Skip to main content

Advertisement

Log in

A milder variant of Pierson syndrome

  • Brief Report
  • Published:
Pediatric Nephrology Aims and scope Submit manuscript

Abstract

Congenital nephrotic syndrome (CNS) comprises a heterogeneous group of conditions having in common the disruption of normal glomerular permselectivity, and it carries a poor prognosis, with most patients progressing to end-stage renal disease. Recently, mutations in the LAMB2 gene encoding laminin β2 were described as the cause of Pierson syndrome, which is characterized by CNS and a complex ocular maldevelopment with microcoria as the most prominent clinical features. Most affected children exhibit early onset of chronic renal failure, neurodevelopmental deficits, and blindness. We report on a patient with CNS, high-grade myopia, and minor structural eye anomalies, including remnants of pupillary membranes, but no microcoria. The patient had not developed renal failure by the age of 16 months, and he showed no neurodevelopmental deficits. He was identified to be homozygous for a novel LAMB2 missense mutation. This observation, together with two recent reports on milder variants of Pierson syndrome, corroborates the concept that the clinical expression of Pierson syndrome is more variable than initially described, and that milder phenotypes may be related to hypomorphic LAMB2 alleles.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

References

  1. Habib R (1993) Nephrotic syndrome in the 1st year of life. Pediatr Nephrol 7:347–353

    Article  PubMed  CAS  Google Scholar 

  2. Jalanko H, Kääriäinen H, Norio R (2002) Nephrotic disorders. In: Rimoin DL, Connor JM, Pyeritz RE, Korf BR (eds) Principles and practice of medical genetics, 4th edn. Churchill Livingstone, London, pp 1708–1719

    Google Scholar 

  3. Hinkes BG, Mucha B, Vlangos CN, Gbadegesin R, Liu J, Hasselbacher K, Hangan D, Ozaltin F, Zenker M, Hildebrandt F (2007) Nephrotic syndrome in the first year of life: two thirds of cases are caused by mutations in 4 genes (NPHS1, NPHS2, WT1, and LAMB2). Pediatrics 119:e907–e919

    Article  PubMed  Google Scholar 

  4. Zenker M, Aigner T, Wendler O, Tralau T, Muntefering H, Fenski R, Pitz S, Schumacher V, Royer-Pokora B, Wuhl E, Cochat P, Bouvier R, Kraus C, Mark K, Madlon H, Dotsch J, Rascher W, Maruniak-Chudek I, Lennert T, Neumann LM, Reis A (2004) Human laminin {beta}2 deficiency causes congenital nephrosis with mesangial sclerosis and distinct eye abnormalities. Hum Mol Genet 13:2625–2632

    Article  PubMed  CAS  Google Scholar 

  5. Pierson M, Cordier J, Hervouuet F, Rauber G (1963) An unusual congenital and familial congenital malformative combination involving the eye and kidney. J Genet Hum 12:184–213

    PubMed  CAS  Google Scholar 

  6. Zenker M, Tralau T, Lennert T, Pitz S, Mark K, Madlon H, Dotsch J, Reis A, Muntefering H, Neumann LM (2004) Congenital nephrosis, mesangial sclerosis, and distinct eye abnormalities with microcoria: an autosomal recessive syndrome. Am J Med Genet 130A:138–145

    Article  Google Scholar 

  7. Tunggal P, Smyth N, Paulsson M, Ott MC (2000) Laminins: structure and genetic regulation. Microsc Res Tech 51:214–227

    Article  PubMed  CAS  Google Scholar 

  8. Hunter DD, Shah V, Merlie JP, Sanes JR (1989) A laminin-like adhesive protein concentrated in the synaptic cleft of the neuromuscular junction. Nature 338:229–234

    Article  PubMed  CAS  Google Scholar 

  9. VanDeVoorde R, Witte D, Kogan J, Goebel J (2006) Pierson syndrome: a novel cause of congenital nephrotic syndrome. Pediatrics 118:e501–e505

    Article  PubMed  Google Scholar 

  10. Wuhl E, Kogan J, Zurowska A, Matejas V, Vandevoorde RG, Aigner T, Wendler O, Lesniewska I, Bouvier R, Reis A, Weis J, Cochat P, Zenker M (2007) Neurodevelopmental deficits in Pierson (microcoria-congenital nephrosis) syndrome. Am J Med Genet A 143:311–319

    PubMed  Google Scholar 

  11. McKee KK, Harrison D, Capizzi S, Yurchenco PD (2007) Role of laminin terminal globular domains in basement membrane assembly. J Biol Chem 282:21437–21447

    Article  PubMed  CAS  Google Scholar 

  12. Hasselbacher K, Wiggins RC, Matejas V, Hinkes BG, Mucha B, Hoskins BE, Ozaltin F, Nurnberg G, Becker C, Hangan D, Pohl M, Kuwertz-Broking E, Griebel M, Schumacher V, Royer-Pokora B, Bakkaloglu A, Nurnberg P, Zenker M, Hildebrandt F (2006) Recessive missense mutations in LAMB2 expand the clinical spectrum of LAMB2-associated disorders. Kidney Int 70:1008–1012

    Article  PubMed  CAS  Google Scholar 

  13. Matejas V, Al-Gazali L, Amirlak I, Zenker M (2006) A syndrome comprising childhood-onset glomerular kidney disease and ocular abnormalities with progressive loss of vision is caused by mutated LAMB2. Nephrol Dial Transplant 21:3283–3286

    Article  PubMed  CAS  Google Scholar 

  14. Noakes PG, Miner JH, Gautam M, Cunningham JM, Sanes JR, Merlie JP (1995) The renal glomerulus of mice lacking s-laminin/laminin beta 2: nephrosis despite molecular compensation by laminin beta 1. Nat Genet 10:400–406

    Article  PubMed  CAS  Google Scholar 

  15. Cohen AH, Turner MC (1994) Kidney in Galloway-Mowat syndrome: clinical spectrum with description of pathology. Kidney Int 45:1407–1415

    Article  PubMed  CAS  Google Scholar 

  16. Zurowska A, Zaluska-Lesniewska I, Zenker M (2006) LAMB2 gene mutation as a cause of congenital nephrotic syndrome with distinct eye abnormalities and hypotonia. Przegl Lek 63(Suppl 3):37–39

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Mikhail Kagan.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kagan, M., Cohen, A.H., Matejas, V. et al. A milder variant of Pierson syndrome. Pediatr Nephrol 23, 323–327 (2008). https://doi.org/10.1007/s00467-007-0624-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00467-007-0624-x

Keywords

Navigation