Daniel Roshan, Dawman Lesa, Nada Ritambhra, Sekar Aravind, Mahajan Rahul, Tiewsoh Karalanglin
Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Indian J Nephrol. 2024 Jul-Aug;34(4):400-403. doi: 10.4103/ijn.IJN_26_21. Epub 2023 Aug 10.
Secondary amyloidosis may complicate inherited dermatoses, but recessive dystrophic epidermolysis bullosa (RDEB) complicated by renal amyloidosis is rare. We report a case of a 12-year-old male child with RDEB presenting with progressive generalized anasarca for 20 days. Kidney biopsy showed diffuse expansion of mesangial matrix by pale acellular Periodic Acid-Schiff (PAS)-negative amorphous material, which was congophilic on Congo red stain and gave apple green birefringence on polarization and extending along the glomerular basement membrane, suggestive of amyloidosis. Genetic analysis showed a compound heterozygous pathogenic variant in the gene with autosomal recessive inheritance.
继发性淀粉样变性可能并发于遗传性皮肤病,但隐性营养不良性大疱性表皮松解症(RDEB)合并肾淀粉样变性则较为罕见。我们报告一例12岁男性儿童,患有RDEB,出现进行性全身性水肿20天。肾脏活检显示,肾小球系膜基质被淡染的无细胞过碘酸希夫(PAS)阴性无定形物质弥漫性扩张,刚果红染色呈嗜刚果红性,偏振光下呈苹果绿双折射,并沿肾小球基底膜延伸,提示淀粉样变性。基因分析显示该基因存在复合杂合致病性变异,呈常染色体隐性遗传。