Successful kidney transplantation in a patient with neonatal-onset ILNEB

Pediatr Transplant. 2021 Aug;25(5):e13971. doi: 10.1111/petr.13971. Epub 2021 Jan 20.

Abstract

Background: ILNEB constitute an autosomal recessive disorder caused by homozygous or compound heterozygous mutation of the gene for the ITGA3. To date, 8 ILNEB patients have been reported, but all 6 neonatal-onset ILNEB patients suffered early death within 2 years. The most common cause of death among previously reported ILNEB patients was exacerbation of the respiratory condition.

Methods: In this study, we describe a case of ILNEB with neonatal onset in a female patient and the genetic and histopathological testing performed.

Results: Our patient had a compound heterozygous mutation in ITGA3. Compared to previously reported patients, this patient exhibited milder clinical and histopathological characteristics. After experiencing a life-threatening respiratory infection at 8 months old, the patient started periodic subcutaneous immunoglobulin treatment once every 1-2 weeks for nephrotic-range proteinuria-induced secondary hypogammaglobulinemia. At the age of 3 years, proteinuria gradually increased with severe edema despite strict internal management. Therefore, our patient underwent unilateral nephrectomy and insertion of a peritoneal dialysis catheter followed by another unilateral nephrectomy. One month later, she underwent an ABO-compatible living-donor kidney transplantation at the age of 4 years.

Conclusions: Our patient is a neonatal-onset ILNEB patient who survived for more than 2 years and underwent successful kidney transplantation.

Keywords: congenital nephrotic syndrome; integrin α3; interstitial lung disease; junctional epidermolysis bullosa.

Publication types

  • Case Reports

MeSH terms

  • Epidermolysis Bullosa, Junctional / genetics
  • Epidermolysis Bullosa, Junctional / surgery*
  • Female
  • Genetic Markers
  • Humans
  • Infant, Newborn
  • Integrin alpha3 / genetics
  • Kidney Transplantation*
  • Lung Diseases, Interstitial / congenital
  • Lung Diseases, Interstitial / genetics
  • Lung Diseases, Interstitial / surgery*
  • Mutation
  • Nephrectomy
  • Nephrotic Syndrome / congenital
  • Nephrotic Syndrome / genetics
  • Nephrotic Syndrome / surgery*
  • Syndrome

Substances

  • Genetic Markers
  • ITGA3 protein, human
  • Integrin alpha3