All issues > Volume 37(6); 1994

Case Report

J Korean Pediatr Soc. 1994;37(6):872-879. Published online June 15, 1994.

A Case of Incomplete Drash Syndrom

Im Jae IJ Park¹, Hyunee He Yim², Jae Seung JS Lee¹, Hyeon Joo HJ Jeong², Woo Hee WH Jung²

¹Department of Pediatrics, Yonsei University, College of Medicine, Seoul, Korea
²Department of Pathology, Yonsei University, College of Medicine, Seoul, Korea

Abstract

Drash syndrome, which was first reported by Denys et al. In 1967 is a complex disorder which associates a nephropathy, Wilms?tumor, and male pseudohermaphroditism. The common denominator is a nephropathey. The nephropathy may be associated with either genital abnormalities or Wilms?tumor, and these associations are called incomplete form of Drash syndrome. This syndrome appears early in life and the first sign usually is genital ambiguity. The nephropathy presents with proteinuria, hematuria and hypertension, and eventually progresses to end stage renal failure. Renal biopsy may reveal a variety of glomerular and interstitial changes. Wilms?tumor may appear as a mass on ultrasound or it may not be recognized until nephrectomy or even autopsy. We report on a boy with nephropathy and genital abnormalities. A nephrotic syndrome with hypertension was present when first seen at 15 days of age. The karyotype was 46, XY and external genitalia was ambiguous. The nephrotic syndrome and signs of renal insufficiency persisted and he died at the age of 40 days. Histopathologic findings of kidney at autopsy revealed those of diffuse mesangial sclerosis. The case was presented with brief review of literatures.

Keywords :Incomplete Drash syndrome, Male pseudohermaph