• Takashi Ishide, Hiroshi Nishi, Shinako Miyano, Yosuke Hirakawa, Kenjiro Honda, Hiroyuki Abe, Masaaki Sato, and Masaomi Nangaku.
• Division of Nephrology and Endocrinology, The University of Tokyo Graduate School of Medicine, Japan.
• Intern. Med. 2023 Jul 1; 62 (13): 196519701965-1970.

AbstractA 55-year-old woman showed progressive renal dysfunction after unilateral deceased-donor lung transplantation for lymphangioleiomyomatosis. A kidney biopsy showed a striped pattern of interstitial fibrosis, suggesting calcineurin inhibitor toxicity, and zebra body accumulation predominantly in the podocytes, characteristics of Fabry disease. Nevertheless, she had no extra-renal symptoms of the disease, and gene testing identified no known pathogenic variant or exon deletion. Our case report and literature review suggest that this atypical lysosomal inclusion may be phospholipidosis induced by sertraline. Potential underlying etiologies linking zebra body deposits may be not only hereditary but also drug-induced phospholipidosis.

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