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Alport Sendromunda Uzun Dönemli Takip Potansiyel Kardiyovasküler Riskleri Değerlendirebilir mi?

Year 2026, Volume: 16 Issue: 1, 83 - 88, 23.01.2026

Abstract

Amaç: Alport Sendromu (AS), glomerüler bazal membran ve ekstraselüler matriksin önemli bir proteini olan tip 4 kollajen deki yapısal bozukluklar sonucu klinik bulgulara neden olur. Çalışmanın amacı, genetik olarak AS tanısı konulan 8 hastanın güncel kardiyolojik, klinik ve biyokimyasal verilerini 5 yıl öncesine ait veriler ile karşılaştırmak ve elde edilen verilerle, uzun vadede gelişebilecek olası akut kardiyovasküler hastalık risklerini araştırmaktır.
Gereç ve Yöntemler: Genetik analiz sonucunda AS tanısı alan sekiz hastanın güncel demografik, laboratuvar ve klinik verileri, 5 yıl öncesine ait veriler ile karşılaştırıldı. Hastalara oftalmolojik ve işitsel testlerin yanısıra, transtorasik ekokardiyografi işlemi yapıldı. Hastaların demografik özellikleri kaydedildi, laboratuvar bulguları ölçüldü.
Bulgular: Hematüri ve kalp kapak yetersizliği varlığı 5 yıl önceki veriler ile karşılaştırıldığında, güncel değerlerde anlamlı iyileşme olduğu saptandı. Bununla birlikte, böbrek, karaciğer ve tiroid fonksiyonlarını gösteren biyokimyasal parametreler 5 yıl öncesine ait değerlerle karşılaştırıldığında anlamlı bir değişiklik saptanmadı. Ayrıca istatistiksel olarak anlamlı olmasa da görme kaybı ile ilgili problemlerin azaldığı görüldü.
Sonuç: Literatürde AS'a eşlik eden yaşamı tehdit eden kardiyovasküler olaylar genellikle hastaların klinik takibinde böbrek yetmezliği ve hipertansiyon saptandıktan sonra ortaya çıkmaktadır. Bu nedenle AS tanısı almış hastaların böbrek fonksiyonlarının ve kan basınçlarının yaşamları boyunca yakından izlenmesi, yüksek mortaliteye sahip kardiyovasküler hastalıklardan korunma da ve önleyici tedbirler alınmasında hayati önem arz etmektedir.

Ethical Statement

Eight patients genetically diagnosed with Alport syndrome were included in this study after obtaining informed consent. Permission was obtained from the local Ethics Committee for the current study (ethical approval code: 2024/148).

