1
|
Wang Y, Xiao X, Lin Q, Song R, Wang X, Liang Y, Chen J, Luan X, Zhou Z, Xiao Y, Xue Y, Hu J. Hepatocyte nuclear factor 1B deletion, but not intragenic mutation, might be more susceptible to hypomagnesemia. J Diabetes Investig 2024; 15:121-130. [PMID: 37737534 PMCID: PMC10759714 DOI: 10.1111/jdi.14084] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 08/15/2023] [Accepted: 08/24/2023] [Indexed: 09/23/2023] Open
Abstract
AIMS HNF1B syndrome is caused by defects in the hepatocyte nuclear factor 1B (HNF1B) gene, which leads to maturity-onset diabetes of the young type 5 and congenital organ malformations. This study aimed to identify a gene defect in a patient presenting with diabetes and severe diarrhea, while also analyzing the prevalence of hypomagnesemia and its correlation with the HNF1B genotype. MATERIALS AND METHODS Whole exome sequencing was used to identify responsible point mutations and small indels in the proband and their family members. Multiplex ligation-dependent probe amplification was carried out to identify HNF1B deletions. Furthermore, an analysis of published data on 539 cumulative HNF1B cases, from 29 literature sources, was carried out to determine the correlation between the HNF1B genotype and the phenotype of serum magnesium status. RESULTS Using multiplex ligation-dependent probe amplification, we identified a de novo heterozygous HNF1B deletion in the patient, who showed dorsal pancreas agenesis and multiple kidney cysts, as detected by magnetic resonance imaging. Magnesium supplementation effectively alleviated the symptoms of diarrhea. Hypomagnesemia was highly prevalent in 192 out of 354 (54.2%) patients with HNF1B syndrome. Compared with patients with intragenic mutations, those with HNF1B deletions were more likely to suffer from hypomagnesemia, with an odds ratio of 3.1 (95% confidence interval 1.8-5.4). CONCLUSIONS Hypomagnesemia is highly prevalent in individuals with HNF1B syndrome, and those with HNF1B deletion are more susceptible to developing hypomagnesemia compared with those with intragenic mutations. The genotype-phenotype associations in HNF1B syndrome have significant implications for endocrinologists in terms of genotype detection, treatment decisions and prognosis assessment.
Collapse
Affiliation(s)
- Yanfei Wang
- Department of Endocrinology and Metabolism, Nanfang HospitalSouthern Medical UniversityGuangzhouChina
- Department of EndocrinologyThe First People's Hospital of FoshanFoshanChina
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and EndocrinologyThe Second Xiangya Hospital of Central South UniversityChangshaChina
| | - Xiaoyu Xiao
- Department of Metabolism and Endocrinology, The Xiangya HospitalCentral South UniversityChangshaChina
| | - Qiuqiu Lin
- Shunde HospitalSouthern Medical UniversityFoshanChina
| | - Rong Song
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and EndocrinologyThe Second Xiangya Hospital of Central South UniversityChangshaChina
| | - Xiaozhou Wang
- Department of EndocrinologyThe First People's Hospital of FoshanFoshanChina
| | - Yiji Liang
- Department of EndocrinologyThe First People's Hospital of FoshanFoshanChina
| | - Jingsong Chen
- Department of EndocrinologyThe First People's Hospital of FoshanFoshanChina
| | - Xiaojun Luan
- Department of EndocrinologyThe First People's Hospital of FoshanFoshanChina
| | - Zhiguang Zhou
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and EndocrinologyThe Second Xiangya Hospital of Central South UniversityChangshaChina
| | - Yang Xiao
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and EndocrinologyThe Second Xiangya Hospital of Central South UniversityChangshaChina
| | - Yaoming Xue
- Department of Endocrinology and Metabolism, Nanfang HospitalSouthern Medical UniversityGuangzhouChina
| | - Jingyi Hu
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and EndocrinologyThe Second Xiangya Hospital of Central South UniversityChangshaChina
| |
Collapse
|
2
|
