Amira Peco-Antić1, Fatih Ozaltin2, Vojislav Parezanović3, Gordana Milosevski-Lomić4, Verica Zdravković3. 1. School of Medicine, University of Belgrade, Belgrade, Serbia. amira@udk.bg.ac.rs 2. Pediatric Nephrology Unit, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey. 3. School of Medicine, University of Belgrade, Belgrade, Serbia. 4. Nephrology Unit, University Children's Hospital, Belgrade, Serbia.
Abstract
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.
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.
Authors: Axler Jean Paul; Dieuguens Louis; Ansly Jefferson Desravines; Raema Mimrod Jean; Alfadler Jean Baptiste; Jean Henold Buteau; Wislet Andre Journal: Int Med Case Rep J Date: 2021-08-12