Abstract
The oculocerebrorenal disorder of Lowe syndrome is an X-linked mutation in the gene oculocerebrorenal syndrome of Lowe 1 (OCRL), characterized by the triad of congenital cataracts, severe intellectual impairment, and renal tubular dysfunction. Manifestations of phenotype in female carriers and patients are extremely rare. We present a female case with congenital cataracts, severe intellectual impairment, sensorineural hearing loss, and renal tubular dysfunction as Lowe syndrome. A 9-year-old Japanese girl visited our hospital due to prolonged proteinuria. Her renal biopsy revealed diffuse mesangium proliferation, sclerosis and dilatation of renal tubules, and mild IgA deposition in the mesangial region. Furthermore, she had congenital cataracts, severe intellectual impairment, and sensorineural hearing loss. Genetic screening did not identify mutations of the ORCL gene encoding inositol polyphosphate 5-phosphatase (IPP-5P) (46 XX, female). However, we found the reduction of enzyme activity of IPP-5P to 50% of the normal value. Furthermore, her renal function had deteriorated to renal failure within a decade. Finally, she received peritoneal dialysis and renal transplantation. We present the oculocerebrorenal phenotype of Lowe syndrome in a female patient with reduced activity of IPP-5P without OCRL gene mutation.
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Acknowledgements
We are grateful to the past Dr. Youichi Mizusawa at Tokyo Medical and Dental University for enzyme assays and the past Dr. Takashi Sekine at The University of Tokyo for genetic investigations. We also thank Dr. Makoto Ishida at Ishida Clinic and Dr. Hidehito Kondou at Japanese Red Cross Kyoto Daiichi Hospital for useful discussions and Dr. Mai Ihashi, other pediatricians, and many medical staff working in Minoh City Hospital for their clinical co-operation.
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Yamamoto, K., Hasegawa, Y., Ohata, Y. et al. Complete oculocerebrorenal phenotype of Lowe syndrome in a female patient with half reduction of inositol polyphosphate 5-phosphatase. CEN Case Rep 9, 95–100 (2020). https://doi.org/10.1007/s13730-019-00434-z
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DOI: https://doi.org/10.1007/s13730-019-00434-z