PMC4235317_01
Dystrophic thumb nails in the index case
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PMC4235317_01_GMS-12-16-g-001.jpg
F1
The musculoskeletal examination showed dystrophic nails (Figure 1 (Fig. 1)) and a bilateral absence of patella with normal range of movement in all her joints.
Absent patella
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F2
Keeping in view her long duration of pedal edema due to nephrotic range proteinuria, the characteristic dystrophic nail changes, an X-ray of knees demonstrated the absence of bilateral patella (Figure 2 (Fig. 2)).
Absent patella and dystrophic nails in children (3A: Limited extension of the elbow; 3B: Prominent tibial and lateral condyles of both tibia due to aplastic patella; 3C: Dystrophic nail of the son)
GMS-12-16-g-003.jpg
PMC4235317_01_GMS-12-16-g-003.jpg
F3
All her children showed classical features of NPS as shown in Figure 3 (Fig. 3).