ABSTRACT
We describe a 10-year-old boy with X-linked ichthyosis, Kallmann Syndrome and unilateral renal agenesis who presented with nephrotic syndrome. DNA analysis revealed deletion of the Steroid Sulfatase (STS) gene. STS deficiency in X-linked ichthyosis leads to cholesterol sulfate accumulation, which induces transglutaminase-1 dysfunction. Since the slit diaphragm of the glomerular epithelial cell is a modified adherens junction, the accumulation of cholesterol sulfate could interfere with the normal slit diaphragm function of the glomerular visceral epithelial cell, resulting in nephrotic range proteinuria. The child went into remission on oral prednisolone.
Subject(s)
Child , Gene Deletion , Humans , Ichthyosis, X-Linked/diagnosis , Kallmann Syndrome/diagnosis , Kidney/abnormalities , Male , Nephrotic Syndrome/diagnosis , Steryl-Sulfatase/geneticsABSTRACT
Harlequin fetus is a rare and the most severe form of congenital ichthyosis. Most of the infants die within a few weeks after birth due to sepsis and respiratory difficulties. The case of a female harlequin baby is reported. The baby survived because of good neonatal intensive care, topical emollients and oral etretinate. Now she is over three years old and the skin developed into congenital non-bullous ichthyosiform erythroderma. Unfortunately she had delayed growth and development. This is the first case report of a harlequin fetus in Thailand that had prolonged survival.
Subject(s)
Female , Follow-Up Studies , Humans , Ichthyosis, X-Linked/diagnosis , Infant, Newborn , Intensive Care, Neonatal , ThailandABSTRACT
Nas ictioses recessivas ligadas ao x (IRLX) ocorre deficiência ou ausência de atividade da enzima colesterol-sulfatase (arilsulfatase C). A descamaçäo da camada córnea é retardada, determinando quadro clínico característico. Com base em um caso clínico de IRLX, säo discutidos os aspectos clínicos, bioquímicos e genéticos dessa forma de ictiose