS) sepsis due to intrapartum antibiotic prophylaxis, the incidence of late-onset (LOS) infection has remained unchanged. However, LOS GBS sepsis affecting twins is very rare. We report on preterm twins born at 29 weeks of gestation: Twin B was 31 days old when he developed LOS GBS sepsis and meningitis, and Twin A was 35 days old when he developed LOS GBS sepsis. Tests for maternal GBS colonization in breast milk were negative. Both babies were treated with antibiotics and eventually discharged without complications.