References

  • 1. Warady BA, Agarwal R, Bangalore S, Chapman A, Levin A, Stenvinkel P, et al. Alport Syndrome classification and management. Kidney Med. 2020;2(5):639-49. doi:10.1016/j.xkme.2020.05.014.
  • 2. Suh JH, Miner JH. The glomerular basement membrane as a barrier to albumin. Nat Rev Nephrol. 2013;9(8):470-7. doi:10.1038/nrneph.2013.109.
  • 3. Pöschl E, Schlötzer-Schrehardt U, Brachvogel B, Saito K, Ninomiya Y, Mayer U. Collagen IV is essential for basement membrane stability but dispensable for initiation of its assembly during early development. Development. 2004;131(7):1619-28. doi: 10.1242/dev.01037.
  • 4. Eroz R, Damar İH, Kiliçaslan O. Thrombosis risk of Alport syndrome patients: evaluation of cardiological, clinical, biochemical, genetic and possible causes of inherited thrombophilia and identification of a novel COL4A3 variant. Blood Coagulation Fibrinolysis. 2020;31(4):264-9. doi:10.1097/MBC.0000000000000911.
  • 5. Kelly Y, Wallis L, Patil A, Murray S, Kant S, Kaballo M, et al. Alport Syndrome: no evidence of improved prognosis in modern Era. J Clin Nephrol Ren Care. 2018;4(1):036. doi:10.23937/2572-3286.1510036.
  • 6. Gregorio V, Caparali EB, Shojaei A, Ricardo S, Barua M. Alport Syndrome: clinical spectrum and therapeutic advances. Kidney Med. 2023;5(5):100631. doi:10.1016/j.xkme.2023.100631.
  • 7. Savige J, Renieri A, Ars E, Daga S, Pinto AM, Rothe H, et al. Digenic Alport Syndrome. Clin J Am Soc Nephrol. 2022;17(11):1697-706. doi:10.2215/CJN.03120322.
  • 8. Adone A, Anjankar A. Alport Syndrome: a comprehensive review. Cureus. 2023;15(10):e47129. doi:10.7759/cureus.47129.
  • 9. Yavas C, Ozdemir Ozgenturk N, Dogan M, Gezdirici A, Keskin E, Gokpinar İli E, et al. A deeper insight into COL4A3, COL4A4, and COL4A5 variants and genotype-phenotype correlation of a Turkish cohort with Alport Syndrome. Mol Syndromol. 2024;15(1):1-13. doi:10.1159/000533915.
  • 10. Nozu K, Nakanishi K, Abe Y, Udagawa T, Okada S, Okamoto T, et al. A review of clinical characteristics and genetic backgrounds in Alport Syndrome. Clin Exp Nephrol. 2019;23(2):158-68. doi:10.1007/s10157-018-1629-4.
  • 11. Bose S, Pathireddy S, Baradhi KM, Aeddula NR. Alport’s Syndrome and intracranial aneurysm: mere coincidence or undiscovered causal relationship. BMJ Case Rep. 2019;12(1):e228175. doi:10.1136/bcr-2018-228175.
  • 12. Patel J, Abt P, Cheng K, Aurigemma G, Rosenthal L. Type a dissection in a patient with alport syndrome. Circ Cardiovasc Imaging. 2020;13(12):e010701. doi:10.1161/CIRCIMAGING.120.010701.
  • 13. Díez-Del Hoyo F, Sanz-Ruiz R, Díez-Villanueva P, Núñez-García A, Casado-Plasencia A, Angulo-Llanos R, et al. A novel cardiovascular presentation of Alport Syndrome: spontaneous coronary artery dissection. Int J Cardiol. 2014;177(3):e133-4. doi:10.1016/j.ijcard.2014.09.065.
  • 14. Smith JD, Colville D, Lyttle N, Lamoureux E, Savige J. Increased microvascular disease in X-linked and autosomal recessive Alport syndrome: a case control cross sectional observational study. Ophthalmic Genet. 2019;40(2):129-134. doi:10.1080/13816810.2019.1589528.
  • 15. Lang RM, Badano LP, Victor MA, Afilalo J, Armstrong A, Ernande L, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28(1):1-39.e14. doi:10.1016/j.echo.2014.10.003.
  • 16. Vedula R, Iyengar AA. Approach to diagnosis and management of Hematuria. Indian J Pediatr. 2020;87(8):618-24. doi:10.1007/s12098-020-03184-4.
  • 17. Chen D, Zhang L, Rao J, Zhou Y, Dai L, Huang S, et al. Effects of a Novel COL4A3 Homozygous/Heterozygous Splicing Mutation on the mild phenotype in a family with autosomal recessive Alport Syndrome and a literature review. Mol Genet Genomic Med. 2025;13(2):e70053. doi:10.1002/mgg3.70053.
  • 18. Levy Erez D, Rheault MN. An update on women and girls with Alport Syndrome. Current Pediatrics Reports. 2022;10(4):195-201. doi:10.1007/s40124-022-00279-8.
  • 19. Domagała D, Data K, Szyller H, Farzaneh M, Mozdziak P, Woźniak S, et al. Cellular, molecular and clinical aspects of aortic aneurysm—vascular physiology and pathophysiology. Cells. 2024;13(3):274. doi:10.3390/cells13030274.
  • 20. Nishiori H, Sakata T, Makino S ichi, Kawakami M, Matsumiya G. Alport Syndrome: a case study of chronic type A aortic dissection. J Card Surg. 2022;37(7):2134-7. doi:10.1111/jocs.16496.
  • 21. Kashtan CE, Segal Y, Flinter F, Makanjuola D, Gan J Sen, Watnick T. Aortic abnormalities in males with Alport Syndrome. Nephrol Dial Transplant. 2010;25(11):3554-60. doi:10.1093/ndt/gfq271.
  • 22. Kamiar A, Alitter Q, Capcha JMC, Saad A, Webster KA, Shehadeh LA. Ascending aortic aneurysm and histopathology in Alport syndrome: a case report. BMC Nephrol. 2023;24(1):300. doi:10.1186/s12882-023-03345-5.
  • 23. Anuwatworn A, Sethi P, Steffen K, Jonsson O, Petrasko M. Spontaneous coronary artery dissection: a rare manifestation of alport syndrome. Case Rep Cardiol. 2017;2017:1705927. doi:10.1155/2017/1705927.
  • 24. Auer J, Lamm G. Multiple coronary artery aneurysms in Alport syndrome. J Invasive Cardiol. 2019;31(12):E392-E393.

