Frasier Syndrome: A Rare Cause of Refractory Steroid-Resistant Nephrotic Syndrome
Abstract
:1. Introduction
2. Case Report
3. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Time (The Patient’s Age) | Symptoms | Laboratory Findings | Image Finding | Pathological Findings | Management |
---|---|---|---|---|---|
6 years old | Proteinuria during an elementary school health screening | UPCR: 1.34 g/g 24-h urine protein: 0.66 g | Renal sonography: increased echogenicity bilaterally | ||
2 months later | UPCR: 2.14 g/g | Renal biopsy: FSGS 2/7 glomeruli involved. IF *: negative EM **: 70% podocyte effacement. | MTP pulse therapy | ||
8 years old | Persistent proteinuria | Renal biopsy: FSGS 4/67 glomeruli involved. IF *:negative EM **:70% podocyte effacement. | Tried MTP pulse therapy, oral prednisolone, mycophenolate mofetil, tacrolimus, and Abatacept; her proteinuria persisted | ||
12 years old | UPCR: 4.01 g/g | regular medical treatment was halted | |||
14 years old | Prolonged menstrual period of up to 1 month | CA-125, 77.96 unit/mL; CA-199, 57.01 unit/mL; alpha fetal protein, 94.88 ng/mL Serum albumin: 2.2 g/dL, cholesterol: 183 mg/dL, triglyceride: 133 mg/dL | CT scan: a lobulated mass lesion, maximum diameter: 10.1 cm | Malignant mixed germ cell tumor: 75% dysgerminoma, 10% immature teratoma, 10% embryonal carcinoma, and 5% yolk sac tumor | cytoreductive left salpingo-oophorectomy |
Following 3 months | Chemotherapy Regular ezetimibe/atorvastatin and ACE-I | ||||
1 month later | Genetic test: point mutation in intron 9 of the WT1 gene, c.1447 + 4 C > T; serum albumin: 3.7 g/dL, cholesterol: 202 mg/dL, triglyceride: 93 mg/dL | Gonadoblastoma (right side) | Right salpingo-oophorectomy | ||
To this date | UPCR: 11.7 g/g; Serum albumin between 2.7–3.7 g/dL | Regular ezetimibe/atorvastatin and ACE-I |
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Huang, Y.-C.; Tsai, M.-C.; Tsai, C.-R.; Fu, L.-S. Frasier Syndrome: A Rare Cause of Refractory Steroid-Resistant Nephrotic Syndrome. Children 2021, 8, 617. https://0-doi-org.brum.beds.ac.uk/10.3390/children8080617
Huang Y-C, Tsai M-C, Tsai C-R, Fu L-S. Frasier Syndrome: A Rare Cause of Refractory Steroid-Resistant Nephrotic Syndrome. Children. 2021; 8(8):617. https://0-doi-org.brum.beds.ac.uk/10.3390/children8080617
Chicago/Turabian StyleHuang, Yung-Chieh, Ming-Chin Tsai, Chi-Ren Tsai, and Lin-Shien Fu. 2021. "Frasier Syndrome: A Rare Cause of Refractory Steroid-Resistant Nephrotic Syndrome" Children 8, no. 8: 617. https://0-doi-org.brum.beds.ac.uk/10.3390/children8080617