PMID: 9648150Jul 2, 1998Paper

Glomerulopathy in Denys-Drash syndrome. Case report of a model disease

Der Pathologe
T StallmachS Hailemariam

Abstract

About 10% of all nephroblastomas (Wilms' tumor) present as part of malformation syndromes. The Denys-Drash syndrome (DDS) comprises pseudohermaphroditism, glomerulopathy and, early, often bilateral Wilms' tumors. A nephrectomy was performed in a 4-month-old girl because of a Wilms' tumor. Two months later, low serum albumin levels and proteinuria had developed. A biopsy from the remaining kidney showed a glomerulopathy which could also be seen in the nephrectomy specimen. The morphology was highly characteristic: the innermost layer of the kidney cortex exhibited augmentation of the mesangial matrix only; the intermediate layer showed severe sclerosis of glomeruli with deposition of fibrillary material; and the subcapsular layer revealed very small glomeruli and atrophic tubuli. Fifteen months later, peritoneal dialysis was necessary and due to the high risk of tumor development in the remaining kidney, a nephrectomy was performed. Molecular analysis revealed a point mutation within exon 9 of the WT1 gene (394 ARG-->TRP), which was homozygous in the tumor and heterozygous within renal parenchyma. The DDS is caused by a mutation in the WT1 gene on chromosome 11p13 which occurs during oogenesis or spermiogenesis. The WT1 gene is ...Continue Reading

Citations

Dec 11, 2008·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Ana Pilar Nso RocaMercedes Navarro
Jan 28, 2006·Pediatric Research·Bettina MuchaUNKNOWN Members of the APN Study Group

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