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No HPO annotations are available for this condition.
Age of onset: infancy, adulthood, at birth, before birth, childhood, newborn period, adolescence.
Although phenotypes may overlap, three clinical phenotypes of cystinosis are recognized: nephropathic (the most severe form that presents in infancy), later-onset (juvenile), and non-nephropathic (ocular) cystinosis .
Nephropathic cystinosis should be suspected in infants and young children with the following clinical, laboratory, and imaging features and family history.
Clinical features
Typically, birth weight and initial growth are normal. Poor weight gain and growth deficiency occurs by age six to 12 months.
Vomiting and feeding difficulties
No approved treatments are currently available for inborn disorder of amino acid transport. The disease remains an area of unmet medical need.
Expert guidance on the multidisciplinary management of cystinosis in adolescent and adult patients is available, including clinical recommendations [, , , ].
Evaluations Following Initial Diagnosis
Table 3.
Cystinosis: Recommended Evaluations Following Initial Diagnosis
To monitor existing manifestations, the individual's response to supportive care, and the emergence of new manifestations, the evaluations summarized in are recommended. Clinical and laboratory examinations should be performed in individuals with nephropathic cystinosis according to disease severity and may include renal, endocrine, ophthalmologic, neurologic, and cardiac examinations . Table 6. Cystinosis: Recommended Surveillance
No clinical trials have been registered for inborn disorder of amino acid transport.
99 publications have been identified in PubMed for inborn disorder of amino acid transport. Research spans Basic Science / Preclinical (41%), Review / Meta-Analysis (22%), and Case Report / Case Series (20%).
Research Type | Count | % of Total |
|---|---|---|
Laboratory research | 40 | 41% |
Data assembled from 4 of 12 sources · Last updated Sep 20, 2026, 9:35 PM UTC
European rare disease database
Genetic and Rare Diseases Info Center
The clinical characteristics of untreated nephropathic cystinosis include poor weight gain, growth deficiency, renal tubular Fanconi syndrome, renal glomerular failure, and non-renal involvement of a variety of tissues and organ systems. Treatment with cysteamine allows depletion of lysosomal cystine in most tissues. Although cysteamine does not cure the disease, it dramatically improves the overall prognosis and life span . Growth. Infants with untreated nephropathic cystinosis typically have normal birth measurements.
Source: GeneReviews — "Cystinosis"
Severe polyuria, polydipsia, and dehydration
Progressive rachitic skeletal changes; failure to walk at a normal age
Tetany
Corneal crystals, typically observed by slit lamp examination in most individuals by age 12 months and in virtually all individuals by age 18 months (See .)
Laboratory features
Source: GeneReviews — "Cystinosis"
Renal tubular Fanconi syndrome. Untreated nephropathic cystinosis is the most common identifiable cause of renal tubular Fanconi syndrome in childhood. Genetic disorders associated with renal tubular Fanconi syndrome are listed in . Table 2. Genetic Disorders Associated with Renal Tubular Fanconi Syndrome in the Differential Diagnosis of Cystinosis
Gene(s) | Disorder | MOI | Features of Disorder | Comment |
|---|---|---|---|---|
Wilson disease | AR | Can manifest in individuals age 3 yrs to 70 yrs as hepatic, neurologic, or psychiatric disturbances, or a combination of these. Other multisystem involvement can include eyes (Kayser-Fleischer rings), hemolytic anemia, kidneys, endocrine glands, heart. | Findings in common w/cystinosis are renal Fanconi syndrome occurrence of eye findings. The absence of CKD in Wilson disease distinguishes it from cystinosis. CLCN5 OCRL | — |
Dent disease | XL | Disorder of proximal renal tubular dysfunction characterized by LMW proteinuria, hypercalciuria, at least 1 additional finding (e.g., nephrocalcinosis, nephrolithiasis, hematuria, hypophosphatemia, CKD). | Finding in common w/cystinosis is renal tubular dysfunction. FAH | — |
Tyrosinemia type I | AR | Usually presents in young infants w/severe liver involvement or later in the 1st yr w/liver dysfunction renal tubular dysfunction assoc w/poor growth rickets. G6PC1 SLC37A4 | — | — |
Glycogen storage disease type I | AR | Characterized by accumulation of glycogen fat in liver kidneys resulting in hepatomegaly nephromegaly. Severely affected infants present in neonatal period w/severe hypoglycemia due to fasting intolerance. | — | — |
Classic galactosemia | AR | Can result in feeding problems, poor growth, hepatocellular damage, bleeding, E coli sepsis in untreated infants. Both tubular reabsorption glomerular filtration can be impaired. | — | — |
OCRL | Lowe syndrome (oculocerebrorenal syndrome) | XL | In males, Lowe syndrome involves eyes (cataracts, glaucoma, decreased visual acuity), CNS (hypotonia, ID), kidneys (Fanconi syndrome). Slowly progressive glomerulosclerosis kidney failure are often noted after age 10 yrs. | Similar renal findings in Lowe syndrome cystinosis. |
Source: GeneReviews — "Cystinosis"
Biomarker and diagnostic research for inborn disorder of amino acid transport has been reported in the published literature.
