Presented at the age of 16 during her first pregnancy with proteinuria. Aged 19 in view of the continued renal impairment and proteinuria a renal biopsy was undertaken in 1995. The renal biopsy demonstrated focal segmental sclerosing glomerular lesions, similar to LS but with less chronic damage and at an earlier stage with fewer glomerular lesions. TS also suffered with obesity. Renal function progressively declined, necessitating a pre-emptive renal transplant in 2008. She had a 16 year old deceased donor with a mismatch grade of 0-0-0. Despite this she had borderline cellular rejection at a 3 month protocol renal biopsy. Complications post transplantation included cervical intra-epithelial neoplasia grade 3 and diarrhoea induced by MMF. TS has 4 children, but there is no history of TBS in them (?true). She did not have the typical TBS triad features but has the SALL1 mutation (??). There is a history of hypertension since 2003 and she has recently suffered with depression and anxiety.