Proteinuria in a 6‐year‐old girl with Wilson disease: Lessons learnt

Narayan, Aditya; Karunakar, Pediredla; Krishnamurthy, Sriram; Deepthi, Bobbity; Srinivas, Bheemanathi Hanuman

doi:10.1111/jpc.15936

Cited by 2 publications

(1 citation statement)

References 10 publications

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“…Indeed, in the review of Habib et al , 6% of the patients had focal mesangioproliferative or membranoproliferative glomerulonephritis, rather than a classical MN [ 95 ]. Drug-induced systemic lupus with glomerulonephritis, for example, has been described up to 8 years after DPA initiation, with complete resolution after withdrawal [ 35 , 102 , 103 ]. In more severe cases, crescentic glomerulonephritis with proliferation of parietal epithelial cells and necrosis of glomerular capillaries walls has been observed [ 104 ].…”

Section: Resultsmentioning

confidence: 99%

Kidney involvement in Wilson's disease: a review of the literature

Dang,

Chevalier,

Letavernier

et al. 2024

Clinical Kidney Journal

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Wilson's disease (WD) is a rare inherited disease due to the mutation of the ATP7B gene, resulting in impaired hepatic copper excretion and its pathological accumulation in various organs such as the liver, the nervous system, or the kidneys. While liver failure and neuropsychiatric disorders are the most common features, less is known about the renal complications. We conducted a review of the literature to define the characteristics and pathophysiology of kidney involvement during WD. This review shed light on strong evidence for direct copper-toxicity to renal tubular cells. Excessive tubular copper accumulation might present with various degrees of tubular dysfunction, ranging from mild hydro-electrolytic and acid-base disorders to complete Fanconi syndrome. Proximal and distal renal tubular acidosis also favors development of nephrolithiasis, nephrocalcinosis and bone metabolism abnormalities. Indirect complications might involve renal hypoperfusion as occurs in hepatorenal or cardiorenal syndrome, but also tubular casts’ formation during acute hemolysis, rhabdomyolysis or bile cast nephropathy. Acute kidney failure is not uncommon in severe WD patients, and independently increases mortality. Finally, specific and long-term therapy by D-penicillamin, one of the most efficient drugs in WD, can cause glomerular injuries, such as membranous nephropathy, minimal-change disease, and rarely severe glomerulonephritis. Altogether, our study supports the need for interdisciplinary evaluation of WD patients involving nephrologists, with regular monitoring of tubular and glomerular functions, in order to provide adequate prevention of renal and bone involvement.

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