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Cystinosis

Cystinosis is a hereditary dysfunction of the renal tubules characterized by the presence of carbohydrates and amino acids in the urine, excessive urination, and low blood levels of potassium ions and phosphates. more...

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Medicines

Cause

It is caused by abnormal transport of the amino acid cystine from lysosomes of all tissues, resulting in a massive intra-lysosomal cystine accumulation. Via an as yet unknown mechanism, lysosomal cystine appears to amplify apoptosis such that cells die inappropriately, leading to loss of renal epithelial cells, accounting for the renal Fanconi syndrome, and simlar loss in other tissues can account for the short stature, retinopathy, and other features of the disease.

Symptoms

Symptoms include Fanconi Syndrome, photophobia, stunted growth and rickets. It is currently being researched at UC San Diego, Tulane University School of Medicine, and at the National Institutes of Health in Bethesda, Maryland.

Genetics

The cause of cystinosis is due to a mutation in the gene CTNS which codes for cystinosin, the lysosomal cystine transporter. Symptoms are seen about 6-18 months of age with profound polyuria ( excessive urination), followed by poor growth, photophobia, and ultimately kidney failure by age 10 years in the nephropathic form. It is importanat for the child to see a biochemical geneticist and pediatric nephrologist to begin cyteamine as early as possible. Cysteamine decreases the amount of cystine stored in lysosomes and correlates with conservation of renal function and improved growth. Cysteamine eyedrops remove the cystine crystals in the cornea that cause photophobia and may impair vision after age 20 years. All forms of cystinosis ( nephropathic, juvenile and ocular) are inherited as autosomal recessive traits, which means that there is a 25% recurrence risk to any couple who have had an affected child. The disease " breeds true" such that parents of a child with the juvenile variety of cystinosis will not have another child with the nephropathic form, etc.

Types

  • OMIM 219800 - Infantile nephropathic
  • OMIM 219900 - Adolescent nephropathic
  • OMIM 219750 - Adult nonnephropathic

Read more at Wikipedia.org


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Orphan drug approved to treat rare kidney disorder - Cystagon, by Mylan Pharmaceuticals Inc., may be used for nephropathic cystinosis and prevent or slow
From FDA Consumer, 11/1/94

Cystagon (cysteamine bitartrate) was approved by FDA last Aug. 15 to treat children with a rare kidney disease.

The disease, nephropathic cystinosis, is characterized by the buildup of an amino acid called cystine in the kidneys. Children with the disorder suffer progressive kidney failure and weak bones, and don't reach their normal height.

During the past 15 to 20 years, most children with the condition had to undergo kidney transplants. Before that, most died by age 10.

Studies showed that Cystagon can stop or slow the progressive kidney failure if patients get treatment early--before substantial kidney damage--and take the drug regularly. Although patients treated with the drug maintained growth, they did not catch up to their normal height. The studies included most of the 200 pre-transplant nephropathic cystinosis patients in the United States.

Side effects include nausea, vomiting, loss of appetite, drowsiness, and skin rash.

Cystagon was designated an orphan drug under the Orphan Drug Act, which provides economic incentives to encourage development of drugs to treat rare diseases.

Under the Orphan Grants Program, FDA has provided more than $900,000 to researchers at the University of California in San Diego, the National Institutes of Health, and the University of Michigan to study the effects of the drug in clinical trials.

Cystagon is manufactured by Mylan Pharmaceuticals Inc., Morgantown, W. Va.

COPYRIGHT 1994 U.S. Government Printing Office
COPYRIGHT 2004 Gale Group

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