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Renal tubular acidosis
Minimal change disease
Focal segmental glomerulosclerosis (NORD)
Rapidly progressive glomerulonephritis
IgA nephropathy (NORD)
Acute tubular necrosis
Renal papillary necrosis
Renal cortical necrosis
Chronic kidney disease
Polycystic kidney disease
Multicystic dysplastic kidney
Medullary cystic kidney disease
Medullary sponge kidney
Renal artery stenosis
Renal cell carcinoma
Nephroblastoma (Wilms tumor)
Posterior urethral valves
Hypospadias and epispadias
Lower urinary tract infection
Transitional cell carcinoma
Non-urothelial bladder cancers
Congenital renal disorders: Pathology review
Renal tubular defects: Pathology review
Renal tubular acidosis: Pathology review
Acid-base disturbances: Pathology review
Electrolyte disturbances: Pathology review
Renal failure: Pathology review
Nephrotic syndromes: Pathology review
Nephritic syndromes: Pathology review
Urinary incontinence: Pathology review
Urinary tract infections: Pathology review
Kidney stones: Pathology review
Renal and urinary tract masses: Pathology review
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Tanner Marshall, MS
WAGR syndrome stands for Wilms’ tumor, aniridia, genitourinary anomalies, and mental retardation, which is now called intellectual disability, and this is a genetic disorder that’s caused when a part of chromosome 11 is missing, or deleted.
Not everyone with WAGR has all of the symptoms, for example only about a half of the individuals have Wilms’ tumor.
On the flip side, some have additional symptoms, too, like progressive kidney failure, growth retardation, small head size, and obesity.
The most specific feature of WAGR syndrome is aniridia, which is the complete or partial absence of the iris, the colored part of the eye. And this is an easily noticeable feature, and it’s present at birth, so it’s usually the first thing to raise suspicion of WAGR syndrome.
Now, a normal iris controls how much light enters the eye, and it constricts the pupil when there’s a lot of light around to keep the vision sharp. With aniridia, too much light gets into the eye, which leads to blurry vision and photophobia, which is discomfort when the eyes are exposed to light.
Additional eye features in WAGR syndrome can include cataracts, which is a clouded lens, glaucoma, or increased pressure in the eye, and nystagmus—abnormal rhythmic eye movements of the eye.
Wilms’ tumor, also called nephroblastoma, is generally a malignant kidney tumor that affects children.
Wilms’ tumor’s composed of metanephric blastema, which is a cell type that’s seen in the developing kidney, stromal cells which are part of the connective tissue, and epithelial cells which self-organize into primitive glomeruli and tubules.
Children with Wilms’ tumor often develop a large flank mass, as well as hematuria, which is blood in the urine, and hypertension.
Now, that hypertension is a result of increased renin secretion; which either comes from the tumor itself or from healthy kidney tissue that secretes renin because it’s physically compressed by the tumor.
WAGR syndrome is a rare genetic disorder caused by a deletion or mutation of certain genes on chromosome 11. It is characterized by four main features: Wilms tumor, aniridia, genitourinary abnormalities, and intellectual disability. People with WAGR syndrome can also present with cataracts, glaucoma, and nystagmus. The severity and range of symptoms can vary widely among affected individuals. Treatment usually involves a multidisciplinary approach, including surgical intervention for Wilms tumor, management of developmental and intellectual issues, and regular monitoring for potential health issues.
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