Botero-Calderon L, Lawrence A, O’Toole N, Guay-Woodford LM. Fetal renal cystic disease and post-natal follow up-a single center experience. Front Pediatr 2023; 11:1243504. [PMID: 37635794 PMCID: PMC10449118 DOI: 10.3389/fped.2023.1243504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 07/21/2023] [Indexed: 08/29/2023] Open
Abstract
Introduction Prenatal sonographic evidence of large, echogenic, or cystic kidneys may indicate any one of a diverse set of disorders including renal ciliopathies, congenital anomalies of the kidney and urinary tract (CAKUT), or multisystem syndromic disorders. Systematic transition planning for these infants from in utero detection to post-natal nephrology management remains to be established. Aim of the work We sought to evaluate the presentation and transition planning for infants identified in utero with bilateral renal cystic disease. Methods Our retrospective observational study identified 72 pregnancies with bilateral renal cystic disease in a single center from 2012 to 2022; 13 of which had a confirmed renal ciliopathy disorder. Clinical and imaging data, genetic test results, and documentation of postnatal follow-up were collected and compared. Results In our suspected renal ciliopathy cohort (n = 17), autosomal recessive polycystic disease (ARPKD) was the most common diagnosis (n = 4), followed by Bardet-Biedl syndrome (BBS, n = 3), autosomal dominant polycystic disease (ADPKD, n = 2), HNF1B-related disease (n = 2), and Meckel-Gruber syndrome (MKS, n = 2). Four cases were not genetically resolved. Anhydramnios was observed primarily in fetuses with ARPKD (n = 3). Polydactyly (n = 3) was detected only in patients with BBS and MKS, cardiac defects (n = 6) were identified in fetuses with ARPKD (n = 3), MKS (n = 2), and BBS (n = 1), and abnormalities of the CNS (n = 5) were observed in patients with ARPKD (n = 1), MKS (n = 2), and BBS (n = 3). In general, documentation of transition planning was incomplete, with post-natal nephrology management plans established primarily for infants with renal ciliopathies (n = 11/13; 85%). Conclusion Prenatal sonographic detection of echogenic kidneys should raise suspicion for a broad range of disorders, including renal ciliopathies and CAKUT. Multicenter collaboration will be required to standardize the implementation of transition guidelines for comprehensive nephrology management of infants identified in utero with enlarged, echogenic kidneys.
Collapse
Affiliation(s)
| | - Anne Lawrence
- Prenatal Pediatrics Institute, Children’s National Hospital, Washington, DC, United States
| | - Natalie O’Toole
- Center for Translational Research, Children’s National Research Institute, Washington, DC, United States
| | - Lisa M. Guay-Woodford
- Division of Nephrology, Children’s National Hospital, Washington, DC, United States
- Center for Translational Research, Children’s National Research Institute, Washington, DC, United States
| |
Collapse
|
3
|
Morton A, Li L, Wilson C. Pregnancy outcome with maternal HNF1B gene mutations and 17q12 deletions. Obstet Med 2023; 16:78-82. [PMID: 37441663 PMCID: PMC10334039 DOI: 10.1177/1753495x221109734] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 05/30/2022] [Accepted: 06/08/2022] [Indexed: 02/12/2024] Open
Abstract
There is an increasing body of literature regarding monogenic diabetes, particularly the more common forms of glucokinase and HNF1-alpha mutations (MODY2 and MODY3). There is relatively little published literature regarding rarer mutations. HNF1-beta mutations and 17q12 deletions may be associated with a broad range of organ dysfunction, renal disease and diabetes in particular resulting in high-risk pregnancies. This manuscript describes pregnancy outcomes in a woman with an HNF1-beta mutation and 2 women with an HNF1B/17q12 deletion and reviews the previously published literature. It highlights the significant rate of adverse maternal and fetal outcomes, and the maternal features suggestive of the diagnosis which should be considered in preconception counselling.
