follow-up of two children with basement membrane abnormalities

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Sirs, We would like to report the follow-up of two children aged 10 months and 15 months who presented with nephrotic-range proteinuria. Kidney biopsy revealed Al- port-like abnormalities, namely basket-weave appear- ance with thickening and splitting of the lamina densa of basement membrane on electron microscopy. Light mi- croscopy was unremarkable in both these patients. We have published these cases previously in Pediatric Neph- rology [1]. Currently both the boys, now 10.5 years and 11 years of age, are well. One has no proteinuria, edema, azote- mia, or hypertension with normal growth. The other has nephrotic-range proteinuria (urinary protein to creatinine ratio between 4 and 5 mg/mg), but has no edema, azote- mia, or hypertension, and has normal growth parameters. The boy with proteinuria has been receiving oral enala- pril for the last 4 years. We have not repeated the kidney biopsies. Neither boy has developed hematuria, deafness, or eye abnormalities described in Alport syndrome. It was interesting to read a report by Akhtar and Sabban [2] of a similar case in a 17-year-old Saudi girl, and we wanted to share our experience with readers. There must be more cases with basement membrane ab- normalities that were thought to be characteristic of Al- port syndrome in other glomerular diseases. References 1. Mehta KP, Ali US, Chitale AR, Jha U, Khubchandani S (1993) Glomerular basement membrane abnormalities in infants with heavy proteinuria. Pediatr Nephrol 7:401–403 2. Akhtar M, Al-Sabban E (2000) Alport-like glomerular changes in a patient with nephrotic syndrome: report of a case. Pediatr Nephrol 14:973–975 K.P. Mehta ( ) · U. Ali Nephrology Division, Bai Jerbai Wadia Hospital for Children and Research Center, Mumbai-400 012, India Pediatr Nephrol (2001) 16:688 © IPNA 2001 LETTER TO THE EDITORS Kumud P. Mehta · Uma Ali Follow-up of two children with basement membrane abnormalities

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Sirs,We would like to report the follow-up of two childrenaged 10 months and 15 months who presented withnephrotic-range proteinuria. Kidney biopsy revealed Al-port-like abnormalities, namely basket-weave appear-ance with thickening and splitting of the lamina densa ofbasement membrane on electron microscopy. Light mi-croscopy was unremarkable in both these patients. Wehave published these cases previously in Pediatric Neph-rology [1].

Currently both the boys, now 10.5 years and 11 yearsof age, are well. One has no proteinuria, edema, azote-mia, or hypertension with normal growth. The other hasnephrotic-range proteinuria (urinary protein to creatinineratio between 4 and 5 mg/mg), but has no edema, azote-

mia, or hypertension, and has normal growth parameters.The boy with proteinuria has been receiving oral enala-pril for the last 4 years. We have not repeated the kidneybiopsies. Neither boy has developed hematuria, deafness,or eye abnormalities described in Alport syndrome.

It was interesting to read a report by Akhtar and Sabban [2] of a similar case in a 17-year-old Saudi girl,and we wanted to share our experience with readers.There must be more cases with basement membrane ab-normalities that were thought to be characteristic of Al-port syndrome in other glomerular diseases.

References

1. Mehta KP, Ali US, Chitale AR, Jha U, Khubchandani S (1993)Glomerular basement membrane abnormalities in infants withheavy proteinuria. Pediatr Nephrol 7:401–403

2. Akhtar M, Al-Sabban E (2000) Alport-like glomerular changesin a patient with nephrotic syndrome: report of a case. PediatrNephrol 14:973–975

K.P. Mehta (✉ ) · U. AliNephrology Division, Bai Jerbai Wadia Hospital for Children and Research Center, Mumbai-400 012, India

Pediatr Nephrol (2001) 16:688 © IPNA 2001

L E T T E R T O T H E E D I T O R S

Kumud P. Mehta · Uma Ali

Follow-up of two children with basement membrane abnormalities