Alport syndrome
Dr Yuranga Weerakkody and Dr Frank Gaillard et al.
The Alport syndrome is an X-linked recessive disease characterised by :
- haematuria
- sensory neural hearing loss : typically high frequency 2
- ocular abnormalities
- anterior lenticonus : most common ocular abnormality; may result in cataracts
- perimacular pigmentary changes
- flecks around the fovea 2
- multiple leiomyomas 1-2
- oesophagus
- tracheobronchial tree
- female genitalia
Pathology
It is the result of mutation in collagen type IV, which is found in the basement membrane of the glomerulus, the cochlea and the eye.
Males are predictably more severely affected, although females also demonstrate abnormalities 2.
Associations
Radiological features
Ultrasound
Normal size and echotexture in early stage, however advanced disease may show small, shrunken and echogenic kidneys.
CT
Kidneys may be shrunken with delayed or non-excretion of contrast in advanced stages.
Multiple leiomyomas can be seen in esophagus5, tracheobronchial tree, or uterus.
MRI
MRI brain may show patchy/nodular lesions in gangliothalamic complexes, with reduced white matter myelination4.
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