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Kabuki 综合征相关肾畸形的临床与分子特征。

Clinical and molecular spectrum of renal malformations in Kabuki syndrome.

机构信息

Pediatrics 1 and Medical Genetics, Center of Reference for Developmental Abnormalities and Malformative Syndromes, Children's Hospital, University of Burgundy, Dijon, France.

出版信息

J Pediatr. 2013 Sep;163(3):742-6. doi: 10.1016/j.jpeds.2013.02.032. Epub 2013 Mar 25.

Abstract

OBJECTIVE

To determine the frequency and types of renal malformations, and to evaluate renal function in a cohort of patients with Kabuki syndrome (KS).

STUDY DESIGN

Renal ultrasound scans and plasma creatinine measurements were collected from a French cohort of 94 patients with genotyped KS. Renal function was evaluated based on the estimated glomerular filtration rate. A genotype-phenotype study was conducted for renal and urinary tract malformations.

RESULTS

Renal malformations were present in 22% of cases, and urinary tract anomalies were present in 15%. Renal malformations were observed in 28% of the MLL2 mutation-positive group and in 0% of the MLL2 mutation-negative group (P = .015). No correlation was found between the presence or absence of renal or urinary tract malformations and the location or type of MLL2 mutation. Renal function was normal except for 1 patient with a MLL2 mutation diagnosed in the first days of life and severe renal disease due to unilateral renal agenesia and controlateral severe hypoplasia that progressed to the terminal stage at age 2 years.

CONCLUSION

Our study emphasizes the need for ultrasound and renal function screening in children diagnosed with KS.

摘要

目的

确定卡布基综合征(KS)患者队列中肾脏畸形的频率和类型,并评估其肾功能。

研究设计

从一个经基因分型的法国 KS 患者队列中收集了肾脏超声扫描和血浆肌酐测量值。根据肾小球滤过率评估肾功能。对肾脏和泌尿道畸形进行了基因型-表型研究。

结果

22%的病例存在肾脏畸形,15%的病例存在泌尿道异常。在 MLL2 突变阳性组中观察到 28%的肾脏畸形,而在 MLL2 突变阴性组中则没有(P =.015)。肾脏或泌尿道畸形的存在与否与 MLL2 突变的位置或类型之间没有相关性。除了 1 例在生命最初几天诊断出 MLL2 突变且因单侧肾发育不全和对侧严重发育不良导致严重肾脏疾病的患者外,肾功能正常,该患者在 2 岁时进展为终末期。

结论

我们的研究强调了对诊断为 KS 的儿童进行超声和肾功能筛查的必要性。

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