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病例报告:从临床和患者角度诊断家族性肾病

Case Report: Making a diagnosis of familial renal disease - clinical and patient perspectives.

作者信息

Iqbal Zahra, Sayer John A

机构信息

Renal Services, Newcastle upon Tyne NHS Foundation Trust, Newcastle, NE77DN, UK.

Institute of Genetic Medicine, Newcastle University, UK, Newcastle, NE1 3BZ, UK.

出版信息

F1000Res. 2017 Apr 12;6:470. doi: 10.12688/f1000research.11316.1. eCollection 2017.

Abstract

BACKGROUND

A precise molecular genetic diagnosis has become the gold standard for the correct identification and management of many inherited renal diseases.

METHODS

Here we describe a family with familial focal segmental glomerulosclerosis, and include a clinical and patient perspective on the diagnostic workup and relaying of genetic results following whole exome sequencing.

RESULTS

Through next generation sequencing approaches, we identified a pathogenic mutation in , the underlying cause of the phenotype. The identification of this mutation had important clinical consequences for the family, including allowing a living-unrelated kidney transplant to proceed in the index case. There are also wider ranging social and ethical dilemmas presented when reaching a genetic diagnosis like this one, which are explored here by both physicians and the index case.

CONCLUSIONS

Through physician and patient perspectives in a family with inherited renal failure we explore the implications and the magnitude of a molecular genetic diagnosis.

摘要

背景

精确的分子遗传学诊断已成为正确识别和管理许多遗传性肾脏疾病的金标准。

方法

在此,我们描述了一个患有家族性局灶节段性肾小球硬化症的家庭,并从临床和患者角度阐述了全外显子组测序后的诊断检查及遗传结果的传达情况。

结果

通过下一代测序方法,我们在 中鉴定出一个致病突变,这是该表型的根本原因。该突变的鉴定对这个家庭具有重要的临床意义,包括使得首例患者能够进行非亲属活体肾移植。做出这样的基因诊断还会引发更广泛的社会和伦理困境,本文中医生和首例患者对此进行了探讨。

结论

通过从一个遗传性肾衰竭家庭中的医生和患者角度出发,我们探讨了分子遗传学诊断的影响及重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d8cb/5443337/9ea8feda8bcf/f1000research-6-12212-g0000.jpg

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