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Alport Syndrome

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Alport syndrome is a rare hereditary disorder that affects the kidneys. It can also affect hearing and vision as well.

Basically, this hereditary disorder causes mutation of a gene for collagen and is typically found on the X chromosome.

(Collagen is a protein substance that is widely found in the body in connective tissue, tendons, skin, cartilage, bone and ligaments).

This condition affects more males than females. The symptoms and effects of this disease are also, usually, more severe in male patients than females and, in extreme cases, it results in renal failure, hearing disorder, and vision loss.

It causes chronic glomerulonephritis (inflammation of the kidneys' glomeruli), and there is progressive loss of kidney function and accumulation of fluids and wastes in the body. Within a relatively short period of time (few years), the progressive loss of kidney function leads to end-stage renal disease (ESRD) at an early age. ESRD, caused by Alport syndrome, often develops between adolescence and age 40.

In females, the effects of this disease are usually mild, with minimal or no symptoms. In some cases there may be blood in the urine. It is possible for women with this condition to transmit the gene to their children, even if the mother has no symptoms. Most women with this condition usually enjoy a normal life span, with little or no signs of the disease.

 

Risk Factors and Symptoms

Risk factors include: having a family history of Alport syndrome, nephritis, end-stage renal disease, loss of hearing before age 30, glomerulonephritis, and similar disorders.

Symptoms include:

  • Urine discoloration
  • Blood in the urine
  • Loss of hearing
  • Decrease or loss of vision
  • Ankle, feet, and leg swelling
  • Swelling, overall
  • Swelling around the eyes
  • High blood pressure

Most of these symptoms are usually more severe in males with this disorder. Some women will have high blood pressure, swelling, and nerve deafness during pregnancy.


Diagnosis

In diagnosing this condition a doctor will usually check for a family history of the disorder or other kidney diseases. Minute amounts of blood in the urine (microscopic hematuria) may be present from birth of nearly all affected males. Blood pressure may be elevated. Examination of the eyes may show changes in the fundus (posterior inner part of eye) or lens changes.

The doctor usually orders a series of kidney function tests and other tests to confirm diagnosis. Tests may show the following:

  • Urinalysis shows blood, protein, and other abnormalities.
  • BUN, creatinine are elevated.
  • Red blood cell count, hematocrit may decrease.
  • Hematuria test is positive.
  • Audiometry may show nerve deafness.
  • Renal biopsy shows chronic glomerulonephritis with the changes typical of this hereditary disorder.

 

Treatment

Since this condition is genetic, it is difficult to treat. Treatment mainly seeks to control and minimize the effects of the symptoms. The most important task is strict control of high blood pressure. Treatment of chronic renal failure will become necessary... this may include dietary modifications, fluid restriction, and other treatments. Ultimately, chronic renal failure progresses to end-stage renal disease, requiring dialysis or transplantation.

Surgical intervention (such as cataract extraction) may be required to repair eye defects. Hearing loss is difficult to treat and it is likely to be permanent. Counseling and education to increase coping skills may be necessary. Learning new skills such as lip reading or sign language may be of some benefit. Hearing aids are helpful. Young men with Alport syndrome should use hearing protection in noisy environments.

The earlier this condition is detected, the better the chances of monitoring and controlling the symptoms. Seek immediate medical assistance if symptoms suggest Alport syndrome, or if there is a family history of the disorder, and you are planning to have children.

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