Collapse
Affiliation(s)
- Adam Morton
- Adam Morton, Obstetric Medicine, Mater Health, Raymond Terrace, South Brisbane, Queensland, Australia.
| | - Ling Li
- Obstetric Medicine, Mater Health, South Brisbane, Australia
| | | |
Collapse
|
4
|
Wu X, Li Y, Lin N, Su L, Xie X, Liang B, Shen Q, Cai M, Guo D, Huang H, Xu L. Evaluation of genetic variants using chromosomal microarray analysis for fetuses with polyhydramnios. BMC Med Genomics 2022; 15:73. [PMID: 35354480 PMCID: PMC8966299 DOI: 10.1186/s12920-022-01224-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 03/23/2022] [Indexed: 12/23/2022] Open
Abstract
Background Polyhydramnios, the excessive accumulation of amniotic fluid, is associated with an elevated risk of abnormal karyotype, particularly aneuploidy. Studies focusing on chromosomal microarray analysis (CMA) in pregnancies with polyhydramnios are limited. The aim of this study is to evaluate the implications of pregnancy with polyhydramnios by CMA testing and routine karyotyping. Methods Data from 131 singleton and 17 twin pregnancies that underwent prenatal CMA testing due to polyhydramnios between May 2017 and May 2021 were reviewed. Enrolled cases were grouped into isolated polyhydramnios (N = 39) and non-isolated polyhydramnios (N = 111). Non-isolated group was further categorized as subgroup of soft markers (n = 59) and non-soft markers (n = 52). Results CMA revealed an additional 10 (6.7%) chromosomal aberrations with clinical significance in 9 fetuses from singleton pregnancies and 1 from a twin pregnancy. Six microdeletion/microduplication syndromes were observed, of which 4 were located on chromosome 17. The incremental yields of clinically significant CMA findings in non-isolated polyhydramnios was 8.1%, and the values in fetuses along with soft markers and non-soft markers were 5.1% and 11.5% (p > 0.05), respectively. Only one incidental finding related to neuropathy with liability to pressure palsies was detected from 39 fetuses with isolated polyhydramnios. Conclusions Non-isolated polyhydramnios is associated with several microdeletion/microduplication syndromes, regardless of singleton or twin pregnancies. Our results suggest insufficient evidence to recommend CMA in pregnancies with isolated polyhydramnios. Supplementary Information The online version contains supplementary material available at 10.1186/s12920-022-01224-w.
Collapse
Affiliation(s)
- Xiaoqing Wu
- Fujian Provincial Key Laboratory for Prenatal Diagnosis and Birth Defect, Medical Genetic Diagnosis and Therapy Center of Fujian Provincial Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, No. 18 Daoshan Road, Fuzhou City, 350001, Fujian Province, China.,Fujian Provincial Key Laboratory for Prenatal Diagnosis and Birth Defect, Fuzhou City, Fujian Province, China.,Department of Laboratory Medicine, Fujian Medical University, Fuzhou City, Fujian Province, China
| | - Ying Li
- Fujian Provincial Key Laboratory for Prenatal Diagnosis and Birth Defect, Medical Genetic Diagnosis and Therapy Center of Fujian Provincial Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, No. 18 Daoshan Road, Fuzhou City, 350001, Fujian Province, China.,Fujian Provincial Key Laboratory for Prenatal Diagnosis and Birth Defect, Fuzhou City, Fujian Province, China
| | - Na Lin
