Benetti Elisa, Murer Luisa, Bordugo Andrea, Andreetta Barbara, Artifoni Lina
Pediatric Nephrology, Dialysis and Transplantation Unit, Department of Pediatrics, University of Padua, Via Giustiniani, 3, 35128 Padua, Italy.
Exp Mol Pathol. 2009 Feb;86(1):74-6. doi: 10.1016/j.yexmp.2008.10.003. Epub 2008 Oct 31.
GATA3 gene encodes a transcription factor expressed during thymus, liver, kidney, adrenal gland, central and peripheral nervous systems, placenta and T lymphocytes embryonic development. Mutations of GATA3 cause Hypoparathyroidism, sensorineural Deafness and Renal dysplasia syndrome (HDR). We report the case of a girl with a terminal deletion of the short arm of chromosome 10 (10p12.1-pter), including both HDR locus and the DiGeorge critical region 2 (DGCR2), with HDR phenotype but not DiGeorge syndrome 2 features. The girl developed chronic renal failure during the first year of life, associated with sensorineural hearing loss, facial dysmorphic features and psychomotor development. She had hypodysplastic kidneys and bilateral grade 3-vesicoureteric reflux. Her karyotype was 46,XX,del(10)(p12.1-pter). Quantitative analysis by Real Time PCR on blood DNA confirmed the lack of one copy of GATA3 gene. She underwent renal transplantation at the age of 11. Our patient is the first case with a large deletion of the short arm of chromosome 10 - that certainly involves DGCR2 - with the HDR phenotype but without the clinical features of DGS2. This peculiarity suggests the hypothesis that the mechanisms underlying this syndrome may be more complex. It is therefore possible that DGS2 may be determined by locus heterogeneity.
GATA3基因编码一种转录因子,在胸腺、肝脏、肾脏、肾上腺、中枢和外周神经系统、胎盘以及T淋巴细胞的胚胎发育过程中表达。GATA3基因突变会导致甲状旁腺功能减退、感音神经性耳聋和肾发育不良综合征(HDR)。我们报告了一名患有10号染色体短臂末端缺失(10p12.1-pter)的女孩病例,该缺失区域包括HDR位点和22q11.2缺失综合征关键区域2(DGCR2),患儿具有HDR表型,但无22q11.2缺失综合征2型的特征。该女孩在出生后第一年出现慢性肾衰竭,并伴有感音神经性听力损失、面部畸形特征和精神运动发育迟缓。她的肾脏发育不全,双侧存在3级膀胱输尿管反流。其核型为46,XX,del(10)(p12.1-pter)。通过对血液DNA进行实时荧光定量PCR分析,证实GATA3基因缺失一个拷贝。她在11岁时接受了肾移植。我们的患者是首例10号染色体短臂大片段缺失(肯定涉及DGCR2)且具有HDR表型但无22q11.2缺失综合征2型临床特征的病例。这种特殊性提示了该综合征潜在机制可能更为复杂的假说。因此,22q11.2缺失综合征2型可能由基因座异质性决定。