Raina Manan, S Savita, Singh Kanika, Sethi Sidharth K
Hawken High School, Cleveland, OH, United States.
Pediatric Nephrology, Kidney Institute, Medanta, The Medicity, Gurgaon, Haryana, India.
Indian J Nephrol. 2024 May-Jun;34(3):261-262. doi: 10.4103/ijn.ijn_108_23. Epub 2023 Nov 6.
Mutations in the HNF-1β gene have been found to be associated with renal cysts and diabetes syndrome (RCAD), also known as MODY5. The mutation is inherited in an autosomal dominant fashion, although sporadic mutations can be seen. Pediatric cases of HNF - 1β mutations are more likely to present with renal involvement like renal failure or renal hypoplasia. In young individuals, the detection of renal abnormalities usually pre-date the diagnosis of diabetes with a mean age of 24 years. We report a 5 year old, end stage kidney disease patient with renal cysts and hypertriglyceridemia (in the absence of overt diabetes) with a known pathogenic mutation in the Hepatocyte Nuclear Factor-1β () gene on chromosome 17q12. This case expands the clinical spectrum of HNF-1β mutation disorders with a take home message, that end stage renal disease patients with unexplained hypertriglyceridemia (even in absence of diabetes mellitus) should alert a clinician for HNF-1β mutational analysis.
已发现肝细胞核因子-1β(HNF-1β)基因的突变与肾囊肿和糖尿病综合征(RCAD,也称为MODY5)相关。该突变以常染色体显性方式遗传,不过也可见散发性突变。HNF-1β突变的儿科病例更易出现肾脏受累情况,如肾衰竭或肾发育不全。在年轻个体中,肾脏异常的检测通常早于糖尿病诊断,平均年龄为24岁。我们报告了一名5岁的终末期肾病患者,患有肾囊肿和高甘油三酯血症(无明显糖尿病),其17号染色体q12区域的肝细胞核因子-1β(HNF-1β)基因存在已知的致病突变。该病例扩展了HNF-1β突变疾病的临床谱,传递了一个重要信息,即患有不明原因高甘油三酯血症(即使无糖尿病)的终末期肾病患者应提醒临床医生进行HNF-1β突变分析。