- Fujian Provincial Key Laboratory for Prenatal Diagnosis and Birth Defect, Medical Genetic Diagnosis and Therapy Center of Fujian Provincial Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, No. 18 Daoshan Road, Fuzhou City, 350001, Fujian Province, China.,Fujian Provincial Key Laboratory for Prenatal Diagnosis and Birth Defect, Fuzhou City, Fujian Province, China
| | - Linjuan Su
- Fujian Provincial Key Laboratory for Prenatal Diagnosis and Birth Defect, Medical Genetic Diagnosis and Therapy Center of Fujian Provincial Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, No. 18 Daoshan Road, Fuzhou City, 350001, Fujian Province, China.,Fujian Provincial Key Laboratory for Prenatal Diagnosis and Birth Defect, Fuzhou City, Fujian Province, China
| | - Xiaorui Xie
- Fujian Provincial Key Laboratory for Prenatal Diagnosis and Birth Defect, Medical Genetic Diagnosis and Therapy Center of Fujian Provincial Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, No. 18 Daoshan Road, Fuzhou City, 350001, Fujian Province, China.,Fujian Provincial Key Laboratory for Prenatal Diagnosis and Birth Defect, Fuzhou City, Fujian Province, China
| | - Bing Liang
- Fujian Provincial Key Laboratory for Prenatal Diagnosis and Birth Defect, Medical Genetic Diagnosis and Therapy Center of Fujian Provincial Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, No. 18 Daoshan Road, Fuzhou City, 350001, Fujian Province, China.,Fujian Provincial Key Laboratory for Prenatal Diagnosis and Birth Defect, Fuzhou City, Fujian Province, China
| | - Qingmei Shen
- Fujian Provincial Key Laboratory for Prenatal Diagnosis and Birth Defect, Medical Genetic Diagnosis and Therapy Center of Fujian Provincial Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, No. 18 Daoshan Road, Fuzhou City, 350001, Fujian Province, China.,Fujian Provincial Key Laboratory for Prenatal Diagnosis and Birth Defect, Fuzhou City, Fujian Province, China
| | - Meiying Cai
- Fujian Provincial Key Laboratory for Prenatal Diagnosis and Birth Defect, Medical Genetic Diagnosis and Therapy Center of Fujian Provincial Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, No. 18 Daoshan Road, Fuzhou City, 350001, Fujian Province, China.,Fujian Provincial Key Laboratory for Prenatal Diagnosis and Birth Defect, Fuzhou City, Fujian Province, China
| | - Danhua Guo
- Fujian Provincial Key Laboratory for Prenatal Diagnosis and Birth Defect, Medical Genetic Diagnosis and Therapy Center of Fujian Provincial Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, No. 18 Daoshan Road, Fuzhou City, 350001, Fujian Province, China.,Fujian Provincial Key Laboratory for Prenatal Diagnosis and Birth Defect, Fuzhou City, Fujian Province, China.,Department of Laboratory Medicine, Fujian Medical University, Fuzhou City, Fujian Province, China
| | - Hailong Huang
- Fujian Provincial Key Laboratory for Prenatal Diagnosis and Birth Defect, Medical Genetic Diagnosis and Therapy Center of Fujian Provincial Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, No. 18 Daoshan Road, Fuzhou City, 350001, Fujian Province, China. .,Fujian Provincial Key Laboratory for Prenatal Diagnosis and Birth Defect, Fuzhou City, Fujian Province, China.
| | - Liangpu Xu
- Fujian Provincial Key Laboratory for Prenatal Diagnosis and Birth Defect, Medical Genetic Diagnosis and Therapy Center of Fujian Provincial Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, No. 18 Daoshan Road, Fuzhou City, 350001, Fujian Province, China. .,Fujian Provincial Key Laboratory for Prenatal Diagnosis and Birth Defect, Fuzhou City, Fujian Province, China.
