Skip to main content
Top
Published in: Pediatric Nephrology 5/2009

01-05-2009 | Original Article

Evolutive study of children with diffuse mesangial sclerosis

Authors: Ana Pilar Nso Roca, Antonia Peña Carrión, Marta Benito Gutiérrez, Carmen García Meseguer, Araceli García Pose, Mercedes Navarro

Published in: Pediatric Nephrology | Issue 5/2009

Login to get access

Abstract

Diffuse mesangial sclerosis (DMS) is a renal disease that usually presents as a nephrotic syndrome. It is characterized by early onset and rapid progression to end-stage renal disease, and can occur as an isolated finding or as part of the Denys-Drash syndrome. The aim of this study was to characterize clinical features and outcomes of DMS in a cohort of children. We retrospectively analyzed all cases of DMS diagnosed in our hospital between 1973 and 2008 and evaluated the progression of the disease in relation to different variables. We studied 14 patients, four with incomplete Denys-Drash syndrome and one with Frasier syndrome. All patients developed renal failure. Eight patients received a renal transplant with no relapse of the disease. Bilateral nephrectomy was performed in nine patients with end-stage renal disease. Seven patients died, with sepsis being the main cause of death. Diffuse mesangial sclerosis must be suspected in a child that presents with early onset proteinuria and/or rapidly progressive renal failure. Karyotype and WT1 gene analysis should be performed because of the predisposition of patients to develop different types of tumors. This nephropathy has a poor prognosis, but the survival rate has improved in the last decade.
Literature
1.
go back to reference Ito S, Takata A, Hataya H, Ikeda M, Kikuchi H, Hata J, Honda M (2001) Isolated diffuse mesangial sclerosis and Wilms tumor suppressor gene. J Pediatr 138:425–427CrossRef Ito S, Takata A, Hataya H, Ikeda M, Kikuchi H, Hata J, Honda M (2001) Isolated diffuse mesangial sclerosis and Wilms tumor suppressor gene. J Pediatr 138:425–427CrossRef
2.
go back to reference Habib R, Bois E (1973) Heterogeneity of early onset nephrotic syndromes in infants (nephrotic syndrome "in infants"). Anatomical, clinical and genetic study of 37 cases. Helv Paediatr Acta 29:91–107 Habib R, Bois E (1973) Heterogeneity of early onset nephrotic syndromes in infants (nephrotic syndrome "in infants"). Anatomical, clinical and genetic study of 37 cases. Helv Paediatr Acta 29:91–107
3.
go back to reference Heathcott RW, Morison IM, Gubler MC, Corbett R, Reeve AE (2002) A review of the phenotypic variation due to the Denys-Drash syndrome-associated germline WT1 mutation R362X. Hum Mutat 19:462CrossRef Heathcott RW, Morison IM, Gubler MC, Corbett R, Reeve AE (2002) A review of the phenotypic variation due to the Denys-Drash syndrome-associated germline WT1 mutation R362X. Hum Mutat 19:462CrossRef
4.
go back to reference Garcia-Torres R, Braun G, Ramon G (1992) Drash’s syndrome and its variants. A report of 3 cases. Bol Med Hosp Infant Mex 49:372–379PubMed Garcia-Torres R, Braun G, Ramon G (1992) Drash’s syndrome and its variants. A report of 3 cases. Bol Med Hosp Infant Mex 49:372–379PubMed
5.