May Long-Term Follow-Up in Alport Syndrome Assess Potential Cardiovascular Risks?

Year 2026, Volume: 16 Issue: 1, 83 - 88, 23.01.2026

Abstract

Aim: Alport Syndrome (AS) causes clinical findings as a result of structural defects in type 4 collagen, an important protein of the glomerular basement membrane and extracellular matrix. The aim of the study is to compare the current cardiological, clinical and biochemical data of 8 patients genetically diagnosed with AS with data from 5 years ago and to investigate the possible long-term risks of acute cardiovascular disease with the obtained data.
Material and Methods: Current demographic, laboratory and clinical data of eight patients diagnosed with AS as a result of genetic analysis were compared with data from 5 years ago. Ophthalmological and auditory tests were performed on the patients, as well as transthoracic echocardiography. Demographic characteristics of the patients and laboratory findings were measured.
Results: When the presence of hematuria and heart valve insufficiency were compared, a significant improvement was determined compared to 5 years ago. In addition, when the biochemical parameters indicating kidney, liver and thyroid functions were compared to the values 5 years ago, no significant change was detected. Although not statistically significant, problems related to vision loss were observed to decrease.
Conclusion: In the literature, life-threatening cardiovascular events accompanying AS usually occur after advanced renal failure and hypertension are detected in the clinical follow-up of patients. Therefore, it is vital to closely monitor the renal functions and blood pressure of patients diagnosed with AS throughout their lives in order to protect them from cardiovascular diseases with high mortality and to take preventive measures.

