Abstract
In a retrospective survey performed in Germany and Switzerland, 207 patients (ranging in age from newborn to 70 years) were evaluated in order to establish the frequency, prognosis and diagnostic awareness of kidney involvement in the tuberous sclerosis complex. Renal manifestations were observed in 48% of patients: renal cysts (33 patients), renal angiomyolipoma (AML) (30 patients), a combination of both (8 patients), renal cell carcinoma (3 patients), life-threatening events such as haemorrhage (4 patients), hypertensive crisis (2 patients) and chronic renal failure (10 patients) were also documented. The diagnostic imaging techniques of ultrasonography, intravenous urography, computed tomography and magnetic resonance imaging (MRI) are important but do not always yield definitive information. Differentiation between AML and cysts can be achieved using special MRI techniques (RARE). The potential for renal involvement should be monitored in all patients with the tuberous sclerosis complex.
Similar content being viewed by others
References
Sheperd CW, Beard CM, Gomez MR, Kurland LT, Whisnant JP (1991) Tuberous sclerosis complex in Olmsted County, Minnesota 1950–1989. Arch Neurol 48: 400–401
Hunt A, Lindenbaum RH (1984) Tuberous sclerosis: a new estimate of prevalence within the Oxford region, J Med Genet 21: 272–277
Sampson JR, Scahill SJ, Stephenson JB, Mann L, Connor JM (1989) Genetic aspects of tuberous sclerosis in the west of Scotland. J Med Genet 26: 28–31
Osborne JP, Fryer A, Webb D (1991) Epidemiology of tuberous sclerosis. Ann NY Acad Sci 615: 125–127
Vogt H (1908) Zur Diagnostik der Tuberösen Sklerose. Z Erforsch Behandl Jugendl Schwachsinns 2: 1–12
Fryer AE, Chalmers AH, Osborne JP (1990) The value of investigation for genetic counselling in tuberous sclerosis. J Med Genet 27: 217–223
Rott HD, Fahsold R (1991) Tuberous sclerosis in two sibs of normal parents. Clin Genet 39: 306–308
Sampson JR, Yates JR, Pirrit LA, Fleury P, Winship I, Beighton P, Connor JM (1989) Evidence for heterogeneity in tuberous sclerosis. J Med Genet 26: 511–516
Webb DW, Osborne JP (1991) Non-penetrance in tuberous sclerosis. J Med Genet 28: 417–419
Kandt RS, Pericak-Vance MA, Hung WY, Gardner RJM, Crossen PE, Nellist MD, Speer MC, Roses AD (1991) Linkage studies in tuberous sclerosis. Chromosome 9?, 11?, or maybe 14! Ann NY Acad Sci 615: 284–297
Smith M, Smalley S, Cantor R, Pandolfo M, Gomez MI, Baumann R, Floodmann P, Yoshiyama K, Nakamura Y, Julier C, Dumars K, Haines J, Trofatter J, Spence MA, Weeks D, Conneally M (1990) Mapping of a gene determining tuberous sclerosis to human chromosome 11q14–11q23. Genomics 6: 105–114
Gomez MR (1991) Phenotypes of the tuberous sclerosis complex with a revision of diagnostic criteria. Ann NY Acad Sci 615: 1–7
Borneville DM (1880) Sclérose tubéreuse des circonvolutions cérébrales: idiotie et épilepsie hemiplegique. Arch Neurol (Paris) 1: 81–91
Gomez MR (1987) Tuberous sclerosis. In: Gomez MR (ed) Neurocutaneous syndromes. Butterworths, Boston, London, Durban, Singapore, Sydney, Toronto, Wellington, pp 30–52
Bernstein J, Robbins TO (1991) Renal involvement in tuberous sclerosis. Ann NY Acad Sci 615: 36–49
Cassidy SB, Pagon RA, Pepin M, Blumenhagen JD (1983) Family studies in tuberous sclerosis. Evaluation of apparently anaffected parents. JAMA 249: 1302–1304
Stillwell TJ, Gomez MR, Kelalis PP (1987) Renal lesions in tuberous sclerosis. J Urol 138: 477–481
Narla LD, Slovis TL, Watts FB, Nigro M (1988) The renal lesions of tuberosclerosis (cysts and angiomyolipoma) — screening with sonography and computerized tomography. Pediatr Radiol 18: 205–209
