DOI QR코드

DOI QR Code

아가미-귀-콩팥증후군 환자에서의 신부전 증례

Renal Failure with Branchio-Oto-Renal Syndrome

  • 김지원 (아주대학교 의과대학 신장내과학교실) ;
  • 이선홍 (아주대학교 의과대학 신장내과학교실) ;
  • 임현이 (아주대학교 의과대학 병리학교실) ;
  • 정종철 (아주대학교 의과대학 신장내과학교실) ;
  • 신규태 (아주대학교 의과대학 신장내과학교실) ;
  • 김흥수 (아주대학교 의과대학 신장내과학교실) ;
  • 박인휘 (아주대학교 의과대학 신장내과학교실)
  • Kim, Ji Won (Department of Nephrology, Ajou University School of Medicine) ;
  • Lee, Sunhong (Department of Nephrology, Ajou University School of Medicine) ;
  • Yim, Hyun Ee (Department of Pathology, Ajou University School of Medicine) ;
  • Jeong, Jong Cheol (Department of Nephrology, Ajou University School of Medicine) ;
  • Shin, Gyu-Tae (Department of Nephrology, Ajou University School of Medicine) ;
  • Kim, Heungsoo (Department of Nephrology, Ajou University School of Medicine) ;
  • Park, Inwhee (Department of Nephrology, Ajou University School of Medicine)
  • 투고 : 2017.10.25
  • 심사 : 2018.03.14
  • 발행 : 2018.08.01

초록

BOR 증후군 환자는 일반적으로 평균 수명과 차이 없으나 신기능이 감소되어 다양한 합병증이 발생하고 수명이 단축되므로, 본 증례처럼 청력 소실, 외이 기형 등으로 BOR 증후군이 의심된다면 혈액 검사, 요 검사 및 영상 검사 등을 통하여 콩팥 이상을 확인하는 것이 필요하다.

Branchio-oto-renal (BOR) syndrome is a rare autosomal dominant disorder that is characterized by preauricular pits, branchial fistula, branchial cyst, hearing impairment, and kidney anomalies. Hearing impairment is the single most common feature of BOR syndrome, affecting 89% of patients. Preauricular pits (77%), kidney anomalies (66%), branchial fistula (63%), external auditory canal anomalies (41%) are also common. For most patients, BOR syndrome does not affect life expectancy. The major life-threatening feature of this condition is kidney dysfunction, which occurs with about 6% of kidney anomalies. Therefore, once BOR syndrome is recognized in a patient, careful evaluation to detect renal anomalies and treatment of any kidney involvement are necessary. No case reports of BOR syndrome involving adult-onset end-stage kidney disease have been published in the Korean medical literature. We report a case of end-stage kidney disease in a 19-year-old male patient with BOR syndrome, together with a review of the pertinent literature.

키워드

참고문헌

  1. Stinckens C, Standaert L, Casselman JW, et al. The presence of a widened vestibular aqueduct and progressive sensorineural hearing loss in the branchio-oto-renal syndrome. A family study. Int J Pediatr Otorhinolaryngol 2001;59:163-172. https://doi.org/10.1016/S0165-5876(01)00473-6
  2. Chen A, Francis M, Ni L, et al. Phenotypic manifestations of branchio-oto-renal syndrome. Am J Med Genet 1995;58:365-370. https://doi.org/10.1002/ajmg.1320580413
  3. Melnick M, Bixler D, Nance WE, Silk K, Yune H. Familial branchio-oto-renal dysplasia: a new addition to the branchial arch syndromes. Clin Genet 1976;9:25-34.
  4. Heusinger C. Hals-Kiemen-Fisteln von noch nicht beobachterer form. Virchows. Arch Pathol Anat Physiol 1864;29:358-380. https://doi.org/10.1007/BF01937182
  5. Abdelhak S, Kalatzis V, Heilig R, et al. Clustering of mutations responsible for branchio-oto-renal (BOR) syndrome in the eyes absent homologous region (eyaHR) of EYA1. Hum Mol Genet 1997;6:2247-2255. https://doi.org/10.1093/hmg/6.13.2247
  6. Ruf RG, Berkman J, Wolf MT, et al. A gene locus for branchio-otic syndrome maps to chromosome 14q21.3-q24.3. J Med Genet 2003;40:515-519. https://doi.org/10.1136/jmg.40.7.515
  7. Kim SH, Shin JH, Yeo CK, et al. Identification of a novel mutation in the EYA1 gene in a Korean family with branchio-oto-renal (BOR) syndrome. Int J Pediatr Otorhinolaryngol 2005;69:1123-1128. https://doi.org/10.1016/j.ijporl.2005.03.003
  8. Chang EH, Menezes M, Meyer NC, et al. Branchio-oto-renal syndrome: the mutation spectrum in EYA1 and its phenotypic consequences. Hum Mutat 2004;23:582-589. https://doi.org/10.1002/humu.20048
  9. Klingbeil KD, Greenland CM, Arslan S, et al. Novel EYA1 variants causing branchio-oto-renal syndrome. Int J Pediatr Otorhinolaryngol 2017;98:59-63. https://doi.org/10.1016/j.ijporl.2017.04.037
  10. Barzilai M, Ish-Shalom N. Sonographic features of a dysplastic kidney in Melnick-Fraser syndrome. AJR Am J Roentgenol 1994;163:226.