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一个中国先天性肾病综合征患儿的 NPHS1 基因突变:病例报告。

A novel heterozygous mutation of the NPHS1 gene in a Chinese child with congenital nephrotic syndrome: A case report.

机构信息

Medical College, Guizhou University, Guiyang, China.

Department of Laboratory Medicine, Guizhou Provincial People's Hospital, Guiyang, Guizhou, China.

出版信息

Medicine (Baltimore). 2023 Feb 17;102(7):e32970. doi: 10.1097/MD.0000000000032970.

Abstract

RATIONALE

Congenital nephrotic syndrome (CNS) is a heterogeneous disorder in which massive proteinuria, hypoproteinemia, and hyperlipidemia and marked edema are the main manifestations before 3 months-of-age. Here, we present a case involving the genetic diagnosis of a child with CNS.

PATIENT CONCERNS

A 31-day-old male infant with diarrhea for 25 days and generalized edema for more than 10 days. There was no family history of kidney disease. On proband whole exome sequencing, a compound heterozygous mutation of the NPHS1 gene was identified, including a novel in-frame mutation in exon 14 (c.1864_1866dupACC p. T622dup) and a missense mutation in exon 8 (c.928G>A p. D310N).

DIAGNOSES

Based on the clinical and genetic findings, this patient was finally diagnosed with CNS.

INTERVENTIONS

The main treatment options for the patient were 2-fold: anti-infective treatment and symptomatic treatment.

OUTCOMES

The patient died in follow-up 2 months later; the specific reason for death was unclear.

LESSONS

Whole exome sequencing and Sanger sequencing confirmed that the infant had CNS. Our study identified a novel mutation in an infant, thus expanding the gene-mutation spectrum of the NPHS1 gene, thus providing an efficient prenatal screening strategy and early genetic counseling.

摘要

背景

先天性肾病综合征(CNS)是一种异质性疾病,其主要表现为 3 个月龄前出现大量蛋白尿、低蛋白血症、高脂血症和显著水肿。在此,我们报告了一例 CNS 患儿的基因诊断病例。

病例介绍

一名 31 天大的男性婴儿,腹泻 25 天,全身水肿超过 10 天。无肾脏病家族史。在先证者全外显子组测序中,发现 NPHS1 基因存在复合杂合突变,包括外显子 14 中一个新的框内突变(c.1864_1866dupACC p. T622dup)和外显子 8 中的错义突变(c.928G>A p. D310N)。

诊断

根据临床和遗传学发现,该患者最终被诊断为 CNS。

干预措施

患儿的主要治疗方法有两种:抗感染治疗和对症治疗。

结局

患儿在随访 2 个月后死亡;具体死亡原因尚不清楚。

教训

全外显子组测序和 Sanger 测序证实该婴儿患有 CNS。我们的研究在一名婴儿中发现了一个新的突变,从而扩大了 NPHS1 基因突变谱,为该病提供了有效的产前筛查策略和早期遗传咨询。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b649/9936045/248ab725193a/medi-102-e32970-g001.jpg

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