| |
Collapse
|
5
|
Deng L, Liu Y, Yuan M, Meng M, Yang Y, Sun L. Prenatal diagnosis and outcome of fetal hyperechogenic kidneys in the era of antenatal next-generation sequencing. Clin Chim Acta 2022; 528:16-28. [DOI: 10.1016/j.cca.2022.01.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 12/22/2021] [Accepted: 01/18/2022] [Indexed: 01/19/2023]
|
6
|
Adam MJ, Enderle I, Le Bouar G, Cabaret-Dufour AS, Tardif C, Contin L, Arnaud A, Proisy M, Jaillard S, Pasquier L, Le Lous M. Performance of diagnostic ultrasound to identify causes of hydramnios. Prenat Diagn 2020; 41:111-122. [PMID: 32920845 DOI: 10.1002/pd.5825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 09/01/2020] [Accepted: 09/01/2020] [Indexed: 11/06/2022]
Abstract
INTRODUCTION We aimed to assess the diagnostic yield of ultrasonography in the identification of the etiology of hydramnios, and the added value of MRI or amniocentesis. METHODS We conducted a single-center retrospective study including pregnancies with confirmed hydramnios (defined as deepest pocket ≥8 cm) between January 2013 and May 2017. Twin pregnancies, secondary hydramnios discovered after the diagnosis of a causal pathology, and pregnancies of unknown outcome were excluded. All pregnancies underwent a targeted scan, and selected cases underwent MRI or amniocentesis. RESULTS A total of 158 patients with confirmed hydramnios were included. Hydramnios was associated with a fetal pathology in 37 cases (23.4%), with diabetes in 39 (24.6%), isolated macrosomia in 16 (10.1%), and considered idiopathic in 66 (41.7%). Ultrasonography established a diagnosis of the underlying pathology in 73% of cases. Amniocentesis was done in 31 cases (20%) and it allowed diagnosis of chromosome anomalies, esophageal atresia, myotonic dystrophy congenital type, Prader-Willi syndrome, and Bartter syndrome. MRI was done in 15 cases (10%) and it allowed one additional diagnosis of esophageal atresia. The diagnostic yields of MRI and amniocentesis were 91.7% and 95.2%, respectively. There were five false positive diagnoses at ultrasonography, and one false positive diagnosis at MRI. CONCLUSION Hydramnios can be associated with a wide variety of underlying pathologies. Diagnostic ultrasound can attain a diagnosis in the majority of cases. Amniocentesis offers a valuable complementary assessment.
Collapse
Affiliation(s)
- Marie-José Adam
- Department of Obstetrics and Gynecology, University Hospital of Rennes, Rennes, France
| | - Isabelle Enderle
- Department of Obstetrics and Gynecology, University Hospital of Rennes, Rennes, France.,CIC Inserm 1414, University Hospital of Rennes, University of Rennes, Rennes, France
| | - Gwenaëlle Le Bouar
- Department of Obstetrics and Gynecology, University Hospital of Rennes, Rennes, France
| | | | - Cécile Tardif
- Department of Obstetrics and Gynecology, University Hospital of Rennes, Rennes, France
| | - Laurence Contin
- Department of Obstetrics and Gynecology, University Hospital of Rennes, Rennes, France
| | - Alexis Arnaud
- Department of Pediatric Surgery, University Hospital of Rennes, Rennes, France
| | - Maïa Proisy
- Department of Radiology, University Hospital of Rennes, Rennes, France
| | - Sylvie Jaillard
- Department of Cytogenetics, University Hospital of Rennes, Rennes, France
| | - Laurent Pasquier
- Department of Genetics, University Hospital of Rennes, Rennes, France
| | - Maela Le Lous
- Department of Obstetrics and Gynecology, University Hospital of Rennes, Rennes, France.,CIC Inserm 1414, University Hospital of Rennes, University of Rennes, Rennes, France
| |
Collapse
|
7
|
Zhou X, Wang Y, Shao B, Wang C, Hu P, Qiao F, Xu Z. Molecular diagnostic in fetuses with isolated congenital anomalies of the kidney and urinary tract by whole-exome sequencing. J Clin Lab Anal 2020; 34:e23480. [PMID: 32779812 PMCID: PMC7676188 DOI: 10.1002/jcla.23480] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 06/11/2020] [Accepted: 06/18/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND In prenatal care, accumulating evidences has demonstrated that whole-exome sequencing (WES) expedites the genetic diagnosis of fetal structural anomalies. However, the clinical value of WES in the diagnosis of prenatal isolated congenital anomalies of the kidney and urinary tract (CAKUT) is unknown. METHODS Forty-one fetuses with unexplained isolated CAKUT, normal karyotype and negative chromosomal microarray analysis (CMA) results, underwent WES and were accordingly grouped as (a) Group 1: complex cases with bilateral renal abnormalities (N = 19); and (b) Group 2: cases with isolated unilateral fetal renal abnormalities (N = 22). RESULTS The detection rate of WES for pathogenic variants and incidental variants was 7.32% (3/41) and 2.4% (1/41), respectively. The three pathogenic variants were identified in the genes ACTA2 (multisystem smooth muscle dysfunction syndrome), PKHD1 (autosomal recessive form of polycystic kidney disease), and PKD1 (autosomal dominant polycystic kidney disease type 1). The incidental variants were detected in genes PPM1D (syndromic neurodevelopmental disorders). Furthermore, all above fetuses carrying pathogenic variants came from bilateral kidney anomalies. Thus, the detection rate was 0 for fetuses with unilateral fetal renal abnormalities and 15.7% (3/19) for bilateral renal abnormalities. CONCLUSION This cohort shows that prenatal WES is a supplementary approach for the etiologic diagnosis of unexplained isolated CAKUT with negative CMA, especially for fetuses with bilateral renal abnormality.
