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The novel occurrence of non-syndromic unilateral renal hypoplasia and unilateral aplasia in two brothers

Aamir Jalal Al-Mosawi1

1 Advisor in Pediatrics and Pediatric Psychiatry Children Teaching Hospital of Baghdad Medical City and the National Center of Training and Development

Correspondng Author:

Aamir Jalal Al-Mosawi

Citation:

Aamir Jalal Al-Mosawi, The novel occurrence of non-syndromic unilateral renal hypoplasia and unilateral aplasia in two brothers. Journal of Clinical Sciences and Clinical Research.2(1). DOI: 10.58489/2836-8959/007

Copyright:

© 2023 Aamir Jalal Al-Mosawi, this is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  • Received Date: 03-03-2023   
  • Accepted Date: 08-03-2023   
  • Published Date: 10-03-2023
Abstract Keywords:

Autosomal dominant; non-syndromic; unilateral renal hypoplasia; unilateral renal aplasia Iraq

Abstract

Background: Non-syndromic unilateral renal hypoplasia is a congenital condition associated with one small kidney (hypoplastic) that generally has normal residual parenchyma but smaller calyces. We have previously reported the first case of non-syndromic unilateral renal hypoplasia transmitted in an autosomal dominant fashion from the mother.

Patients and methods: The brother of the boy who was the patient in the medical literature reported to have unilateral renal hypoplasia transmitted from the mother in an autosomal dominant was seen and renal ultrasound performed.                     

Results: The present patient, the brother was seen late during June, 2022 at about the age of eighteen years, for a routine check and was asymptomatic and otherwise healthy. However, abdominal ultrasound showed unilateral right renal aplasia. The right kidney was absent, while left kidney showed compensatory hypertrophy.

Conclusion: This paper reports the novel occurrence of non-syndromic unilateral renal hypoplasia and unilateral aplasia in two brothers. 

Introduction

Non-syndromic unilateral renal hypoplasia is a rare congenital condition associated with one small (hypoplastic) kidney that generally has normal residual parenchyma but smaller calyces. The size of the hypoplastic kidney is less than two standard deviations below the expected mean. The condition can be asymptomatic or presents with urinary tract infections and/or renal urolithiasis. Unilateral renal hypoplasia is typically diagnosed with renal ultrasound. 

We have previously reported the first case of non-syndromic unilateral renal hypoplasia transmitted in an autosomal dominant fashion from the mother [1].

Patients and methods

The brother of the boy who was the patient in the medical literature reported to have unilateral renal hypoplasia transmitted from the mother in an autosomal dominant was seen and renal ultrasound performed.                     

Results

The present patient, the brother was seen late during June, 2022 at about the age of eighteen years, for a routine check and was asymptomatic and otherwise healthy. However, abdominal ultrasound showed unilateral right renal aplasia. The right kidney was absent. The left kidney showed compensatory hypertrophy with dimensions of 10 x 5 cm, cortex 14 mm with homogeneous texture. The cortico-medullary junction was intact with no mass or stone. There was no dilatation of the pelvi-calyceal system or the left ureter. There was no other abnormality on abdominal ultrasound.

Figure-1: The left kidney 

Discussion

The occurrence of non-syndromic unilateral renal hypoplasia has been reported early during the 1900s [1]. Taño Pino et al (1996) described two brothers, not twins who had unilateral congenital renal hypoplasia with vesico-urethral reflux. The diagnosis in the two brothers was made at about the age of 24 years and without any urological history, when they presented with a dysuria-pollakiuria syndrome [3].

Cain et al (2010) emphasized a genetic basis for unilateral renal hypoplasia [4], but the transmission of the condition from a parent to offspring has never been reported. Autosomal dominant non-syndromic unilateral renal hypoplasia has not been reported in Iraq or in any other country [3-9].

The occurrence of non-syndromic isolated unilateral renal aplasia in two siblings has been reported once during the early 1960s.

Conclusion

This paper reports the novel occurrence of non-syndromic unilateral renal hypoplasia and unilateral aplasia in two brothers.

References

  1. Al-Mosawi AJ. (2020) Autosomal dominant non-syndromic unilateral renal hypoplasia: A condition not previously reported in the literature. International Journal of Radiology Research (e-ISSN: 2663-4562, p-ISSN: 2663-4554) Jul; 2(1): 18-19.
  2. Kaser H. (1956)Hypertension in unilateral renal hypoplasia. Ann Paediatr May; 186(5):257-70 [Article in German].
  3. Taño Pino FJ, Galbis Palau F, Monllor Gisbert J, Rodríguez Arteaga PR, (1996) Quintana Domínguez R. Hipoplasia renal y reflujo vesicoureteral familiar. Una rara asociación [Renal hypoplasia and familial vesicoureteral reflux. A rare association]. Actas Urol Esp; 20(1):68-71[Article in Spanish].
  4. Cain J, Di Giovanni V, Smeeton J. (2010) et al. Genetics of renal hypoplasia: Insights into the mechanisms controlling nephron endowment. Pediatr Res; 68, 91-98. Doi: 10. 1203/PDR.0b013e3181e35a88
  5. Al-Mosawi AJ. (2002) The etiology of chronic renal failure in 54 Iraqi children. Pediatr Nephrol. Jun; 17(6):463-4. Doi: 10.1007/s00467-001-0774-1. PMID: 12162275.
  6. Al-Mosawi AJ. (2008) Chronic renal failure in Iraqi children: 14-year experience of a single center. Journal of Nephrology and Renal Transplantation (JNRT); 1(1): 32-40. Doi: 10.5281/zenodo.3875727
  7. Al-Mosawi AJ. (2020) Clinical genetics and dysmorphology: A unique pioneering experiences .1st ed., Saarbrücken; LAP Lambert Academic Publishing: (ISBN: 978-620-2-68085).
  8. Klinische Genetik und Dysmorphologie: Eine einzigartige bahnbrechende Erfahrung (German Edition). Verlag Unser Wissen. 2020 (ISBN-10: 6202646780, ISBN-13: 978-6202646789).
  9. Genetica clinica e dismorfologia: Un'esperienza pionieristica unica (Italian Edition). Edizioni Sapienza. 2020 (ISBN-10: 6202646756 ISBN-13: 978-6202646758).
  10. Gorvoy JD, Smulewicz J, Rothfeld SH. (1962) Unilateral renal agenesis in two siblings. Case report. Pediatrics. Feb; 29:270-3.

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