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在中国的两例儿童病例中,TTC21B基因的突变导致了不同的表型。

Mutations in TTC21B cause different phenotypes in two childhood cases in China.

作者信息

Zhang Hongwen, Su Baige, Liu Xiaoyu, Xiao Huijie, Ding Jie, Yao Yong

机构信息

Department of Pediatric, Peking University First Hospital, Beijing, China.

出版信息

Nephrology (Carlton). 2018 Apr;23(4):371-376. doi: 10.1111/nep.13008.

Abstract

AIM

The TTC21B gene is now known as causative of nephronophthisis-related ciliopathies (NPHP-RC). We reported two Chinese paediatric cases with end-stage renal disease and other phenotypes caused by the TTC21B gene mutations.

METHODS

The clinical features of Chinese paediatric cases with NPHP-RC were summarized. Mutation analysis of the TTC21B gene was performed using next-generation sequencing.

RESULTS

The two cases both had nephrotic proteinuria, renal failure, hypertension and abnormal liver function (or hepatic fibrosis). One case also presented situs inversus and short phalanges. They developed end-stage renal disease (ESRD) at 1 year old and 8 years old, respectively, when renal pathology both showed focal segmental glomerular sclerosis (FSGS) with tubulointerstitial lesions including interstitial fibrosis and atrophic tubules. Three novel disease-causing TTC21B mutations were identified. One case carried homozygous mutation c.2211 + 3A > G, while the other case carried compound heterozygous mutations c.1552 T > C (p.C518R) and c.1456dupA (p.R486KfsX22).

CONCLUSION

Mutations in TTC21B cause a range of ciliopathy phenotypes in humans. We identified 3 novel TTC21B mutations in two Chinese paediatric cases that both presented end-stage renal disease and other different features. This is the first TTC21B mutations ever reported in China.

摘要

目的

TTC21B基因现已知是导致肾单位肾痨相关纤毛病(NPHP-RC)的病因。我们报告了两例由TTC21B基因突变引起的终末期肾病及其他表型的中国儿科病例。

方法

总结中国儿科NPHP-RC病例的临床特征。采用二代测序对TTC21B基因进行突变分析。

结果

两例均有肾病性蛋白尿、肾衰竭、高血压及肝功能异常(或肝纤维化)。其中一例还表现为内脏反位和指骨短小。他们分别在1岁和8岁时发展为终末期肾病(ESRD),肾病理均显示局灶节段性肾小球硬化(FSGS)伴肾小管间质病变,包括间质纤维化和肾小管萎缩。鉴定出3个新的致病TTC21B突变。一例携带纯合突变c.2211+3A>G,另一例携带复合杂合突变c.1552T>C(p.C518R)和c.1456dupA(p.R486KfsX22)。

结论

TTC21B基因突变在人类中导致一系列纤毛病表型。我们在两例均表现为终末期肾病及其他不同特征的中国儿科病例中鉴定出3个新的TTC21B突变。这是中国首次报道的TTC21B突变。

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