Ophthalmic manifestations and histopathology of infantile nephropathic cystinosis: report of a case and review of the literature.

Abstract

Cystinosis is a rare autosomal recessive metabolic disorder characterized by the intracellular accumulation of cystine, the disulfide of the amino acid cysteine, in many organs and tissues. Infantile nephropathic cystinosis is the most severe phenotype. Corneal crystal accumulation and pigmentary retinopathy were originally the most commonly described ophthalmic manifestations, but successful kidney transplantation significantly changed the natural history of the disease. As cystinosis patients now live longer, long-term complications in extrarenal tissues, including the eye, have become apparent. A case of an adult patient with infantile nephropathic cystinosis is reported. He presented with many long-term ocular complications of cystinosis. After 4 years of follow-up, the patient died from sepsis. Pathology of the phthisical eyes demonstrated numerous electron-transparent polygonal spaces, bounded by single membrane, in corneal cells, retinal pigment epithelial cells, and even choroidal endothelial cells. The ophthalmic manifestations and pathology of infantile nephropathic cystinosis are discussed and reviewed in light of the current report and other cases in the literature.

• Authors: Ekaterini Tsilou, Min Zhou, William Gahl, Pamela C Sieving, Chi-Chao Chan
• Journal: Survey of ophthalmology (Surv Ophthalmol) 2007 Jan-Feb Vol. 52 Issue 1 Pg. 97-105 ISSN: 0039-6257 [Print] United States
• PMID: 17212992 (Publication Type: Case Reports, Journal Article, Research Support, N.I.H., Intramural, Review)

Chemical References

• Cysteine

Topics

• Adult
• Choroid Diseases (metabolism, pathology)
• Corneal Diseases (metabolism, pathology)
• Cysteine (metabolism)
• Cystinosis (metabolism, pathology)
• Fatal Outcome
• Humans
• Kidney Diseases (metabolism, pathology)
• Male
• Retinal Diseases (metabolism, pathology)