Renal disease in Marfan syndrome

G D Sbar1, V S Venkataseshan, Z Huang

  • 1Department of Pathology, Barnert Hospital, Paterson, N.J. 07514, USA.

Insights

Marfan syndrome patients can experience kidney problems like microhematuria and proteinuria. Renal biopsies revealed glomerular and arterial changes linked to connective tissue defects in this genetic disorder.

Area of Science:

  • Nephrology
  • Genetics
  • Pathology

Background:

  • Marfan syndrome is a genetic connective tissue disorder affecting multiple organ systems.
  • Kidney involvement in Marfan syndrome is not well-characterized, but renal abnormalities can occur.

Observation:

  • Four individuals with Marfan syndrome presented with microhematuria and proteinuria.
  • Renal biopsies in two patients showed focal segmental mesangial matrix increase and early sclerosis.
  • Ultrastructural analysis revealed subendothelial widening with abnormal microfibrils and arterial wall changes including elastolysis.

Findings:

  • Glomerular basement membrane alterations were observed in Marfan syndrome patients with proteinuria and microhematuria.
  • Arterial changes in renal biopsies included elastolysis and fragmentation of the internal elastic lamina.

Implications:

  • These renal findings suggest a potential link between Marfan syndrome's connective tissue defects (fibrillin, collagen IV) and glomerular basement membrane pathology.
  • Understanding these kidney manifestations is crucial for comprehensive Marfan syndrome patient management and monitoring.

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