Xyu Shu, Xyu Chen, Lyu Yuan, Li Chuang, Liu Caixia
Chaoyang Central Hospital, Chaoyang, Liaoning 122000, China.
Zhonghua Yi Xue Yi Chuan Xue Za Zhi. 2021 Sep 10;38(9):880-883. doi: 10.3760/cma.j.cn511374-20200617-00447.
To explore the genetic etiology of a fetus with autosomal recessive polycystic kidney disease (ARPKD).
Prenatal ultrasonography has revealed oligohydramnios and abnormal structure of fetal kidneys. After careful counseling, the couple opted induced abortion. With informed consent, genomic DNA was extracted from the muscle sample of the abortus and peripheral blood samples of the couple. High throughput whole exome sequencing was carried out to detect potential variants in relation with the disease. Suspected variants were verified by Sanger sequencing.
Prenatal ultrasound revealed increased size of fetal kidneys, with multiple hyperechos from the right kidney, and multiple hyperechos with anechoic masses within the left kidney. DNA sequencing revealed that the fetus has carried heterozygous variants of the PKHD1 gene, including c.7994T>C inherited from its father, and two heterozygous variants of the PKHD1 gene c.5681G>A from its mother.
The compound heterozygous c.7994T>C and c.5681G>A variants of the PKHD1 gene probably underlay the pathogenesis of ARPKD in this fetus. Above results can provide guidance for subsequent pregnancies of the couple.
探讨一名患有常染色体隐性多囊肾病(ARPKD)胎儿的遗传病因。
产前超声检查显示羊水过少及胎儿肾脏结构异常。经过仔细咨询,这对夫妇选择了人工流产。在获得知情同意后,从流产胎儿的肌肉样本以及夫妇双方的外周血样本中提取基因组DNA。进行高通量全外显子测序以检测与该疾病相关的潜在变异。通过桑格测序验证疑似变异。
产前超声显示胎儿肾脏增大,右肾有多个高回声,左肾有多个伴有无回声团块的高回声。DNA测序显示该胎儿携带PKHD1基因的杂合变异,包括从父亲遗传的c.7994T>C,以及从母亲遗传的PKHD1基因的两个杂合变异c.5681G>A。
PKHD1基因的复合杂合变异c.7994T>C和c.5681G>A可能是该胎儿ARPKD发病机制的基础。上述结果可为这对夫妇后续的妊娠提供指导。