Collapse
Affiliation(s)
- Xiaoyan Zhou
- State Key Laboratory of Reproductive MedicineDepartment of Prenatal DiagnosisWomen's Hospital of Nanjing Medical UniversityNanjingChina
- Department of ObstetricsThe Affiliated Huai an No. 1 People's Hospital of NanjingMedical UniversityHuai anChina
| | - Yan Wang
- State Key Laboratory of Reproductive MedicineDepartment of Prenatal DiagnosisWomen's Hospital of Nanjing Medical UniversityNanjingChina
| | - Binbin Shao
- State Key Laboratory of Reproductive MedicineDepartment of Prenatal DiagnosisWomen's Hospital of Nanjing Medical UniversityNanjingChina
| | - Chen Wang
- State Key Laboratory of Reproductive MedicineDepartment of Prenatal DiagnosisWomen's Hospital of Nanjing Medical UniversityNanjingChina
| | - Ping Hu
- State Key Laboratory of Reproductive MedicineDepartment of Prenatal DiagnosisWomen's Hospital of Nanjing Medical UniversityNanjingChina
| | - Fengchang Qiao
- State Key Laboratory of Reproductive MedicineDepartment of Prenatal DiagnosisWomen's Hospital of Nanjing Medical UniversityNanjingChina
| | - Zhengfeng Xu
- State Key Laboratory of Reproductive MedicineDepartment of Prenatal DiagnosisWomen's Hospital of Nanjing Medical UniversityNanjingChina
| |
Collapse
|
8
|
Abstract
Autosomal dominant tubulointerstitial kidney disease (ADTKD) is a recently defined entity that includes rare kidney diseases characterized by tubular damage and interstitial fibrosis in the absence of glomerular lesions, with inescapable progression to end-stage renal disease. These diseases have long been neglected and under-recognized, in part due to confusing and inconsistent terminology. The introduction of a gene-based, unifying terminology led to the identification of an increasing number of cases, with recent data suggesting that ADTKD is one of the more common monogenic kidney diseases after autosomal dominant polycystic kidney disease, accounting for ~5% of monogenic disorders causing chronic kidney disease. ADTKD is caused by mutations in at least five different genes, including UMOD, MUC1, REN, HNF1B and, more rarely, SEC61A1. These genes encode various proteins with renal and extra-renal functions. The mundane clinical characteristics and lack of appreciation of family history often result in a failure to diagnose ADTKD. This Primer highlights the different types of ADTKD and discusses the distinct genetic and clinical features as well as the underlying mechanisms.
