Seeman Tomáš, Šuláková Terezie, Bosáková Alice, Indráková Jana, Grečmalová Dagmar
Department of Pediatrics, University Hospital Ostrava and Medical Faculty of the University Ostrava, Ostrava, Czech Republic.
Department of Clinical and Molecular Pathology and Medical Genetics, University Hospital Ostrava and Medical Faculty of the University Ostrava, Ostrava, Czech Republic.
Case Rep Nephrol Dial. 2024 Jul 1;14(1):104-109. doi: 10.1159/000539176. eCollection 2024 Jan-Dec.
Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disease, which is mainly caused by pathogenic variants in two particular genes: and . ADPKD caused by variants in other genes ( or ) is very rare.
In a 6-year-old girl examined for abdominal pain, a cystic mass in the upper part of the right kidney was detected during an abdominal ultrasound. She was referred to pediatric oncology and urology for suspicion of a tumorous mass and the condition was assessed as a cystic nephroma. A heminephrectomy was then performed on the upper cystic part of the right kidney. The histological examination was inconclusive; therefore, genetic testing was recommended. Kidney and liver cysts were detected sonographically in the mother, but DNA analysis of the and genes did not reveal any pathogenic variant; the cause of the pathological formation in the kidneys remained unclear. Nine years later, next-generation sequencing of a panel of genes for kidney disease was performed and a heterozygous deletion was found on chromosome 16; this included exon 13 of the gene. The same deletion was found in the patient's mother. Currently, the patient is 14 years old and has mild sonographic findings, normal glomerular filtration, mild proteinuria, and hypertension.
Pathogenic variants of the gene very rarely cause ADPKD; however, they should be considered in all children with autosomal dominant forms of PKD and asymmetric/atypical cystic kidney involvement or negative findings of and .
常染色体显性多囊肾病(ADPKD)是最常见的遗传性肾病,主要由两个特定基因的致病变异引起: 和 。由其他基因( 或 )变异导致的ADPKD非常罕见。
一名6岁女童因腹痛接受检查,腹部超声检查发现右肾上部有一个囊性肿块。因怀疑是肿瘤性肿块,她被转诊至儿科肿瘤学和泌尿外科,病情被评估为囊性肾瘤。随后对右肾上部囊性部分进行了半肾切除术。组织学检查结果不明确;因此,建议进行基因检测。超声检查在母亲身上发现了肾囊肿和肝囊肿,但对 和 基因的DNA分析未发现任何致病变异;肾脏病理形成的原因仍不清楚。九年后,对一组肾病相关基因进行了二代测序,发现16号染色体上有一个杂合缺失;这包括 基因的第13外显子。在患者母亲身上也发现了相同的缺失。目前,患者14岁,超声检查结果轻微,肾小球滤过正常,有轻度蛋白尿和高血压。
基因的致病变异极少引起ADPKD;然而,对于所有常染色体显性形式的PKD且有不对称/非典型性肾囊肿累及或 和 基因检测结果为阴性的儿童,都应考虑这种情况。