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IEMbase 0525: CTNS-related nephropathic cystinosis

Scope

Field Value
IEMbase ID 525
Nosology 1.11.01.02
Gene CTNS
External IDs OMIM:219800; OMIM:219900; OMIM:219750; ORPHA:411634
Generated mapping AMBIGUOUS; identifier match on OMIM:219750
Candidate DisMech targets Cystinosis.yaml; Cystinosis.yaml#Non-nephropathic ocular cystinosis
Review date 2026-07-07

IEMbase phenotype signal

IEMbase represents this as CTNS-related nephropathic cystinosis, with juvenile cystinosis and CTNS as alternate labels. The record is autosomal recessive, treatability is marked yes, and treatment rows list oral cysteamine bitartrate and cysteamine eyedrops.

The characteristic biochemical rows include increased cystine in fibroblasts and white blood cells, aminoaciduria, urinary losses of albumin, glucose, phosphate, potassium, sodium, calcium, and uric acid, low plasma bicarbonate, low plasma phosphate, low plasma potassium, and low or normal free carnitine. Clinical rows emphasize renal Fanconi syndrome, chronic renal failure, polyuria, rickets, renal osteodystrophy, nephrocalcinosis/nephrolithiasis, failure to thrive, corneal cystine crystals, photophobia, retinopathy, hypogonadism, male infertility, hypothyroidism, diabetes, myopathy, swallowing difficulty, and later neurologic involvement.

DisMech phenotype coverage

Cystinosis.yaml is the correct local target, but the generated mapping is ambiguous because the IEMbase row carries the ocular-cystinosis OMIM identifier alongside nephropathic infantile and juvenile identifiers. The local file explicitly models CTNS lysosomal cystine transporter deficiency and has nephropathic infantile, nephropathic juvenile, and non-nephropathic ocular subtypes.

Local coverage is strong for CTNS/cystinosin biology, lysosomal cystine accumulation, proximal tubule dysfunction, renal Fanconi syndrome, progressive kidney disease, corneal crystal disease, oral and ophthalmic cysteamine, and replacement therapy for Fanconi losses.

Concordance and completeness

Judgement: correct local cystinosis target; manually resolve the ambiguity to the nephropathic cystinosis context rather than the ocular-only subtype.

IEMbase and DisMech agree on CTNS, lysosomal cystine storage, autosomal recessive inheritance, Fanconi syndrome, renal progression, corneal crystals, photophobia, and cysteamine therapy. IEMbase is useful as a detailed analyte checklist for tubular solute wasting and extrarenal late manifestations.

Curation actions

  • Keep this record mapped to Cystinosis.yaml, with nephropathic infantile and juvenile subtype context.
  • Do not use OMIM:219750 alone to collapse this record to ocular cystinosis.
  • Preserve the IEMbase renal-wasting analytes, free-carnitine row, endocrine, gonadal, ocular, myopathy, swallowing, and neurologic prompts for future review.