go back to reference Gallo GE, Chemes HE (1987) The association of Wilms’ tumor, male pseudohermaphroditism and diffuse glomerular disease (Drash syndrome): report of eight cases with clinical and morphologic findings and review of the literature. Pediatr Pathol 7:175–189PubMed Gallo GE, Chemes HE (1987) The association of Wilms’ tumor, male pseudohermaphroditism and diffuse glomerular disease (Drash syndrome): report of eight cases with clinical and morphologic findings and review of the literature. Pediatr Pathol 7:175–189PubMed
6.
go back to reference Swiatecka-Urban A, Mokrzycki MH, Kaskel F, Da Silva F, Denamur E (2001) Novel WT1 mutation (C388Y) in a female child with Denys-Drash syndrome. Pediatr Nephrol 16:627–630CrossRef Swiatecka-Urban A, Mokrzycki MH, Kaskel F, Da Silva F, Denamur E (2001) Novel WT1 mutation (C388Y) in a female child with Denys-Drash syndrome. Pediatr Nephrol 16:627–630CrossRef
7.
go back to reference Melocoton TL, Salusky IB, Hall TR, Cohen AH, Ehrlich RM, Fine RN (1991) A case report of Drash syndrome in a 46,XX female. Am J Kidney Dis 18:503–508CrossRef Melocoton TL, Salusky IB, Hall TR, Cohen AH, Ehrlich RM, Fine RN (1991) A case report of Drash syndrome in a 46,XX female. Am J Kidney Dis 18:503–508CrossRef
8.
go back to reference McTaggart SJ, Algar E, Chow CW, Powell HR, Jones CL (2001) Clinical spectrum of Denys-Drash and Frasier syndrome. Pediatr Nephrol 16:335–339CrossRef McTaggart SJ, Algar E, Chow CW, Powell HR, Jones CL (2001) Clinical spectrum of Denys-Drash and Frasier syndrome. Pediatr Nephrol 16:335–339CrossRef
9.
go back to reference Call KM, Glaser T, Ito CY, Buckler AJ, Pelletier J, Haber DA, Rose EA, Kral A, Yeger H, Lewis WH, Jones C, Housman DE (1990) Isolation and characterization of a zinc finger polypeptide gene at the human chromosome 11 Wilms’ tumor locus. Cell 60:509–520CrossRef Call KM, Glaser T, Ito CY, Buckler AJ, Pelletier J, Haber DA, Rose EA, Kral A, Yeger H, Lewis WH, Jones C, Housman DE (1990) Isolation and characterization of a zinc finger polypeptide gene at the human chromosome 11 Wilms’ tumor locus. Cell 60:509–520CrossRef
10.
go back to reference Gessler M, Poustka A, Cavenee W, Neve RL, Orkin SH, Bruns GA (1990) Homozygous deletion in Wilms tumours of a zinc-finger gene identified by chromosome jumping. Nature 343:774–778CrossRef Gessler M, Poustka A, Cavenee W, Neve RL, Orkin SH, Bruns GA (1990) Homozygous deletion in Wilms tumours of a zinc-finger gene identified by chromosome jumping. Nature 343:774–778CrossRef
11.
go back to reference Muñoz-Chápuli R, Carmona R, González-Iriarte M, Macías D, Pérez-Pomares J (2003) Las múltiples caras del gen WT1: funciones en el desarrollo e implicaciones clínicas. Acta Pediatr Méx 24:29–38 Muñoz-Chápuli R, Carmona R, González-Iriarte M, Macías D, Pérez-Pomares J (2003) Las múltiples caras del gen WT1: funciones en el desarrollo e implicaciones clínicas. Acta Pediatr Méx 24:29–38
12.
go back to reference Morrison AA, Viney RL, Saleem MA, Ladomery MR (2008) New insights into the function of the Wilms tumor suppressor gene WT1 in podocytes. Am J Physiol Renal Physiol 295:F12–F17CrossRef Morrison AA, Viney RL, Saleem MA, Ladomery MR (2008) New insights into the function of the Wilms tumor suppressor gene WT1 in podocytes. Am J Physiol Renal Physiol 295:F12–F17CrossRef
13.