Collapse
|
9
|
A renal hyperechogenicity study: From the phenotype to the genotype in the mutation of hepatocyte nuclear factor-1 beta gene. ANALES DE PEDIATRÍA (ENGLISH EDITION) 2019. [DOI: 10.1016/j.anpede.2018.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|
10
|
Ribes Hernández P, Granados Molina A, García Pérez A, Tahsin Swafiri S, Pérez Carbajo E. [A renal hyperechogenicity study: from the phenotype to the genotype in the mutation of hepatocyte nuclear factor-1 beta gene]. An Pediatr (Barc) 2018; 90:315-316. [PMID: 29887368 DOI: 10.1016/j.anpedi.2018.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 04/29/2018] [Accepted: 05/02/2018] [Indexed: 10/14/2022] Open
Affiliation(s)
- Pilar Ribes Hernández
- Servicio de Pediatría, Hospital Universitario Infanta Elena, Valdemoro, Madrid, España.
| | | | - Alicia García Pérez
- Servicio de Nefrología, Hospital Universitario Infanta Elena, Valdemoro, Madrid, España
| | - Saoud Tahsin Swafiri
- Servicio de Genética, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
| | - Esther Pérez Carbajo
- Servicio de Ginecología y Obstetricia, Hospital Universitario Infanta Elena, Valdemoro, Madrid, España
| |
Collapse
|
11
|
Sudrié-Arnaud B, Marguet F, Patrier S, Martinovic J, Louillet F, Broux F, Charbonnier F, Dranguet H, Coutant S, Vezain M, Lanos R, Tebani A, Fuller M, Lamari F, Chambon P, Brehin AC, Trestard L, Tournier I, Marret S, Verspyck E, Laquerrière A, Bekri S. Metabolic causes of nonimmune hydrops fetalis: A next-generation sequencing panel as a first-line investigation. Clin Chim Acta 2018; 481:1-8. [PMID: 29476731 DOI: 10.1016/j.cca.2018.02.023] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 02/19/2018] [Indexed: 11/24/2022]
Abstract
PURPOSES Hydrops fetalis is a life-threatening fetal condition, and 85% of all cases are classified as nonimmune hydrops fetalis (NIHF). Up to 15% of NIHF cases may be due to inborn errors of metabolism (IEM), but a large proportion of cases linked to metabolic disorders remains undiagnosed. This lack of diagnosis may be related to the limitations of conventional biological procedures, which involve sequential investigations and require multiple samples and steps. In addition, this approach is time consuming. We have developed a next-generation sequencing (NGS) panel to investigate metabolic causes of NIHF, ascites, and polyhydramnios associated to another fetal abnormality. METHODS The hydrops fetalis (HydFet) panel was designed to cover the coding regions and flanking intronic sequences of 41 genes. A retrospective study of amniotic fluid samples from 40 subjects was conducted. A prospective study was subsequently initiated, and six samples were analyzed using the NGS panel. RESULTS Five IEM diagnoses were made using the HydFet panel (Niemann-Pick type C (NPC), Barth syndrome, HNF1Β deficiency, GM1 gangliosidosis, and Gaucher disease). This analysis also allowed the identification of 8p sequence triplication in an additional case. CONCLUSION NGS combined with robust bioinformatics analyses is a useful tool for identifying the causative variants of NIHF. Subsequent functional characterization of the protein encoded by the altered gene and morphological studies may confirm the diagnosis. This paradigm shift allows a significant improvement of IEM diagnosis in NIHF.
