Presentation
Gross: Kidneys are small at presentation due to cortical atrophy. Cysts congregate at the corticomedullary junction and range up to 1 cm in diameter (image A) and (image B). Cyst formation does not appear to progress as the disease progresses. [auanet.org]
Our study provides a rare presentation of NPHP3-related ciliopathy and adds to the mutation spectrum of the gene, being the first one from Pakistani population. [ncbi.nlm.nih.gov]
Presentation History A family history of consanguinity, early death, or renal disease is present in 67% of patients with nephronophthisis (NPH). [emedicine.medscape.com]
Infantile : bilateral disease due to cortical cysts with renal failure by 3 years of age; may have extrarenal presentation including retinitis pigmentosa, hepatic fibrosis, skeletal / CNS malformations, situs inversus, etc. [pathologyoutlines.com]
Entire Body System
- Pain
We ask about general symptoms (anxious mood, depressed mood, fatigue, pain, and stress) regardless of condition. Last updated: May 13, 2019 [patientslikeme.com]
[…] receptor blockers (ARBs), are used to control blood pressure Undertaking treatment of anemia Correction of vision abnormalities through corrective lenses, although progressive optical atrophy cannot be treated using such lenses Growth hormone therapy Pain [dovemed.com]
Surgery for vesicoureteral reflux 673 Chapter 45 Minimally invasive approaches to correct vesicoureteral reflux 687 Chapter 46 Injection therapy for vesicoureteral reflux 691 SECTION V 711 Chapter 47 Basic science of the urinary bladder 713 Chapter 9 Pain [books.google.com]
- Infertility
Gastrointestinal bleeding, ulcers Hemorrhage (excessive bleeding) High blood pressure Hyponatremia (low blood sodium level) Hyperkalemia (too much potassium in the blood), especially with end-stage kidney disease Hypokalemia (too little potassium in the blood) Infertility [medlineplus.gov]
"In a disease called Bardet-Biedl Syndrome, patients have a combination of nephronophthisis with retinitis pigmentosa, but also diabetes mellitus, obesity, infertility and mental retardation," says Hildebrandt. [sciencedaily.com]
Table 1 shows list of genes searched with term ‘NPHP’, ‘SLSN’, ‘JBTS’, ‘MKS’ and ‘Bardet-Biedl syndrome (BBS, syndrome of NPHP, RP, obesity, polydactyly, cognitive impairment, and male infertility)’, representatives of NPHP-RC. [chikd.org]
Pleiotropic phenotypes in NPHP or BBS include cystic kidney disease, retinitis pigmentosa, infertility, diabetes, and other diseases of premature aging of organs. [doi.org]
- Weight Loss
loss Seizures Confusion, decreased alertness, coma There is no cure for ADTKD. [medlineplus.gov]
Gastrointestinal
- Vomiting
[…] bruising or bleeding Fatigue, weakness Frequent hiccups Headache Increased skin color (skin may appear yellow or brown) Itching Malaise (general ill feeling) Muscle twitching or cramps Nausea Pale skin Reduced sensation in the hands, feet, or other areas Vomiting [medlineplus.gov]
Skin
- Dermatitis
Página 54 - Pedigree demonstrating a sex-linked recessive condition characterized by draining ears, eczematoid dermatitis and bloody diarrhea. Página 51 - Selective IgA deficiency: presentation of 30 cases and a review of the literature. [books.google.es]
Neurologic
- Cerebellar Ataxia
Cerebellar ataxia (Joubert's syndrome). Liver fibrosis. Differential diagnosis Polycystic kidney disease Chronic pyelonephritis Urinary tract obstruction Investigations Hyponatraemia may occur if sodium intake is reduced for any reason. [patient.info]
NPHP is a therefore considered to be a ciliopathy, and can be part of a broad spectrum of clinical disease that includes extra-renal manifestations including retinal degeneration, cerebellar ataxia, liver fibrosis and situs inversus. [thieme-connect.com]
ataxia, bone anomalies and liver fibrosis Juvenile subtype associated with mutations in NPHP1 ( OMIM 256100 ) (chromosome 2q), 4 (chromosome 1p) Infantile subtype associated with NPHP2 (chromosome 9q) Adolescent subtype associated with NPHP3 (chromosome [pathologyoutlines.com]
Some children present with extrarenal symptoms: tapetoretinal degeneration (as in Senior-Loken syndrome, see this term), intellectual deficiency, cerebellar ataxia, bone anomalies or liver involvement. [rarediseases.info.nih.gov]
Urogenital
- Kidney Failure
leading to chronic kidney disease with kidney failure. [merckmanuals.com]
The disorder is inherited in an autosomal recessive fashion and, although rare, is the most common genetic cause of childhood kidney failure. It is a form of ciliopathy. [en.wikipedia.org]
The treatment is focused on decreasing the progression of nephronophthisis to kidney failure and treating the symptoms. [dovemed.com]
Kidney failure Spasticity Underdeveloped cerebellum Weak arms Weak legs Prevention - Nephronophthisis familial adult spastic quadriparesis Not supplied. [checkorphan.org]
