Cystinosis is a rare autosomal recessive disease causing cystine deposition in all tissues, primarily affecting the kidneys. There are few published reports of pregnancy in women with cystinosis, and little evidence is available regarding optimal management. Kidney transplantation and cystine-depleting therapy have transformed the prognosis of cystinosis, and pregnancy is increasingly considered. The evidence base for cystinosis management in pregnancy, therefore, requires expansion. We report three successful pregnancy outcomes and five early pregnancy losses in two women with cystinosis. The challenges of pregnancy in patients with cystinosis are discussed. Pre-pregnancy planning and antenatal management in a specialist renal obstetric clinic are paramount.
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http://dx.doi.org/10.1093/ckj/sfz047 | DOI Listing |
J Cachexia Sarcopenia Muscle
December 2024
Division of Pediatric Nephrology, Rady Children's Hospital, University of California, San Diego, La Jolla, CA, USA.
Background: The CTNS gene mutation causes infantile nephropathic cystinosis (INC). Patients with INC develop Fanconi syndrome and chronic kidney disease (CKD) with significant bone deformations. C57BL/6 Ctns mice are an animal model for studying INC.
View Article and Find Full Text PDFPract Neurol
November 2024
Wessex Neurological Centre, Southampton General Hospital, Tremona Road, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Cystinosis is a lysosomal storage disorder usually presenting with renal disease in infancy. As soon as the diagnosis is made, cysteamine (a cystine-depleting medication), is started, significantly improving life expectancy. We describe a young woman taking lifelong cysteamine for nephropathic cystinosis, who became acutely encephalopathic with a spastic tetraparesis secondary to cysteamine toxicity, which was potentially worsened by copper deficiency.
View Article and Find Full Text PDFClin J Am Soc Nephrol
April 2024
Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California.
Background: Nephritis is a common manifestation of IgA vasculitis and is morphologically indistinguishable from IgA nephropathy. While MEST-C scores are predictive of kidney outcomes in IgA nephropathy, their value in IgA vasculitis nephritis has not been investigated in large multiethnic cohorts.
Methods: Biopsies from 262 children and 99 adults with IgA vasculitis nephritis ( N =361) from 23 centers in North America, Europe, and Asia were independently scored by three pathologists.
J Anesth Analg Crit Care
June 2022
Department of Anesthesiology, Critical Care Medicine and Emergency, SS. Annunziata Hospital, Via dei Vestini, 66100, Chieti, Italy.
Here, we describe the case of a 39-year-old woman with cystinosis who already suffered from an extra parenchymal pattern of restrictive lung disease and, after SARS-CoV-2-related respiratory failure, had a difficult weaning from mechanical ventilation and required tracheostomy. In this rare disease, due to the mutation of the CTNS-gene located on chromosome 17p13, cystine accumulation in the distal muscle has been reported, even in the absence of manifest muscle fatigue. We were able to evaluate diaphragmatic weakness in this patient through the ultrasonographic evaluation of the diaphragm.
View Article and Find Full Text PDFbioRxiv
April 2023
The Cognitive Neurophysiology Laboratory, Department of Pediatrics, Albert Einstein College of Medicine, Bronx, New York, USA.
Cystinosis, a rare lysosomal storage disease, is characterized by cystine crystallization and accumulation within tissues and organs, including the kidneys and brain. Its impact on neural function appears mild relative to its effects on other organs, but therapeutic advances have led to substantially increased life expectancy, necessitating deeper understanding of its impact on neurocognitive function. Behaviorally, some deficits in executive function have been noted in this population, but the underlying neural processes are not understood.
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