Collapse
Affiliation(s)
| | - Florent Marguet
- Department of Pathology, Rouen University Hospital, Rouen 76000, France; Normandie Univ, UNIROUEN, CHU Rouen, INSERM U1245, 76000 Rouen, France
| | - Sophie Patrier
- Department of Pathology, Rouen University Hospital, Rouen 76000, France
| | - Jelena Martinovic
- Unit of Fetal Pathology, Antoine Beclere Hospital, South Paris University, Clamart, France
| | - Ferielle Louillet
- Department of Pediatrics, Rouen University Hospital, 76000 Rouen, France
| | - Françoise Broux
- Department of Pediatrics, Rouen University Hospital, 76000 Rouen, France
| | | | - Hélène Dranguet
- Department of Metabolic Biochemistry, Rouen University Hospital, Rouen 76000, France
| | - Sophie Coutant
- Normandie Univ, UNIROUEN, CHU Rouen, INSERM U1245, 76000 Rouen, France
| | - Myriam Vezain
- Normandie Univ, UNIROUEN, CHU Rouen, INSERM U1245, 76000 Rouen, France
| | - Raphaël Lanos
- Normandie Univ, UNIROUEN, CHU Rouen, INSERM U1245, 76000 Rouen, France
| | - Abdellah Tebani
- Department of Metabolic Biochemistry, Rouen University Hospital, Rouen 76000, France
| | - Maria Fuller
- Genetics and Molecular Pathology, SA Pathology [at Women's and Children's Hospital], 72 King William Road, North Adelaide, South Australia 5006, Australia; Department of Pediatrics, University of Adelaide, Adelaide, South Australia 5005, Australia
| | - Foudil Lamari
- Bioclinic and Genetic Unit of Neurometabolic Diseases, Pitié-Salpêtrière Hospital, APHP, Paris 75013, France
| | - Pascal Chambon
- Normandie Univ, UNIROUEN, CHU Rouen, INSERM U1245, 76000 Rouen, France; Department of Genetics, Normandy Centre for Genomic and Personalized Medicine, Rouen University Hospital, Rouen 76000, France
| | - Anne-Claire Brehin
- Normandie Univ, UNIROUEN, CHU Rouen, INSERM U1245, 76000 Rouen, France; Department of Genetics, Normandy Centre for Genomic and Personalized Medicine, Rouen University Hospital, Rouen 76000, France
| | - Laetitia Trestard
- Department of Obstetrics and Gynecology, Belvedere Hospital, Mont-Saint-Aignan, France
| | - Isabelle Tournier
- Normandie Univ, UNIROUEN, CHU Rouen, INSERM U1245, 76000 Rouen, France
| | - Stéphane Marret
- Normandie Univ, UNIROUEN, CHU Rouen, INSERM U1245, 76000 Rouen, France; Department of Neonatal Pediatrics, Intensive Care and Neuropediatrics, Rouen University Hospital, 76000 Rouen, France
| | - Eric Verspyck
- Normandie Univ, UNIROUEN, CHU Rouen, INSERM U1245, 76000 Rouen, France; Department of Obstetrics and Gynecology, Rouen University Hospital, 76000 Rouen, France
| | - Annie Laquerrière
- Department of Pathology, Rouen University Hospital, Rouen 76000, France; Normandie Univ, UNIROUEN, CHU Rouen, INSERM U1245, 76000 Rouen, France
| | - Soumeya Bekri
- Department of Metabolic Biochemistry, Rouen University Hospital, Rouen 76000, France; Normandie Univ, UNIROUEN, CHU Rouen, INSERM U1245, 76000 Rouen, France.
| |
Collapse
|
12
|
Abstract
PURPOSE OF REVIEW Magnesium (Mg) imbalances are frequently overlooked. Hypermagnesemia usually occurs in preeclamptic women after Mg therapy or in end-stage renal disease patients, whereas hypomagnesemia is more common with a prevalence of up to 15% in the general population. Increasing evidence points toward a role for mild-to-moderate chronic hypomagnesemia in the pathogenesis of hypertension, type 2 diabetes mellitus, and metabolic syndrome. RECENT FINDINGS The kidneys are the major regulator of total body Mg homeostasis. Over the last decade, the identification of the responsible genes in rare genetic disorders has enhanced our understanding of how the kidney handles Mg. The different genetic disorders and medications contributing to abnormal Mg homeostasis are reviewed. SUMMARY As dysfunctional Mg homeostasis contributes to the development of many common human disorders, serum Mg deserves closer monitoring. Hypomagnesemic patients may be asymptomatic or may have mild symptoms. In severe hypomagnesemia, patients may present with neurological symptoms such as seizures, spasms, or cramps. Renal symptoms include nephrocalcinosis and impaired renal function. Most conditions affect tubular Mg reabsorption by disturbing the lumen-positive potential in the thick ascending limb or the negative membrane potential in the distal convoluted tubule.
Collapse
|