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Unexpectedly high prevalence of rare genetic disorders in kidney transplant recipients with an unknown causal nephropathy.
[fabry disease]
Patients
with
a
rare
genetic
disease
may
receive
renal
transplantation
(
KTx
)
without
a
correct
diagnosis
of
causal
nephropathy
and
therefore
develop
unexpected
and
even
severe
complications
.
The
aim
of
the
study
was
to
describe
the
cases
of
rare
genetic
disorders
diagnosed
after
KTx
,
in
order
to
draw
clinical
lessons
for
the
transplant
physician
.
We
retrospectively
assessed
all
patients
who
had
received
a
diagnosis
of
a
rare
genetic
disorder
after
KTx
.
In
our
center
,
more
than
30
%
(
278
/
911
)
of
kidney
transplant
(
KTx
)
recipients
were
diagnosed
with
a
causal
nephropathy
:
Prevalence
of
rare
genetic
disorders
in
this
group
was
4
.
32
%
(
12
/
278
)
,
including
2
,
8
-
dihydroxyadeninuria
(
2
,
8
-
DHA
)
disease
(
n
Â
=
Â
2
)
,
HNF-
1
B
-
associated
nephropathy
(
n
Â
=
Â
2
)
,
UMOD
-related
nephropathy
(
n
Â
=
Â
5
)
,
Fabry
disease
(
n
Â
=
Â
1
)
,
INF
2
focal
segmental
glomerulosclerosis
(
n
Â
=
Â
1
)
,
and
Senior-
Løken
syndrome
(
n
Â
=
Â
1
)
.
2
,
8
-
DHA
nephropathy
relapsed
in
both
patients
causing
an
acute
renal
failure
and
jeopardizing
the
graft
.
Kidney
transplant
recipients
without
a
diagnosis
of
causal
nephropathy
appear
to
be
a
selected
population
in
which
rare
genetic
diseases
might
be
more
common
than
expected
.
As
even
a
belated
diagnosis
after
KTx
can
have
a
significant
impact
on
graft
and
patient
survival
and
on
other
family
members
,
this
possibility
should
be
evaluated
in
KTx
recipients
without
a
known
causal
nephropathy
.
Diseases
Validation
Diseases presenting
"renal transplantation"
symptom
fabry disease
familial mediterranean fever
junctional epidermolysis bullosa
primary effusion lymphoma
primary hyperoxaluria type 1
systemic capillary leak syndrome
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