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Expanding the Phenotypic Spectrum: Chronic Kidney Disease in a Patient with Combined Oxidative Phosphorylation Defect 21 Cover

Expanding the Phenotypic Spectrum: Chronic Kidney Disease in a Patient with Combined Oxidative Phosphorylation Defect 21

Open Access
|Mar 2024

Figures & Tables

Figure 1.

1.5T Brain MRI of the patient: a–c were performed at the age of 2.5 years; a- pathologically increased signal of the brain parenchyma on T2/DVI/FLAIR sequences, in the projection of the white matter of the cerebellum; b- in the projection of nucleus caudate, globus pallidus, putamen and dentate nuclei there are punctiform and slightly linear zones of reduced signal intensity on the chemo-sensitive sequence, which are hyperintense on T1WI (c); d–f Brain MRI were performed at the age of 4 years; d- in the same regions, there are significantly larger hypointense signal lesions on T2WI/FLAIR sequences and SWI sequences (e), hyperintense on T1WI (f), corresponding to punctiform and serpiginous calcification zones. Mild ventriculomegaly is shown on these sequences.
1.5T Brain MRI of the patient: a–c were performed at the age of 2.5 years; a- pathologically increased signal of the brain parenchyma on T2/DVI/FLAIR sequences, in the projection of the white matter of the cerebellum; b- in the projection of nucleus caudate, globus pallidus, putamen and dentate nuclei there are punctiform and slightly linear zones of reduced signal intensity on the chemo-sensitive sequence, which are hyperintense on T1WI (c); d–f Brain MRI were performed at the age of 4 years; d- in the same regions, there are significantly larger hypointense signal lesions on T2WI/FLAIR sequences and SWI sequences (e), hyperintense on T1WI (f), corresponding to punctiform and serpiginous calcification zones. Mild ventriculomegaly is shown on these sequences.

Key laboratory findings in serum/plasma over the course of the disease in a patient with COXPD21

Laboratory findings in blood6 months of age2 years of age4.5 years of ageReference range
Blood gases
pH7.47.397.427.35–7.45
HCO3m mmol/L20.016.424.221–28
Base excess, mmol/L−4.5−8.5−0.2−2−+3
Biochemistry
Serum creatinine, mcmol/L2411127423–37
GFR*, ml/min116.43217≥90
Cystatin C, mg/L1.162.224.50.62–1.2
Urea, mmol/L4.915.035.03.3–7.5
Uric acid, mcmol/L272238148120–320
Potassium, mmol/L2.86.85.83.4–4.7
Sodium, mmol/L136121146136–148
Calcium, mmol/L2.712.272.382.05–2.74
Magnesium, mmol/L0.880.670.900.7–1.05
Phosphorus, mmol/L2.20.962.881.05–1.80
Lactate, mmol/L2.532.152.00.2–2.0
Hormonal status
Parathyroid hormone, pg/mL26.33.317.515.8–68.3
25-hydroxyitamin D, nmol/L47.858.918.075.0–250.0
Thyroid stimulating hormone, mIU/L1.063.589.170.35–4.94
Free T4, pmol/L16.6312.78.989.0–19.0

Results of urinary analyses over the course of the disease in a patient with COXPD21

Urinalysis6 months of age2 years of age4.5 years of ageReference Range
pH6.06.56.55–8
Urine- Specific gravity1010101010051010–1030
Urine protein, g/L<0.1<0.1<0.1<0.1
Urine glucose, mmol/LNegativeNegative5.5Negative
Urine blood, RBC/uLNegativeNegativeNegativeNegative
Urine white blood cellsNegativeNegativeNegativeNegative
Protein/Cr, mg/mmoL203052<50
AminoaciduriaNegativeNegativeGeneralizedNegative
Beta-2 microglobulin/Cr, mg/mmoL0.140.3426.0<0.35
Calcium/Cr, mmol/mmol0.260.211.64*
Uric acid/Cr, mmol/mmol1.40.350.08*
FeNa, %0.83.132<1
FeMg, %6.654.9838.4<4
TTKG9324–6*
TRP, %93.881.24585–95
TmP/GFR, mmol/L1.411.640.781.13–1.88
Language: English
Page range: 59 - 64
Published on: Mar 12, 2024
Published by: Macedonian Academy of Sciences and Arts
In partnership with: Paradigm Publishing Services
Publication frequency: 2 issues per year

© 2024 A Paripović, A Maver, N Stajić, J Putnik, S Ostojić, B Alimpić, N Ilić, A Sarajlija, published by Macedonian Academy of Sciences and Arts
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.