Pediatric Nephrology

, Volume 26, Issue 2, pp 205–215

Cystinosis: practical tools for diagnosis and treatment

  • Martijn J. Wilmer
  • Joost P. Schoeber
  • Lambertus P. van den Heuvel
  • Elena N. Levtchenko
Educational Review
  • 700 Downloads

Abstract

Cystinosis is the major cause of inherited Fanconi syndrome, and should be suspected in young children with failure to thrive and signs of renal proximal tubular damage. The diagnosis can be missed in infants, because not all signs of renal Fanconi syndrome are present during the first months of life. In older patients cystinosis can mimic idiopathic nephrotic syndrome due to focal and segmental glomerulosclerosis. Measuring elevated white blood cell cystine content is the corner stone for the diagnosis. The diagnosis is confirmed by molecular analysis of the cystinosin gene. Corneal cystine crystals are invariably present in all patients with cystinosis after the age of 1 year. Treatment with the cystine depleting drug cysteamine should be initiated as soon as possible and continued lifelong to prolong renal function survival and protect extra-renal organs. This educational feature provides practical tools for the diagnosis and treatment of cystinosis.

Keywords

Cystinosis Cystinosin Renal Fanconi syndrome Proximal tubule Cysteamine 

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Copyright information

© IPNA 2010

Authors and Affiliations

  • Martijn J. Wilmer
    • 1
  • Joost P. Schoeber
    • 1
  • Lambertus P. van den Heuvel
    • 1
    • 2
  • Elena N. Levtchenko
    • 1
    • 3
  1. 1.Laboratory of PediatricsKatholieke Universiteit LeuvenLeuvenBelgium
  2. 2.Laboratory of Genetic Endocrine and Metabolic Diseases, Department of Laboratory MedicineRadboud University Nijmegen Medical CentreNijmegenThe Netherlands
  3. 3.Department of Pediatric NephrologyUniversity Hospitals LeuvenLeuvenBelgium

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