go back to reference Jeanpierre C, Denamur E, Henry I, Cabanis MO, Luce S, Cecille A, Elion J, Peuchmaur M, Loirat C, Niaudet P, Gubler MC, Junien C (1998) Identification of constitutional WT1 mutations, in patients with isolated diffuse mesangial sclerosis, and analysis of genotype/phenotype correlations by use of a computerized mutation database. Am J Hum Genet 62:824–833CrossRef Jeanpierre C, Denamur E, Henry I, Cabanis MO, Luce S, Cecille A, Elion J, Peuchmaur M, Loirat C, Niaudet P, Gubler MC, Junien C (1998) Identification of constitutional WT1 mutations, in patients with isolated diffuse mesangial sclerosis, and analysis of genotype/phenotype correlations by use of a computerized mutation database. Am J Hum Genet 62:824–833CrossRef
14.
go back to reference Schumacher V, Scharer K, Wuhl E, Altrogge H, Bonzel KE, Guschmann M, Neuhaus TJ, Pollastro RM, Kuwertz-Broking E, Bulla M, Tondera AM, Mundel P, Helmchen U, Waldherr R, Weirich A, Royer-Pokora B (1998) Spectrum of early onset nephrotic syndrome associated with WT1 missense mutations. Kidney Int 53:1594–1600CrossRef Schumacher V, Scharer K, Wuhl E, Altrogge H, Bonzel KE, Guschmann M, Neuhaus TJ, Pollastro RM, Kuwertz-Broking E, Bulla M, Tondera AM, Mundel P, Helmchen U, Waldherr R, Weirich A, Royer-Pokora B (1998) Spectrum of early onset nephrotic syndrome associated with WT1 missense mutations. Kidney Int 53:1594–1600CrossRef
15.
go back to reference Fukuzawa R, Sakamoto J, Heathcott R, Hata J (2002) A necropsy case of Denys-Drash syndrome with a mutation in exon 7 WT1. J Med Genet 39:48–50CrossRef Fukuzawa R, Sakamoto J, Heathcott R, Hata J (2002) A necropsy case of Denys-Drash syndrome with a mutation in exon 7 WT1. J Med Genet 39:48–50CrossRef
16.
go back to reference National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents (2004) The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. Pediatrics 114:555–576CrossRef National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents (2004) The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. Pediatrics 114:555–576CrossRef
17.
go back to reference Niaudet P, Gubler MC (2006) WT1 and glomerular diseases. Pediatr Nephrol 21:1653–1660CrossRef Niaudet P, Gubler MC (2006) WT1 and glomerular diseases. Pediatr Nephrol 21:1653–1660CrossRef
18.
go back to reference Yamamoto K, Santo Y, Satomura K (2003) A case of Denys-Drash syndrome with prophylactic bilateral nephrectomy. Nippon Jinzo Gakkai Shi 45:42–46PubMed Yamamoto K, Santo Y, Satomura K (2003) A case of Denys-Drash syndrome with prophylactic bilateral nephrectomy. Nippon Jinzo Gakkai Shi 45:42–46PubMed
19.
go back to reference Rodríguez F (2000) Disgenesias gonadales. In: Tratado de endocrinología pediátrica y de la adolescencia. Madrid, pp 797–818 Rodríguez F (2000) Disgenesias gonadales. In: Tratado de endocrinología pediátrica y de la adolescencia. Madrid, pp 797–818
20.
go back to reference Jadresic L, Leake J, Gordon I, Dillon MJ, Grant DB, Pritchard J, Risdon RA, Barratt TM (1990) Clinicopathologic review of twelve children with nephropathy, Wilms tumor, and genital abnormalities (Drash syndrome). J Pediatr 117:717–725CrossRef Jadresic L, Leake J, Gordon I, Dillon MJ, Grant DB, Pritchard J, Risdon RA, Barratt TM (1990) Clinicopathologic review of twelve children with nephropathy, Wilms tumor, and genital abnormalities (Drash syndrome). J Pediatr 117:717–725CrossRef
21.
go back to reference Kist-van Holthe JE, Ho PL, Stablein D, Harmon WE, Baum MA (2005) Outcome of renal transplantation for Wilms’ tumor and Denys-Drash syndrome: a report of the North American Pediatric Renal Transplant Cooperative Study. Pediatr Transplant 9:305–310CrossRef Kist-van Holthe JE, Ho PL, Stablein D, Harmon WE, Baum MA (2005) Outcome of renal transplantation for Wilms’ tumor and Denys-Drash syndrome: a report of the North American Pediatric Renal Transplant Cooperative Study. Pediatr Transplant 9:305–310CrossRef
