Ma Jianglei, Zhang Huijie, Wang Guangming
School of Clinical Medicine, Dali University, Dali, Yunnan 671000, China.
Zhonghua Yi Xue Yi Chuan Xue Za Zhi. 2023 Aug 10;40(8):973-978. doi: 10.3760/cma.j.cn511374-20220914-00620.
To explore the genetic basis of a Chinese pedigree affected with chronic kidney disease (CKD).
A Chinese pedigree comprised of 10 individuals from four generation who had visited the First Affiliated Hospital of Dali University from August 15, 2018 to July 5, 2021 was selected as the study subject. Clinical data of the proband were collected, and a pedigree survey was conducted. The proband was subjected to whole exome sequencing (WES). Candidate variant was verified by Sanger sequencing and bioinformatic analysis.
The proband, a 41-year-old female, has been diagnosed with chronic nephritis for more than 4 years. Routine urinary examination showed proteinuria and blood creatinine of 1 130 μmol/L. Renal biopsy has revealed hyperplastic glomerulonephritis, moderate tubulointerstitial disease and renal arteriosclerosis. Her elder sister, younger brother, younger sister and mother were all diagnosed with CKD stage 5. Except for her elder sister, all of them had deceased, whilst no abnormality was found in the remainders. Genetic testing revealed that the proband and four family members had harbored a c.467G>A missense variant of the PAX2 gene. The variant has been associated with focal segmental glomerulosclerosis and classified as likely pathogenic (PS1+PP3+PP4) based on the guidelines from the American College of Medical Genetics and Genomics (ACMG).
The c.167G>A variant of the PAX2 gene probably underlay the CKD in this Chinese pedigree.
探讨一个患慢性肾脏病(CKD)的中国家系的遗传基础。
选取一个由四代10人组成的中国家系作为研究对象,该家系成员于2018年8月15日至2021年7月5日就诊于大理大学第一附属医院。收集先证者的临床资料并进行家系调查。先证者接受全外显子组测序(WES)。候选变异通过桑格测序和生物信息学分析进行验证。
先证者为一名41岁女性,已被诊断为慢性肾炎4年多。尿常规检查显示蛋白尿,血肌酐为1130μmol/L。肾活检显示增生性肾小球肾炎、中度肾小管间质病变和肾动脉硬化。她的姐姐、弟弟、妹妹和母亲均被诊断为CKD 5期。除姐姐外,其他人均已去世,其余成员未发现异常。基因检测显示,先证者和四名家庭成员携带PAX2基因的c.467G>A错义变异。根据美国医学遗传学与基因组学学会(ACMG)的指南,该变异与局灶节段性肾小球硬化相关,并被分类为可能致病(PS1+PP3+PP4)。
PAX2基因的c.167G>A变异可能是这个中国家系CKD的病因。