Cystinosis: a review.
Cystinosis is the most common hereditary cause of renal Fanconi syndrome in children. It is an autosomal recessive lysosomal storage disorder caused by mutations in the CTNS gene encoding for the carrier protein cystinosin, transporting cystine out of the lysosomal compartment. Defective cystinosin function leads to intra-lysosomal cystine accumulation in all body cells and organs. The kidneys are initially affected during the first year of life through proximal tubular damage followed by progressive glomerular damage and end stage renal failure during mid-childhood if not treated. Other affected organs include eyes, thyroid, pancreas, gonads, muscles and CNS. Leucocyte cystine assay is the cornerstone for both diagnosis and therapeutic monitoring of the disease. Several lines of treatment are available for cystinosis including the cystine depleting agent cysteamine, renal replacement therapy, hormonal therapy and others; however, no curative treatment is yet available. In the current review we will discuss the most important clinical features of the disease, advantages and disadvantages of the current diagnostic and therapeutic options and the main topics of future research in cystinosis.
Department of Pediatric Nephrology & Growth and Regeneration, University Hospitals Leuven & KU Leuven, UZ Herestraat 49-3000, Leuven, Belgium.|Department of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt.
Mohamed A
MA
Elmonem
Department of Pediatric Nephrology & Growth and Regeneration, University Hospitals Leuven & KU Leuven, UZ Herestraat 49-3000, Leuven, Belgium.
Koenraad R
KR
Veys
Department of Pediatrics, Center of Pediatric Nephrology and Transplantation (CPNT), Faculty of Medicine, Cairo University, Cairo, Egypt.|EGORD, Egyptian group of orphan renal diseases, Cairo, Egypt.
Neveen A
NA
Soliman
Department of Pediatric Nephrology & Growth and Regeneration, University Hospitals Leuven & KU Leuven, UZ Herestraat 49-3000, Leuven, Belgium.
Maria
M
van Dyck
Department of Pediatric Nephrology & Growth and Regeneration, University Hospitals Leuven & KU Leuven, UZ Herestraat 49-3000, Leuven, Belgium.|Department of Pediatric Nephrology, Radboud University Medical Center, Nijmegen, The Netherlands.
Lambertus P
LP
van den Heuvel
Department of Pediatric Nephrology & Growth and Regeneration, University Hospitals Leuven & KU Leuven, UZ Herestraat 49-3000, Leuven, Belgium. elena.levtchenko@uzleuven.be.
Elena
E
Levtchenko
D026921:Amino Acid Transport Systems, Neutral / Q000235:genetics / Q000378:metabolism; D002648:Child; D003553:Cystine / Q000378:metabolism; D003554:Cystinosis / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology / Q000378:metabolism; D006801:Humans
D026921:Amino Acid Transport Systems, Neutral; C111445:CTNS protein, human; D003553:Cystine