Servicio de Nefrología, Hospital Universitario La Paz, IdiPAZ, Universidad Autónoma, Madrid, Spain.
Instituto de Genética Médica y Molecular (INGEMM)-IdiPAZ, Hospital Universitario La Paz, Universidad Autónoma, Madrid, Spain.
Mol Genet Genomic Med. 2020 Aug;8(8):e1321. doi: 10.1002/mgg3.1321. Epub 2020 Jun 13.
Autosomal dominant polycystic kidney disease (ADPKD) and neurofibromatosis type 1 (NF1) are both autosomal dominant disorders with a high rate of novel mutations. However, the two disorders have distinct and well-delineated genetic, biochemical, and clinical findings. Only a few cases of coexistence of ADPKD and NF1 in a single individual have been reported, but the possible implications of this association are unknown.
We report an ADPKD male belonging to a family of several affected members in three generations associated with NF1 and optic pathway gliomas. The clinical diagnosis of ADPKD and NF1 was performed by several image techniques.
Linkage analysis of ADPKD family was consistent to the PKD2 locus by a nonsense mutation, yielding a truncated polycystin-2 by means of next-generation sequencing. The diagnosis of NF1 was confirmed by mutational analysis of this gene showing a 4-bp deletion, resulting in a truncated neurofibromin, as well. The impact of this association was investigated by analyzing putative genetic interactions and by comparing the evolution of renal size and function in the proband with his older brother with ADPKD without NF1 and with ADPKD cohorts.
Despite the presence of both conditions there was not additive effect of NF1 and PKD2 in terms of the severity of tumor development and/or ADPKD progression.
常染色体显性多囊肾病(ADPKD)和神经纤维瘤病 1 型(NF1)都是常染色体显性遗传病,具有较高的新突变率。然而,这两种疾病在遗传、生化和临床方面有明显且明确的区别。虽然有少数报道称单个个体同时存在 ADPKD 和 NF1,但这种关联的可能影响尚不清楚。
我们报告了一名 ADPKD 男性,他属于一个三代家族,家族中多个成员患有 ADPKD,且他还患有 NF1 和视路胶质瘤。通过多种影像学技术对 ADPKD 和 NF1 进行临床诊断。
ADPKD 家系的连锁分析与 PKD2 基因座一致,通过下一代测序得到了一个截断的多囊蛋白-2。NF1 的诊断通过该基因的突变分析得到证实,显示出 4 个碱基对的缺失,导致截断的神经纤维瘤蛋白。通过分析潜在的遗传相互作用和比较先证者与其患有 ADPKD 但无 NF1 的哥哥以及 ADPKD 队列的肾脏大小和功能的演变,研究了这种关联的影响。
尽管存在两种情况,但 NF1 和 PKD2 之间在肿瘤发展和/或 ADPKD 进展的严重程度方面没有相加效应。