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Official publication of the Indian Society of Nephrology
 
CASE REPORT
Ahead of Print

Nail–Patella syndrome: A rare cause of nephrotic syndrome in pregnancy


 Department of Nephrology and Transplantation, Malabar Institute of Medical Sciences, Kozhikode, Kerala, India

Correspondence Address:
IN Aboobacker,
MIMS Hospital, Kozhikode - 673 016, Kerala
India
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Source of Support: None, Conflict of Interest: None

Nail–Patella syndrome (NPS) is an inherited disease with characteristic nail, limb, and renal anomalies. While almost all patients manifest classical skeletal and nail abnormalities, renal involvement is seen in only 40% of patients. Asymptomatic proteinuria is the most common renal presentation. Although a substantial number of patients can progress to nephrotic range proteinuria, development of end-stage kidney disease is rare. Pathological abnormalities are appreciable only by electron microscopy. Our patient who had not been diagnosed with NPS previously presented with new-onset proteinuria during the second trimester of her first pregnancy. The characteristic physical and radiological features confirmed the diagnosis of NPS. Her clinical course was complicated by nephrotic syndrome with fetal loss at 22 weeks and postpartum renal vein thrombosis. Nephrotic state improved after termination of pregnancy. She was managed with angiotensin receptor blocker and anticoagulation. At the end of 2 years of follow-up, she has normal glomerular filtration rate with minimal proteinuria.


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    -  Aboobacker I N
    -  Krishnakumar A
    -  Narayanan S
    -  Hafeeque B
    -  Gopinathan J C
    -  Aziz F
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Indian Journal of Nephrology
Published by Wolters Kluwer - Medknow
Online since 20th Sept '07