22.
go back to reference Stallmach T, Neuhaus TJ, Kosters R, Hailemariam S (1998) Glomerulopathy in Denys-Drash syndrome. Case report of a model disease. Pathologe 19:230–234CrossRef Stallmach T, Neuhaus TJ, Kosters R, Hailemariam S (1998) Glomerulopathy in Denys-Drash syndrome. Case report of a model disease. Pathologe 19:230–234CrossRef
23.
go back to reference Auber F, Lortat-Jacob S, Sarnacki S, Jaubert F, Salomon R, Thibaud E, Jeanpierre C, Nihoul-Fekete C (2003) Surgical management and genotype/phenotype correlations in WT1 gene-related diseases (Drash, Frasier syndromes). J Pediatr Surg 38:124–129CrossRef Auber F, Lortat-Jacob S, Sarnacki S, Jaubert F, Salomon R, Thibaud E, Jeanpierre C, Nihoul-Fekete C (2003) Surgical management and genotype/phenotype correlations in WT1 gene-related diseases (Drash, Frasier syndromes). J Pediatr Surg 38:124–129CrossRef
24.
go back to reference Hahn H, Cho YM, Park YS, You HW, Cheong HI (2006) Two cases of isolated diffuse mesangial sclerosis with WT1 mutations. J Korean Med Sci 21:160–164CrossRef Hahn H, Cho YM, Park YS, You HW, Cheong HI (2006) Two cases of isolated diffuse mesangial sclerosis with WT1 mutations. J Korean Med Sci 21:160–164CrossRef
25.
go back to reference Hinkes B, Wiggins RC, Gbadegesin R, Vlangos CN, Seelow D, Nurnberg G, Garg P, Verma R, Chaib H, Hoskins BE, Ashraf S, Becker C, Hennies HC, Goyal M, Wharram BL, Schachter AD, Mudumana S, Drummond I, Kerjaschki D, Waldherr R, Dietrich A, Ozaltin F, Bakkaloglu A, Cleper R, Basel-Vanagaite L, Pohl M, Griebel M, Tsygin AN, Soylu A, Muller D, Sorli CS, Bunney TD, Katan M, Liu J, Attanasio M, O’Toole JF, Hasselbacher K, Mucha B, Otto EA, Airik R, Kispert A, Kelley GG, Smrcka AV, Gudermann T, Holzman LB, Nurnberg P, Hildebrandt F (2006) Positional cloning uncovers mutations in PLCE1 responsible for a nephrotic syndrome variant that may be reversible. Nat Genet 38:1397–1405CrossRef Hinkes B, Wiggins RC, Gbadegesin R, Vlangos CN, Seelow D, Nurnberg G, Garg P, Verma R, Chaib H, Hoskins BE, Ashraf S, Becker C, Hennies HC, Goyal M, Wharram BL, Schachter AD, Mudumana S, Drummond I, Kerjaschki D, Waldherr R, Dietrich A, Ozaltin F, Bakkaloglu A, Cleper R, Basel-Vanagaite L, Pohl M, Griebel M, Tsygin AN, Soylu A, Muller D, Sorli CS, Bunney TD, Katan M, Liu J, Attanasio M, O’Toole JF, Hasselbacher K, Mucha B, Otto EA, Airik R, Kispert A, Kelley GG, Smrcka AV, Gudermann T, Holzman LB, Nurnberg P, Hildebrandt F (2006) Positional cloning uncovers mutations in PLCE1 responsible for a nephrotic syndrome variant that may be reversible. Nat Genet 38:1397–1405CrossRef
26.
go back to reference Gbadegesin R, Hinkes BG, Hoskins BE, Vlangos CN, Heeringa SF, Liu J, Loirat C, Ozaltin F, Hashmi S, Ulmer F, Cleper R, Ettenger R, Antignac C, Wiggins RC, Zenker M, Hildebrandt F (2008) Mutations in PLCE1 are a major cause of isolated diffuse mesangial sclerosis (IDMS). Nephrol Dial Transplant 23:1291–1297CrossRef Gbadegesin R, Hinkes BG, Hoskins BE, Vlangos CN, Heeringa SF, Liu J, Loirat C, Ozaltin F, Hashmi S, Ulmer F, Cleper R, Ettenger R, Antignac C, Wiggins RC, Zenker M, Hildebrandt F (2008) Mutations in PLCE1 are a major cause of isolated diffuse mesangial sclerosis (IDMS). Nephrol Dial Transplant 23:1291–1297CrossRef
