doiSerbia

Proteinuria in frasier syndrome

Peco-Antić Amira (Medicinski fakultet, Beograd + Univerzitetska dečja klinika, Nefrološko odeljenje, Beograd)
Ozaltin Fatih (Pediatric Nephrology Unit, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey + Nephrogenetics Laboratory, Pediatric Nephrology Unit, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey)
Parezanović Vojislav (Medicinski fakultet, Beograd + Univerzitetska dečja klinika, Kardiološko odeljenje, Beograd)
Miloševski-Lomić Gordana (Univerzitetska dečja klinika, Nefrološko odeljenje, Beograd)
Zdravković Verica (Medicinski fakultet, Beograd + Univerzitetska dečja klinika, Endokrinološko odeljenje, Beograd)

Introduction. Frasier syndrome (FS) is a genetic form of glomerulopathy, which results from mutations in the Wilms’ tumour suppressor gene (WT1). Proteinuria in FS has been traditionally considered unresponsive to any medication and FS inevitably progresses to end stage renal failure. Case Outline. We present a patient with FS who had atypical clinical manifestation and unusual beneficial antiproteinuric response to renin-angiotensin system (RAS) inhibitors given in combination with indomethacin. After 13 years of follow-up, the patient is now 17-year old with normal renal functions and no proteinuria. Conclusion. RAS inhibitors combined with indomethacin showed beneficial effect in our patient. Thus, this combination might be the initial treatment of patients with FS. If this treatment strategy was not satisfied for at least 3 months, then CsA would be considered to be administered taking account of the nephrotoxicity and the increased risk of malignancy. Further prospective study is required to clarify this issue.

Keywords: steroid resistant nephrotic syndrome, Wilms’ tumour suppressor gene (WT1), angiotensin converting enzyme (ACE) inhibitor, angiotensin receptor blocker, indomethacin

Projekat Ministarstva nauke Republike Srbije, br. OI175079