Department of Obstetrics & Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, China.
Mol Genet Genomic Med. 2022 Oct;10(10):e2027. doi: 10.1002/mgg3.2027. Epub 2022 Aug 1.
Type III Bartter syndrome (BS), often known as classic Bartter syndrome is caused by variants in CLCNKB gene, which encoding the basolateral chloride channel protein ClC-Kb, and is characterized by renal salt wasting, hypokalemia, metabolic alkalosis, increased renin, and aldosterone levels.
A 2-year-old boy presented severe malnutrition, severe metabolic alkalosis and severe hypokalemia and was clinically diagnosed with BS. The trio exome sequencing (ES) was performed to discover the genetic cause of this patient, followed by validation using Sanger sequencing and quantitative polymerase chain reaction subsequently.
The genetic analysis indicated that this patient with a compound heterozygous variants of CLCNKB gene including a novel nonsense variant c.876 T > A and a whole-gene deletion. The two variants were inherited from his parents, respectively. Subsequently, target sequencing of CLCNKB gene was performed for next pregnancy, and prenatal genetic diagnosis was provided for the family.
The results of current study identified the compound heterozygous variants in a patient with classic BS. The novel variant expands the spectrum of CLCNKB variants in BS. Our study also indicates that ES is an alternative tool to simultaneously detect single-nucleotide variants and copy-number variants.
III 型巴特综合征(BS),又称经典巴特综合征,是由 CLCNKB 基因突变引起的,该基因编码基底外侧氯离子通道蛋白 ClC-Kb,其特征为肾性盐耗、低钾血症、代谢性碱中毒、肾素和醛固酮水平升高。
一名 2 岁男孩表现为严重营养不良、严重代谢性碱中毒和严重低钾血症,并被临床诊断为 BS。对该患者进行 trio 外显子组测序(ES)以发现遗传病因,随后通过 Sanger 测序和实时定量聚合酶链反应进行验证。
基因分析表明,该患者 CLCNKB 基因存在复合杂合变异,包括一个新的无义变异 c.876T>A 和全基因缺失。这两个变异分别来自于他的父母。随后,对 CLCNKB 基因进行了目标测序,为该家庭提供了产前遗传诊断。
本研究鉴定了经典 BS 患者的复合杂合变异。该新型变异扩展了 BS 中 CLCNKB 变异谱。我们的研究还表明,ES 是一种同时检测单核苷酸变异和拷贝数变异的替代工具。