IS presented to the renal services with proteinuria in 1990, 8 years after the birth of her third child aged 37. Since 1982, post partum, she was obese. With the history of obesity for 8 years and family history of FSGS a renal biopsy was not undertaken. Renal function at this time was … IS was diagnosed with hypothyroidism when the proteinuria was identified, she suffered with premature depigmentation of her hair aged 30. Bariatric surgery was undertaken in 2009 due to Type 2 diabetes mellitus. Despite the history of TBS in her husband’s pedigree she was not related to him, and they were from different regions in Ireland. She did not have any of the typical phenotypic features of TBS (imperforate anus, dysplastic ears and thumb malformations)