Clin Nephrol. 2022 Jun;97(6):328-338. doi: 10.5414/CN110476.
Deletions involving the and genes lead to tuberous sclerosis complex (TSC) and autosomal dominant polycystic kidney disease (ADPKD), which is known as - contiguous gene deletion syndrome (PKDTS). PKDTS leads to severe symptoms and death. There are few reported cases of PKDTS, the phenotypic descriptions are poor, and detailed statistics and descriptions of the time of onset and prognosis of PKDTS are lacking. This is the first study to report on the clinical data of PKDTS patients in China. We analyzed all cases including Chinese individuals and summarized the clinical manifestations and genetic characteristics. Our study was the first to use a combination of exome sequencing and multiplex ligation-dependent probe amplification (MLPA) to screen and diagnose PKDTS. We found that many PKDTS patients have the following: multiple renal cysts; angiofibromas (≥ 3) or fibrous cephalic plaque; subependymal nodules; seizures; intellectual disability. PKDTS develops into polycystic kidney disease from before birth to 17 years old and the time of occurrence of end-stage renal disease or dialysis was 21.62 ± 12.87 years of age, which was significantly earlier than in ADPKD caused by mutation. Compared with non-Chinese individuals of diverse ancestry, Chinese people have significant differences in the clinical characteristics, including ungual fibromas (≥ 2), and shagreen patch. Five novel large deletions were identified in Chinese. We found no relationship between the clinical phenotype and the genotype. We combined exome sequencing with MLPA to develop a diagnostic method for PKDTS.
缺失涉及 和 基因导致结节性硬化症复合征(TSC)和常染色体显性多囊肾病(ADPKD),这被称为 - 连续基因缺失综合征(PKDTS)。PKDTS 导致严重的症状和死亡。报告的 PKDTS 病例很少,表型描述较差,并且缺乏 PKDTS 发病时间和预后的详细统计和描述。这是第一项在中国报告 PKDTS 患者临床数据的研究。我们分析了包括中国个体在内的所有病例,并总结了临床表现和遗传特征。我们的研究首次使用外显子组测序和多重连接依赖性探针扩增(MLPA)相结合来筛选和诊断 PKDTS。我们发现许多 PKDTS 患者具有以下特征:多发性肾囊肿;血管纤维瘤(≥3 个)或纤维性颅面斑块;室管膜下结节;癫痫发作;智力障碍。PKDTS 从出生前到 17 岁发展为多囊肾病,终末期肾病或透析的发病时间为 21.62±12.87 岁,明显早于 突变引起的 ADPKD。与具有不同祖先的非中国个体相比,中国人在临床特征方面存在显著差异,包括指甲纤维瘤(≥2 个)和鲨鱼皮斑。在中国确定了 5 种新的大型缺失。我们发现临床表型与基因型之间没有关系。我们将外显子组测序与 MLPA 相结合,开发了一种 PKDTS 的诊断方法。