Thomas Christian, Zühlsdorf Andrea, Hörtnagel Konstanze, Mulahasanovic Lejla, Grauer Oliver M, Kümpers Philipp, Wiendl Heinz, Meuth Sven G
Clinic of Neurology with Institute of Translational Neurology, University of Münster, Münster, Germany.
Department of General Pediatrics, Metabolic Diseases, University Children's Hospital Münster, Münster, Germany.
Front Neurol. 2018 May 25;9:383. doi: 10.3389/fneur.2018.00383. eCollection 2018.
Autosomal dominant polycystic kidney disease (ADPKD) is a genetic disorder characterized by the presence of renal cysts and specific extrarenal abnormalities. ADPKD is caused by mutations in either or genes that encode for integral membrane proteins Polycystin-1 (PC1) and Polycystin-2 (PC2), respectively. Extrarenal involvement includes noncystic manifestations such as dilatation of the aortic root, artery dissection and intracranial aneurysms. Cerebral cavernous malformation (CCM) is a rare vascular malformation disorder characterized by closely clustered and irregularly dilated capillaries that can be asymptomatic or cause variable neurological manifestations, such as seizures, non-specific headaches, progressive or transient focal neurologic deficits, and cerebral hemorrhages. Familial CCM is typically associated with mutations in (), , and (). The co-occurrence of ADPKD and CCM has been previously described in a single patient, although genetic analysis was not performed in this study. We report here a family with ADPKD associated with CCM in two sisters. Direct sequencing of the index patient revealed a single novel heterozygous frameshift mutation in , and lack of mutations in genes usually related to CCM. This suggests that CCM represents an additional phenotype of ADPKD.
常染色体显性多囊肾病(ADPKD)是一种遗传性疾病,其特征为存在肾囊肿和特定的肾外异常。ADPKD是由分别编码整合膜蛋白多囊蛋白-1(PC1)和多囊蛋白-2(PC2)的PKD1或PKD2基因突变引起的。肾外受累包括非囊性表现,如主动脉根部扩张、动脉夹层和颅内动脉瘤。脑海绵状血管畸形(CCM)是一种罕见的血管畸形疾病,其特征为紧密聚集且不规则扩张的毛细血管,可无症状或引起多种神经系统表现,如癫痫发作、非特异性头痛、进行性或短暂性局灶性神经功能缺损以及脑出血。家族性CCM通常与KRIT1(CCM1)、CCM2和PDCD10(CCM3)基因突变有关。此前曾有报道一名患者同时患有ADPKD和CCM,但该研究未进行基因分析。我们在此报告一个家族,两名姐妹患有与CCM相关的ADPKD。对索引患者进行直接测序发现PKD1基因存在一个新的杂合移码突变,且通常与CCM相关的基因未发现突变。这表明CCM是ADPKD的一种额外表型。