Document Detail


Prenatal findings in four consecutive pregnancies with fetal Pierson syndrome, a newly defined congenital nephrosis syndrome.
MedLine Citation:
PMID:  16450351     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To describe the prenatal findings in Pierson syndrome, a newly defined autosomal recessive entity, comprising congenital nephrotic syndrome (CNS) with diffuse mesangial sclerosis and distinct eye abnormalities due to LAMB2 mutations. METHODS: Serial prenatal ultrasound examinations were performed in four consecutive pregnancies affected by Pierson syndrome in the same family. LAMB2 mutations were demonstrated in retrospect by direct sequencing of the gene in the newborn index patient and three abortuses. RESULTS: Fetal ultrasound consistently revealed marked renal hyperechogenicity associated with variable degree of pyelectasis. These features were detectable by 15 weeks of gestation in all fetuses. Hydrops fetalis due to severe hypalbuminemia demonstrated by chordocentesis occurred in one fetus. Placentas were significantly enlarged. Development of oligohydramnios indicated prenatal decline of renal excretory function. Anencephaly was detected in another fetus with molecularly proven Pierson syndrome at 12 weeks of gestation. CONCLUSION: We conclude that Pierson syndrome has to be considered in the differential diagnosis of nephrotic disorders with prenatal onset. Ultrasound criteria for differentiation from the most common type of CNS-congenital nephrosis of the Finnish type (CNF)-are discussed. Because of its prognostic relevance, we advocate molecular genetic testing of LAMB2 in any case of prenatally detected nephrotic syndrome with negative results of NPHS1 mutational screening, especially in the presence of the typical sonomorphologic findings of the kidneys and the development of oligohydramnios.
Authors:
Karlheinz Mark; André Reis; Martin Zenker
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Prenatal diagnosis     Volume:  26     ISSN:  0197-3851     ISO Abbreviation:  Prenat. Diagn.     Publication Date:  2006 Mar 
Date Detail:
Created Date:  2006-03-06     Completed Date:  2006-08-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8106540     Medline TA:  Prenat Diagn     Country:  England    
Other Details:
Languages:  eng     Pagination:  262-6     Citation Subset:  IM    
Copyright Information:
2006 John Wiley & Sons, Ltd.
Affiliation:
Department of Obstetrics and Prenatal Medicine, Klinikum Weiden, Germany. mark.weiden@t-online.de
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MeSH Terms
Descriptor/Qualifier:
Abnormalities, Multiple*
Anencephaly / genetics,  ultrasonography
Consanguinity
Eye Abnormalities / genetics*
Fatal Outcome
Female
Fetal Death
Fetal Diseases / diagnosis*,  genetics
Glomerular Mesangium / pathology,  ultrasonography*
Humans
Infant
Lamin Type B / genetics*
Male
Mutation
Nephrotic Syndrome / congenital*,  ultrasonography
Pedigree
Pregnancy
Syndrome
Ultrasonography, Prenatal*
Chemical
Reg. No./Substance:
0/Lamin Type B; 0/lamin B2

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