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Polyhydramnios, Transient Antenatal Bartter's Syndrome, and MAGED2 Mutations
Kamel Laghmani1, Bodo B Beck1, Sung-Sen Yang1
1From INSERM, Centre de Recherche des Cordeliers, Unité 1138, Centre National de la Recherche Scientifique, ERL8228 Université Pierre et Marie Curie and Université Paris-Descartes, Paris (K.L., E.S., S.D.); Institute of Human Genetics (B.B.B., A.W., B.R., J.A., G.Y.), Department of Pathology (H.G.), Cologne Center for Genomics and Center for Molecular Medicine (H.T., J.A., P.N.), Department II of Internal Medicine and Center for Molecular Medicine Cologne (M.P.B., T.B., M.M.R.), and Cologne Excellence Cluster on Cellular Stress Responses in Aging Associated Diseases and Systems Biology of Aging Cologne (T.B., M.M.R.) - all at the University of Cologne, Cologne, the Department of Cellular and Integrative Physiology, University Medical Center Hamburg, Hamburg (H.V.), University Children's Hospital, Philipps University Marburg (H.W.S.), and Kuratorium für Heimdialyse, Pediatric Kidney Center (G.K.), Marburg, the Institute of Human Genetics, University Health Services Göttingen, Göttingen (G.Y.), and the Department of General Pediatrics, University Hospital Münster, Münster (K.P.S., M. Konrad) - all in Germany; the Division of Nephrology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center (S.-S.Y., S.-H.L.), and Institute of BioMedical Sciences, Academia Sinica (S.-S.Y.) - both in Taipei, Taiwan; the Department of Biomedical Molecular Biology, Inflammation Research Center, VIB/Ghent University, Ghent (D.P., M.J.M.B.), Unité de Recherche en Physiologie Moléculaire, University of Namur, Namur (C.D., O.B.), and the Division of Nephrology, University Children's Hospital Leuven (E.L.) - all in Belgium; the Divisions of Neonatology (K.B.) and Nephrology (M. Kömhoff), Beatrix Children's Hospital, and the Departments of Obstetrics and Gynecology (L.K.D., S.A.S.), Pathology and Medical Biology (A.T.), and Genetics (T.J.K.) - all at University Medical Center Groningen, Groningen, the Netherlands; and University Children's Hospital Graz
Mutations in the MAGED2 gene cause a severe, transient form of antenatal Bartter's syndrome in male infants. This X-linked condition affects fetal kidney salt reabsorption and pregnancy maintenance.
Area of Science:
- Genetics
- Molecular Biology
- Perinatology
Background:
- Severe polyhydramnios and prematurity complicated three pregnancies with male offspring in one family.
- Two fetuses experienced transient massive salt-wasting and polyuria, mimicking antenatal Bartter's syndrome.
Observation:
- Whole-exome sequencing and targeted gene analysis were performed on affected families.
- MAGED2 mutations were identified in 13 infants with transient antenatal Bartter's syndrome and in two families with idiopathic polyhydramnios.
Findings:
- MAGED2 mutations cause X-linked polyhydramnios with prematurity and a severe, transient antenatal Bartter's syndrome.
- MAGE-D2 protein impacts renal salt transporters (NKCC2, NCC) via cyclic AMP signaling.
- The condition presented more severely than known antenatal Bartter's syndrome types, with spontaneous symptom resolution in survivors.
Implications:
- MAGED2 is crucial for fetal kidney salt reabsorption, amniotic fluid balance, and successful pregnancy.
- Understanding MAGED2 function offers insights into fetal kidney development and pregnancy complications.
- Genetic identification of MAGED2 mutations aids in diagnosing and managing this rare X-linked disorder.
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