Workup
Genetic analysis is highly indicated in order to identify causative mutations, assist with further syndromatic workup and help with prognosis. [renalandurologynews.com]
Treatment
Treatment of Adolescent Nephronophthisis is based on the type and severity of symptoms. [dovemed.com]
Always seek professional medical advice about any treatment or change in treatment plans. Kidney transplant Resources - Nephronophthisis familial adult spastic quadriparesis Not supplied. [checkorphan.org]
545 Dialysis ultrafiltration and hemofiltration 555 Use of drugs in uremia and dialysis 567 Donor and recipient selection in renal transplantation 587 Immunosuppression and treatment of rejection in renal transplantation 595 XIII 606 Renal tubular and [books.google.com]
Thorough review of the clinical phenotypes, their presentations, treatment, potential complications of, and prognosis is discussed. [books.google.ro]
Prognosis
(Outcomes/Resolutions) The prognosis of Adolescent Nephronophthisis is typically guarded. [dovemed.com]
Thorough review of the clinical phenotypes, their presentations, treatment, potential complications of, and prognosis is discussed. [books.google.ro]
Treat associated renal failure - usually haemodialysis followed by renal transplantation (the illness does not recur in the transplanted kidney). [ 1, 2 ] Prognosis Most children will develop renal failure by mean age of 13 years. [patient.info]
Etiology
KIAA0678 was considered a good functional candidate gene for NPH3 and SLS3, because molecular cha- perones are involved in the etiology of renal and retinal diseases. Analysis of the genomic structure of KIAA0678 identified 25 exons. [ncbi.nlm.nih.gov]
Etiology Five genes associated with the disease have been identified. The first gene, NPHP1, has been mapped to chromosome 2q13. [rarediseases.info.nih.gov]
Chapter 41 Laparoscopic management of duplication anomalies 649 anatomic and functional basis of etiology 655 Chapter 43 Nonsurgical management of vesicoureteral reflux 663 Chapter 44 Surgery for vesicoureteral reflux 673 Chapter 45 Minimally invasive [books.google.com]
Epidemiology
[…] recessive and patients develop end-stage renal failure (ESRF) by adolescence. [ 1, 2 ] The protein products, named nephrocystins, which become abnormal in this disorder, have primarily a function in cilial structures (making it a ' ciliopathy '). [ 3 ] Epidemiology [patient.info]
[…] general Group of autosomal recessive disorders characterized by corticomedullary cysts, atrophy and interstitial fibrosis "Phthisis" (Greek): dwindling or wasting away Also referred to as juvenile nephronophthisis medullary cystic kidney disease complex Epidemiology [pathologyoutlines.com]
Epidemiology: 10% of children with end-stage renal disease are suffering from nephronophthisis Nephronophthisis is the most common form of inherited renal failure before the age of 30 years. [urology-textbook.com]
Epidemiology Prevalence is 1/100 000 individuals. Clinical description The disease is both clinically and genetically heterogeneous. Three main clinical forms have been described. [rarediseases.info.nih.gov]
Summary Epidemiology Prevalence is 1/100 000 individuals. Clinical description The disease is both clinically and genetically heterogeneous. Three main clinical forms have been described. [orpha.net]
Pathophysiology
Fibrocystic Diseases of the Liver will be an invaluable resource for hepatologists, gastroenterologists, nephrologists, and hepatic surgeons who care for children and adults with liver disease, as well as basic scientists in molecular genetics, hepatobiliary pathophysiology [books.google.ro]
All diseases mentioned above ground on the same pathophysiological mechanism: the genes causing renal cysts encode for proteins in the primary cilium, a cellular antennae like organelle projecting from the cell surface of most cells. [neocyst.de]
Prevention
Currently, there are no specific methods or guidelines to prevent the Adolescent Nephronophthisis, since it is a genetic condition Genetic testing of the expecting parents (and related family members) and prenatal diagnosis (molecular testing of the fetus [dovemed.com]
"Mutations in NPHP genes prevent cilia from functioning properly, causing damage that leads to kidney disease." These important sensors aren't confined to the kidneys, however. [sciencedaily.com]
Anemia Excessive urination Excessive thirst Causes - Nephronophthisis familial adult spastic quadriparesis Abnormal kidney development Anemia Excessive thirst Excessive urination Kidney failure Spasticity Underdeveloped cerebellum Weak arms Weak legs Prevention [checkorphan.org]
The electrolyte loss prevents hypertension. End-stage renal disease occurs 5–10 years after onset of symptoms. Infantile nephronophthisis Infantile nephronophthisis leads to end-stage renal disease before the age of 5 years. [urology-textbook.com]