End-stage renal disease secondary to IgA nephropathy in recessive dystrophic epidermolysis bullosa: a case report.
Epidermolysis bullosa (EB) consists of a group of dominant or recessive autosomal diseases characterised by skin and mucosa fragility. The lesions leave erosions and scars that, in turn, can cause stenosis of tracheal, oesophageal, and genitourinary tract mucosae. The significantly increased survival of EB patients has determined the onset of complications never observed before, including genitourinary disorders such as hydroureteronephrosis, recurrent urinary tract infections, renal amyloidosis, IgA nephropathy and post-infectious glomerulonephritis. A 6-year-old boy diagnosed with recessive dystrophic EB Hallopeau-Siemens type (RDEB-HS) was referred to our clinic because of microhaematuria that evolved into intra-infectious macrohaematuria. Renal biopsy revealed an increase in both extracellular matrix and mesangial cells, with a focal segmental glomerulosclerosis with severe chronic tubulointerstitial damage. Immunofluorescence showed IgA mesangium deposits. Five years later, he was started on haemodialysis, because of worsening renal function. This is a rare case of a child with EB who was successfully treated with haemodialysis. The pertinent literature has been reviewed.
Tammaro
Fabiana
F
Department of Biomedicine of Developing Age, U.O. B Trambusti, University of Bari, Piazza Giulio Cesare, 11, 70124 Bari, Italy.
Calabrese
Raffaele
R
Aceto
Gabriella
G
Lospalluti
Lucia
L
Garofalo
Lucrezia
L
Bonifazi
Ernesto
E
Piccolo
Tiziana
T
Pannarale
Giovanni
G
Penza
Rosa
R
D000293:Adolescent; D001706:Biopsy; D016108:Epidermolysis Bullosa Dystrophica / Q000150:complications*; D005922:Glomerulonephritis, IGA / Q000150:complications*; D006801:Humans; D007668:Kidney / Q000473:pathology; D007676:Kidney Failure, Chronic / Q000209:etiology*; D008297:Male