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Cystinosis induced by CTNS gene mutation: a rare disease study
Xin Wang1, Bi-Li Zhang1, Xiao-Ying Chen1
1Special Ward of Tianjin Children's Hospital, Tianjin 300134, China.
Insights
This case study highlights a rare genetic disorder, cystinosis, diagnosed in a young boy due to a CTNS gene mutation. Early detection and treatment with cysteamine tartaric acid are crucial for managing this condition.
Area of Science:
- Pediatric Nephrology
- Medical Genetics
- Rare Diseases
Background:
- Cystinosis is a rare lysosomal storage disorder characterized by the accumulation of cystine crystals in various organs.
- Genetic mutations, particularly in the CTNS gene, are the primary cause of nephropathic cystinosis.
Observation:
- A 1-year-old boy presented with persistent glycosuria, polydipsia, polyuria, and growth retardation from 4 months of age.
- Laboratory findings included metabolic acidosis, electrolyte imbalances, and renal rickets, with corneal cystine crystals observed.
- Genetic testing revealed a homozygous CTNS gene mutation (C.922g>A(p.Gly308Arg)).
Findings:
- The patient was diagnosed with cystinosis based on clinical presentation, laboratory results, and genetic confirmation.
- Early symptomatic supportive treatment was initiated, followed by cysteamine tartaric acid to chelate cysteine.
Implications:
- This case underscores the importance of early diagnosis of cystinosis through comprehensive evaluation of clinical and laboratory findings.
- Prompt treatment with cysteamine tartaric acid can help manage symptoms and prevent further complications.
- Further research into CTNS gene mutations and cystinosis pathogenesis is warranted.
Abstract:
A boy, aged 1 year and 6 months, was found to have persistent positive urine glucose at the age of 4 months, with polydipsia, polyuria, and growth retardation. Laboratory examinations suggested that the boy had low specific weight urine, anemia, hypokalemia, hyponatremia, hypomagnesemia, metabolic acidosis, glycosuria, acidaminuria, increased fractional excretion of potassium, and decreased tubular reabsorption of phosphate. X-ray examinations of the head, thorax, and right hand showed changes of renal rickets. The slit-lamp examination showed a large number of cystine crystals in the cornea. The genetic testing showed a suspected pathogenic homozygous mutation of the CTNS gene, C.922g>A(p.Gly308Arg). The boy was finally diagnosed with cystinosis. At the beginning of treatment, symptomatic supportive treatment was given to maintain the stability of the internal environment, and cysteamine tartaric acid capsules were used after diagnosis to remove cysteine. This article reported a case of cystinosis caused by CTNS gene mutation and summarized the etiology, clinical features, diagnosis, and treatment of this disease, which can provide a reference for the early diagnosis, treatment, and subsequent study of the disease.
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