Table 1

Inherited causes of the renal Fanconi syndrome

Disorder Onset/features Defective gene/protein Diagnostic test Specific treatment
CystinosisMid/late infancy, poor growth, may be blond/fair hair, corneal cystine crystals CTNS/cystinosinLeucocyte cystine concentrationCysteamine
TyrosinaemiaInfancy, poor growth, hepatic enlargement and dysfunctionFumaryl acetoacetate hydrolasePlasma amino acids, urine organic acids (succinyl acetone)Nitro-trifluoro-benzoyl cyclohexidine (NTBC)
Lowe's syndromeBirth, X linked, cataracts, hypotonia, developmental delayInositol polyphosphate 5-phosphataseClinical and molecular genetic diagnosis
GalactosaemiaBirth, jaundice, encephalopathyGalactose 1-phosphate uridyl transferaseRed cell galactose 1-phosphate uridyl transferaseGalactose free diet
FructosaemiaRapid onset after fructose given, vomiting, hypoglycaemia, hepatomegalyFructose-1-phosphate aldolase BHepatic fructose-1-phosphate aldolase BFructose and sucrose free diet
Fanconi–Bickel syndromeInfancy, failure to thrive, hepatomegaly, hypoglycaemia rickets, glycosuria, galactosuria GLUT2/Glut2 (facilitated glucose transporter)? Monosaccharide diet
Dent's diseaseChild/adulthood, X-linked, hypercalciuria, nephrocalcinosis CLC-5/CLCN5 (voltage gated chloride channel)Molecular diagnosis? Potassium citrate/thiazide
Mitochondrial disordersUsually in infancy, may be multisystem dysfunctionMitochondrial DNALactate, pyruvate, muscle enzymology
Wilson's diseaseChildhood, hepatic disease, neurological signs, Kayser–Fleischer rings Wc-1/P-type copper transporting ATPaseCopper, caeruloplasminD-penicillamine