Volume 22, Number 10, 1799-1802, DOI: 10.1007/s00467-007-0532-0

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International Pediatric Nephrology Association

Immunodysregulation, polyendocrinopathy, enteropathy, X-linked (IPEX) syndrome: an unusual cause of proteinuria in infancy

Asha Moudgil, Paige Perriello, Brett Loechelt, Ronald Przygodzki, Wendy Fitzerald and Naynesh Kamani

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Abstract

We report on a 6-month-old child presenting with chronic diarrhea, failure to thrive, eczema, autoimmune hemolytic anemia (AIHA), insulin-dependent diabetes mellitus (IDDM), hypoalbuminemia, and proteinuria. Renal biopsy showed membranous glomerulonephritis. A diagnosis of Immunodysregulation, polyendocrinopathy, enteropathy, x-linked (IPEX) syndrome was subsequently confirmed by DNA analysis, which demonstrated the presence of a mutation in exon 2 of the FOXP3 gene (303–304 del TT). Proteinuria secondary to membranous glomerulonephritis is a novel feature of IPEX syndrome. Membranous glomerulonephritis went into remission after the patient had received hematopoietic stem cell transplantation (HSCT).

Keywords  IPEX syndrome - Proteinuria - Nephrotic syndrome - Membranous glomerulonephritis - Autoimmunity - FOXP3

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