| • Height weight, plotted on age-appropriate growth charts
Assessment of feeding nutrition
Lipid panel to assess nutritional status in those w/feeding difficulties requiring formula feeding by gastrostomy tube
|
| • Serum concentrations of creatinine, phosphate, bicarbonate, potassium
Urine concentrations of creatinine, phosphate, bicarbonate, sodium, potassium, magnesium, glucose, protein
Quantitative measurement of urine amino acids GFR or creatinine clearance test
| Measurement of urine amino acids helps to identify severity of renal Fanconi syndrome.1
Skeletal radiographs DXA scan to assess skeletal involvement/ rickets | Beginning at age ~2 yrs
Renal US to assess for nephrocalcinosis |
| Dental eval to assess abnormal dental eruption | Beginning at age ≥1 yr
Eyes | Ophthalmologic eval incl:
Slit lamp exam of cornea for cystine crystals
ERG to assess retinal involvement
Fundoscopic exam to assess for intracranial hypertension
|
| Thyroid function studies to assess hypothyroidism |
Measurement of serum concentration of testosterone, FSH, LH | Beginning in pre- postpubertal males
Source: GeneReviews — "Cystinosis"
Avoid the following:
Dehydration, which compromises remaining kidney function
Sun exposure, which can exacerbate photophobia
Source: GeneReviews — "Cystinosis"
Search ClinicalTrials.gov in the US and EU Clinical Trials Register in Europe for access to information on clinical studies for a wide range of diseases and conditions. Note: There may not be clinical trials for this disorder.
Source: GeneReviews — "Cystinosis"
View trials for inborn disorder of amino acid transport
System/Concern |
|---|
Evaluation |
|---|
Frequency |
|---|
Growth/Nutrition | Height weight plotted on age-appropriate growth charts | Every 3-6 mos throughout childhood until growth is complete; Assess for difficulty w/chewing, aspiration, dysphasia, weight loss, mealtimes of long duration, respiratory symptoms incl respiratory infection. |
Kidney function | Nephrology eval incl kidney function tests (urine albumin; serum creatinine [to calculate eGFR]) | Every 3-6 mos based on severity of kidney impairment Metabolic |
(incl bone disease) | Metabolic specialist eval incl serum electrolytes, calcium, phosphate, serum alkaline phosphatase, intact parathyroid hormone | Annually or more frequently as needed Skeletal radiographs DXA scan to assess for rickets osteopenia |
Dental | Dental exam to assess for enamel defects caries | Every 6 mos Ocular manifestations |
Source: GeneReviews — "Cystinosis"
Research summaries
22 |
22% |
Patient case studies | 20 | 20% |
Testing and diagnosis research | 5 | 5% |
New treatment approaches | 5 | 5% |
Disease patterns and progression | 4 | 4% |
Other research | 1 | 1% |
Clinical study results | 1 | 1% |
Khare V (2026). [PMID: 41876818](https://pubmed.ncbi.nlm.nih.gov/41876818/). *EMBO Rep*. [Basic Science / Preclinical]
Hidalgo Mayoral I (2026). [PMID: 41022664](https://pubmed.ncbi.nlm.nih.gov/41022664/). *Clin Genet*. [Basic Science / Preclinical]
Urquiza N (2026). [PMID: 41475179](https://pubmed.ncbi.nlm.nih.gov/41475179/). *Mol Genet Metab*. [Case Report / Case Series]
Miller JS (2026). [PMID: 41260060](https://pubmed.ncbi.nlm.nih.gov/41260060/). *Pediatr Neurol*. [Epidemiology / Natural History]
Montani C (2026). [PMID: 40729420](https://pubmed.ncbi.nlm.nih.gov/40729420/). *Brain*. [Gene Therapy / Novel Therapeutics]
Stone WL (2026). [PMID: 29493985](https://pubmed.ncbi.nlm.nih.gov/29493985/). *Unknown Journal*. [Review / Meta-Analysis]
Wang D (2026). [PMID: 41794883](https://pubmed.ncbi.nlm.nih.gov/41794883/). *Sci Rep*. [Basic Science / Preclinical]
Marcuzzo MB (2026). [PMID: 41831085](https://pubmed.ncbi.nlm.nih.gov/41831085/). *Neurochem Res*. [Review / Meta-Analysis]
Yamashiro K (2026). [PMID: 41621859](https://pubmed.ncbi.nlm.nih.gov/41621859/). *J Toxicol Sci*. [Basic Science / Preclinical]
Pain E (2026). [PMID: 42047543](https://pubmed.ncbi.nlm.nih.gov/42047543/). *Epilepsia Open*. [Basic Science / Preclinical]