A 22-year-old white male presents with a history of
microscopic hematuria and albuminuria. He also complains of a steady
deterioration in his hearing, accompanied intermittently by low-pitched
tinnitus in both ears in the past 5 years. Family history is notable for an
uncle who developed kidney failure. Pure-tone audiometry with speech testing
confirmed bilateral moderate sensorineural hearing loss. Complete blood count
showed normal values. Blood urea nitrogen (BUN) and creatinine levels were
elevated at 42 and 2.6 mg/dL, respectively. Chest X-ray and ECG were normal.
Ultrasound of the kidneys was normal. A percutaneous kidney biopsy showed the
following electron micrograph (see pic). What is the diagnosis?
Alports syndrome
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