27.
go back to reference Barbaux S, Niaudet P, Gubler MC, Grunfeld JP, Jaubert F, Kuttenn F, Fekete CN, Souleyreau-Therville N, Thibaud E, Fellous M, McElreavey K (1997) Donor splice-site mutations in WT1 are responsible for Frasier syndrome. Nat Genet 17:467–470CrossRef Barbaux S, Niaudet P, Gubler MC, Grunfeld JP, Jaubert F, Kuttenn F, Fekete CN, Souleyreau-Therville N, Thibaud E, Fellous M, McElreavey K (1997) Donor splice-site mutations in WT1 are responsible for Frasier syndrome. Nat Genet 17:467–470CrossRef
28.
go back to reference Gwin K, Cajaiba MM, Caminoa-Lizarralde A, Picazo ML, Nistal M, Reyes-Mugica M (2008) Expanding the clinical spectrum of Frasier syndrome. Pediatr Dev Pathol 11:122–127CrossRef Gwin K, Cajaiba MM, Caminoa-Lizarralde A, Picazo ML, Nistal M, Reyes-Mugica M (2008) Expanding the clinical spectrum of Frasier syndrome. Pediatr Dev Pathol 11:122–127CrossRef
29.
go back to reference Denamur E, Bocquet N, Baudouin V, Da Silva F, Veitia R, Peuchmaur M, Elion J, Gubler MC, Fellous M, Niaudet P, Loirat C (2000) WT1 splice-site mutations are rarely associated with primary steroid-resistant focal and segmental glomerulosclerosis. Kidney Int 57:1868–1872CrossRef Denamur E, Bocquet N, Baudouin V, Da Silva F, Veitia R, Peuchmaur M, Elion J, Gubler MC, Fellous M, Niaudet P, Loirat C (2000) WT1 splice-site mutations are rarely associated with primary steroid-resistant focal and segmental glomerulosclerosis. Kidney Int 57:1868–1872CrossRef
30.
go back to reference Jensen JC, Ehrlich RM, Hanna MK, Fine RN, Grunberger I (1989) A report of 4 patients with the Drash syndrome and a review of the literature. J Urol 141:1174–1176CrossRef Jensen JC, Ehrlich RM, Hanna MK, Fine RN, Grunberger I (1989) A report of 4 patients with the Drash syndrome and a review of the literature. J Urol 141:1174–1176CrossRef
31.
go back to reference Habib R, Gubler MC, Antignac C, Loirat C, Gangnadoux MF (1990) Congenital or childhood nephrotic syndrome with diffuse mesangial sclerosis. Ann Pediatr (Paris) 37:73–77 Habib R, Gubler MC, Antignac C, Loirat C, Gangnadoux MF (1990) Congenital or childhood nephrotic syndrome with diffuse mesangial sclerosis. Ann Pediatr (Paris) 37:73–77
32.
go back to reference Coppes MJ, Liefers GJ, Higuchi M, Zinn AB, Balfe JW, Williams BR (1992) Inherited WT1 mutation in Denys-Drash syndrome. Cancer Res 52:6125–6128PubMed Coppes MJ, Liefers GJ, Higuchi M, Zinn AB, Balfe JW, Williams BR (1992) Inherited WT1 mutation in Denys-Drash syndrome. Cancer Res 52:6125–6128PubMed
33.
34.
go back to reference Ozen S, Tinaztepe K (1996) Diffuse mesangial sclerosis: a unique type of congenital and infantile nephrotic syndrome. Nephron 72:288–291CrossRef Ozen S, Tinaztepe K (1996) Diffuse mesangial sclerosis: a unique type of congenital and infantile nephrotic syndrome. Nephron 72:288–291CrossRef
Metadata
Title
Evolutive study of children with diffuse mesangial sclerosis
Authors
Ana Pilar Nso Roca
Antonia Peña Carrión
Marta Benito Gutiérrez
Carmen García Meseguer
Araceli García Pose
Mercedes Navarro
Publication date
01-05-2009
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Nephrology / Issue 5/2009
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-008-1063-z

Other articles of this Issue 5/2009

Pediatric Nephrology 5/2009 Go to the issue