References

  • 1. Warady BA, Agarwal R, Bangalore S, Chapman A, Levin A, Stenvinkel P, et al. Alport Syndrome classification and management. Kidney Med. 2020;2(5):639-49. doi:10.1016/j.xkme.2020.05.014.
  • 2. Suh JH, Miner JH. The glomerular basement membrane as a barrier to albumin. Nat Rev Nephrol. 2013;9(8):470-7. doi:10.1038/nrneph.2013.109.
  • 3. Pöschl E, Schlötzer-Schrehardt U, Brachvogel B, Saito K, Ninomiya Y, Mayer U. Collagen IV is essential for basement membrane stability but dispensable for initiation of its assembly during early development. Development. 2004;131(7):1619-28. doi: 10.1242/dev.01037.
  • 4. Eroz R, Damar İH, Kiliçaslan O. Thrombosis risk of Alport syndrome patients: evaluation of cardiological, clinical, biochemical, genetic and possible causes of inherited thrombophilia and identification of a novel COL4A3 variant. Blood Coagulation Fibrinolysis. 2020;31(4):264-9. doi:10.1097/MBC.0000000000000911.
  • 5. Kelly Y, Wallis L, Patil A, Murray S, Kant S, Kaballo M, et al. Alport Syndrome: no evidence of improved prognosis in modern Era. J Clin Nephrol Ren Care. 2018;4(1):036. doi:10.23937/2572-3286.1510036.
  • 6. Gregorio V, Caparali EB, Shojaei A, Ricardo S, Barua M. Alport Syndrome: clinical spectrum and therapeutic advances. Kidney Med. 2023;5(5):100631. doi:10.1016/j.xkme.2023.100631.
  • 7. Savige J, Renieri A, Ars E, Daga S, Pinto AM, Rothe H, et al. Digenic Alport Syndrome. Clin J Am Soc Nephrol. 2022;17(11):1697-706. doi:10.2215/CJN.03120322.
  • 8. Adone A, Anjankar A. Alport Syndrome: a comprehensive review. Cureus. 2023;15(10):e47129. doi:10.7759/cureus.47129.
  • 9. Yavas C, Ozdemir Ozgenturk N, Dogan M, Gezdirici A, Keskin E, Gokpinar İli E, et al. A deeper insight into COL4A3, COL4A4, and COL4A5 variants and genotype-phenotype correlation of a Turkish cohort with Alport Syndrome. Mol Syndromol. 2024;15(1):1-13. doi:10.1159/000533915.
  • 10. Nozu K, Nakanishi K, Abe Y, Udagawa T, Okada S, Okamoto T, et al. A review of clinical characteristics and genetic backgrounds in Alport Syndrome. Clin Exp Nephrol. 2019;23(2):158-68. doi:10.1007/s10157-018-1629-4.
  • 11. Bose S, Pathireddy S, Baradhi KM, Aeddula NR. Alport’s Syndrome and intracranial aneurysm: mere coincidence or undiscovered causal relationship. BMJ Case Rep. 2019;12(1):e228175. doi:10.1136/bcr-2018-228175.
  • 12. Patel J, Abt P, Cheng K, Aurigemma G, Rosenthal L. Type a dissection in a patient with alport syndrome. Circ Cardiovasc Imaging. 2020;13(12):e010701. doi:10.1161/CIRCIMAGING.120.010701.
  • 13. Díez-Del Hoyo F, Sanz-Ruiz R, Díez-Villanueva P, Núñez-García A, Casado-Plasencia A, Angulo-Llanos R, et al. A novel cardiovascular presentation of Alport Syndrome: spontaneous coronary artery dissection. Int J Cardiol. 2014;177(3):e133-4. doi:10.1016/j.ijcard.2014.09.065.
  • 14. Smith JD, Colville D, Lyttle N, Lamoureux E, Savige J. Increased microvascular disease in X-linked and autosomal recessive Alport syndrome: a case control cross sectional observational study. Ophthalmic Genet. 2019;40(2):129-134. doi:10.1080/13816810.2019.1589528.
  • 15. Lang RM, Badano LP, Victor MA, Afilalo J, Armstrong A, Ernande L, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28(1):1-39.e14. doi:10.1016/j.echo.2014.10.003.
  • 16. Vedula R, Iyengar AA. Approach to diagnosis and management of Hematuria. Indian J Pediatr. 2020;87(8):618-24. doi:10.1007/s12098-020-03184-4.
  • 17. Chen D, Zhang L, Rao J, Zhou Y, Dai L, Huang S, et al. Effects of a Novel COL4A3 Homozygous/Heterozygous Splicing Mutation on the mild phenotype in a family with autosomal recessive Alport Syndrome and a literature review. Mol Genet Genomic Med. 2025;13(2):e70053. doi:10.1002/mgg3.70053.
  • 18. Levy Erez D, Rheault MN. An update on women and girls with Alport Syndrome. Current Pediatrics Reports. 2022;10(4):195-201. doi:10.1007/s40124-022-00279-8.
  • 19. Domagała D, Data K, Szyller H, Farzaneh M, Mozdziak P, Woźniak S, et al. Cellular, molecular and clinical aspects of aortic aneurysm—vascular physiology and pathophysiology. Cells. 2024;13(3):274. doi:10.3390/cells13030274.
  • 20. Nishiori H, Sakata T, Makino S ichi, Kawakami M, Matsumiya G. Alport Syndrome: a case study of chronic type A aortic dissection. J Card Surg. 2022;37(7):2134-7. doi:10.1111/jocs.16496.
  • 21. Kashtan CE, Segal Y, Flinter F, Makanjuola D, Gan J Sen, Watnick T. Aortic abnormalities in males with Alport Syndrome. Nephrol Dial Transplant. 2010;25(11):3554-60. doi:10.1093/ndt/gfq271.
  • 22. Kamiar A, Alitter Q, Capcha JMC, Saad A, Webster KA, Shehadeh LA. Ascending aortic aneurysm and histopathology in Alport syndrome: a case report. BMC Nephrol. 2023;24(1):300. doi:10.1186/s12882-023-03345-5.
  • 23. Anuwatworn A, Sethi P, Steffen K, Jonsson O, Petrasko M. Spontaneous coronary artery dissection: a rare manifestation of alport syndrome. Case Rep Cardiol. 2017;2017:1705927. doi:10.1155/2017/1705927.
  • 24. Auer J, Lamm G. Multiple coronary artery aneurysms in Alport syndrome. J Invasive Cardiol. 2019;31(12):E392-E393.
There are 24 citations in total.

Details

Primary Language English
Subjects Clinical Sciences (Other)
Journal Section Research Article
Authors

İbrahim Halil Damar 0000-0001-6420-0122

Fatih Kurt 0000-0003-1975-6492

Recep Eröz 0000-0003-0840-2613

Submission Date May 30, 2025
Acceptance Date September 29, 2025
Publication Date January 23, 2026
Published in Issue Year 2026 Volume: 16 Issue: 1

Cite

Vancouver Damar İH, Kurt F, Eröz R. May Long-Term Follow-Up in Alport Syndrome Assess Potential Cardiovascular Risks? VHS. 2026;16(1):83-8.