Lallier TE (1991) Cell lineage and cell migration in the neural crest. Ann NY Acad Sci 615: 158–171
Davidson M, Yoshidome H, Stenroos E, Johnson EG (1991) Neuron-like cells in culture of tuberous sclerosis tissue. Ann NY Acad Sci 615: 196–210
Johnson WG, Hoshidome H, Stenroos E, Johnson WG (1991) Origin of the neuron-like cells in tuberous sclerosis tissue Ann NY Acad Sci 615: 211–219
Khalakhali-Ellis Z, Henderson K, Hemming FW (1991) Glycoprotein and proteoglycan alterations in tuberous sclerosis. Ann NY Acad Sci 615: 149–157
Crossin KL (1991) Cell adhesion molecules in embryogenesis and disease. Ann NY Acad Sci 615: 172–186
Gulcher J, Steffanson K (1991) The hexabrachion gene as a candidate for a tuberous sclerosis gene. Ann NY Acad Sci 615: 220–227
Kousseff BG (1990) The phakomatoses as paracrine growth disorders (paracrinopathies). Clin Genet 37: 97–105
Fahsold R, Rott HD, Lorenz P (1991) A third gene locus for tuberous sclerosis is closely linked to the phenylalanine hydroxylase gene locus. Hum Genet 88: 85–90
Hoffman AD (1991) Imaging of tuberous sclerosis lesions outside of the central nervous system. Ann NY Acad Sci 615: 94–123
Blute ML, Malek RS, Segura JW (1988) Angiomyolipoma: clinical metamorphosis and concepts for management. J Urol 139: 20–24
Brandt H, Fischer C, Deininger HK, Hallwachs O (1989) Gigantisches, blutendes Angiomyolipom der Niere bei Tuberöser Sklerose. Fortschr Röntgenstr 150: 606–608
Amir FA, Stephenson J, Ziervogel M (1989) Angiomyolipoma causing life-threatening hematuria in a child with tuberous sclerosis. J Pediatr Surg 24: 1308–1309
Tong YC, Chieng PU, Tsai TC, Lin SN (1990) Renal angiomyolipoma: report of 24 cases. Br J Urol 66: 585–589
Van Baal JG, Fleury P, Brummelkamp WH (1989) Tuberous sclerosis and the relation with renal angiomyolipoma. A genetic study on the clinical aspects. Clin Genet 35: 167–173
Sigmund G, Stoever B, Zimmerhackl LB, Frankenschmidt A, Nitzsche E, Leititis JU, Struwe FE, Hennig J (1991) RARE-MR-urography in the diagnosis of upper urinary tract abnormalities in children. Pediatr Radiol 21: 416–420
Taylor RS, Joseph DB, Kohaut EC, Wilson ER, Bueschen AJ (1989) Renal angiomyolipoma associated with lymph node involvement and renal cell carcinoma in patients with tuberous sclerosis J Urol 141: 930–932
Washecka R, Hanna M (1991) Malignant renal tumors in tuberous sclerosis. Urology 37: 340–343
Osterling JE, Fishman EK, Goldman SM, Marshall FF (1986) The management of renal angiomyolipoma. J Urol 135: 1121
Pirson Y (1992) Renal transplantation in tuberous sclerosis. BMJ 305: 313
Author information
Authors and Affiliations
Additional information
Participating centres and principal investigators (in alphabetical order): Altötting, PD Dr. R. Schmid; Berlin, Charité, Prof. Dévaux; Bern, Dr. Penzien; Bonn, PD Dr. Zerres; Dortmund, Humangenetisches Institut; Dresden, Prof. P. Lorenz; Erlangen, Prof. H.-P. Rott; Freiburg, PD Dr. L. B. Zimmerhackl, Dr. Rehm; Hannover. Prof. J. Brodehl; Heidelberg, Prof. K. Schärer, Fr. Dr. Wingen; Jena, Prof. Misselwitz; Karlsruhe, Prof. Schindera; Leipzig, Prof. Theile, Dr. Wässer; Lübeck, Dr. Kirschstein; Lüdenscheid, Prof. Weber; Marburg, Dr. Nolte; Münster, Dr. Kurlemann, Prof. Bulla; Neuwied, Dr. Gellisen; Rostock, Doz. Dr. Stolpe; Stuttgart, Dr. Köhler, Dr. Holder.
Rights and permissions
About this article
Cite this article
Zimmerhackl, L.B., Rehm, M., Kaufmehl, K. et al. Renal involvement in tuberous sclerosis complex: a retrospective survey. Pediatr Nephrol 8, 451–457 (1994). https://doi.org/10.1007/BF00856529
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00856529