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A novel mutation of KCNJ1 identified in an affected child with nephrolithiasis
Saisai Yang1, Guanghui Yao1, Xin Chen1
1Department of Obstetrics and Gynecology, Center of Genetics and Prenatal Diagnosis, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, China.
Insights
Nephrolithiasis in children, though rare, is increasing. Next-generation sequencing identified KCNJ1 mutations causing Bartter syndrome in a young boy, highlighting the need for genetic testing in pediatric kidney stones.
Area of Science:
- Pediatric Nephrology
- Medical Genetics
- Molecular Diagnostics
Background:
- Pediatric nephrolithiasis incidence is rising, with diverse contributing factors including genetics.
- Early etiological diagnosis is crucial for effective management and personalized treatment of childhood kidney stones.
Observation:
- A 10-year-old boy presented with incidentally discovered nephrolithiasis.
- Next-generation sequencing (NGS) was employed, utilizing a 248-gene panel for hereditary kidney diseases.
Findings:
- NGS identified two KCNJ1 mutations (c.89G>A [p.C30Y] and a novel c.65G>T [p.R22M]) in the patient, inherited from his father.
- The patient was diagnosed with type II Bartter syndrome (BS) secondary to KCNJ1 mutations.
Implications:
- Bartter syndrome (BS) can be challenging to diagnose early via clinical or biochemical methods.
- NGS offers an efficient diagnostic approach for pediatric nephrolithiasis, guiding treatment and family genetic counseling.
Abstract:
Nephrolithiasis is not common in children, but the incidence is gradually increased in these years. Urinary tract malformations, urinary infection, dietary habits, geographic region and genetic factor are involved in the etiology of nephrolithiasis. For the affected child, it is especially important to elucidate the etiology, which may provide an accurate diagnosis, a personalized therapy and effective follow-up strategy. Here to seek the etiology of a ten-year-old boy incidentally found with nephrolithiasis, next generation sequencing (NGS) including a panel with 248 genes involved in hereditary kidney diseases was performed for the boy and identified two mutations of KCNJ1, c.89G > A (p.C30Y) and c.65G > T (p.R22M), and the later was a novel missense mutation originated from his father. The child was confirmed with type II Bartter syndrome (BS) caused by KCNJ1 mutations. Our study suggests that BS may be difficult to get diagnosed at an early stage based on clinical manifestations or biochemical laboratory tests, and NGS is an efficient way to determine the etiology and provide further treatment and guide fertility counseling for the affected family.
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