A Perihilar Variant of Focal Segmental Glomerulosclerosis Due to &lt;i&gt;De novo&lt;/i&gt; Branchio-oto-renal Syndrome

Saiki, Ryosuke; Katayama, Kan; Kitano, Masako; Tsujimoto, Koichi; Tanaka, Fumika; Suzuki, Yasuo; Murata, Tetsuya; Kurita, Tokika; Okamoto, Ryuji; Takeuchi, Kazuhiko; Dohi, Kaoru

doi:10.2169/internalmedicine.8508-21

Cited by 1 publication

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References 12 publications

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“… 2015 [ 14 ] 35-M Familial - RH (R + L) Glomerular sclerosis. 2021 [ 15 ] 32-M Sporadic Normal eGFR RH (R) Larger glomerulus (295.4 μm); Focal mesangial proliferation; arteriolosclerosis; focal effacement of the foot process; focal weak granular deposits of IgA and IgM. Dashes represent data non-available.…”

Section: Discussionmentioning

confidence: 99%

Misdiagnosed Branchio-Oto-Renal syndrome presenting as proteinuria and renal insufficiency with insidious signs since early childhood: a report of three cases

Lin,

Li,

Pei

et al. 2023

BMC Nephrol

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Background Branchio-oto-renal (BOR) syndrome is an inherited multi-systemic disorder. Auricular and branchial signs are highly suggestive of BOR syndrome but often develop insidiously, leading to a remarkable misdiagnosis rate. Unlike severe morphological abnormalities of kidneys, knowledge of glomerular involvement in BOR syndrome were limited. Case presentation Three cases, aged 8 ~ 9 years, visited pediatric nephrology department mainly for proteinuria and renal insufficiency, with 24-h proteinuria of 23.8 ~ 68.9 mg/kg and estimated glomerular filtration rate of 8.9 ~ 36.0 mL/min/1.73m2. Moderate-to-severe albuminuria was detected in case 1, while mixed proteinuria was detected in case 2 and 3. Insidious auricular and branchial fistulas were noticed, all developing since early childhood but being neglected previously. EYA1 variants were confirmed by genetic testing in all cases. Delay in diagnosis was 8 ~ 9 years since extra-renal appearances, and 0 ~ 6 years since renal abnormalities. In case 1, therapy of glucocorticoid and immunosuppressive agents to accompanying immune-complex mediated glomerulonephritis was unsatisfying. Conclusions BOR syndrome is a rare cause of proteinuria and abnormal kidney function and easily missed, thus requiring more awareness. Careful medical history taking and physical examination are essential to early diagnosis. Massive proteinuria was occasionally seen in BOR syndrome, which might be related to immune complex deposits. A novel pathogenic variant (NM_000503.6 (EYA1): c.1171delT p.Ser391fs*9) was firstly reported.

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