在符合严格定义的类固醇耐药性性综合征中,单一性变体比预期的少得多
Yuta Ichikawa1, Nana Sakakibara2, China Nagano2
1Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-Cho, Chuo-Ku, Kobe, 650-0017, Japan. y0gobro@med.kobe-u.ac.jp.
Pediatric nephrology (Berlin, Germany)
|August 2, 2024
概括
基因分析显示,12%的儿科类固醇耐药性性综合征 (SRNS) 患者符合严格标准的单一原因. 发病时的存在显著影响了SRNS中单基变异检测率.
科学领域:
- 儿科脏病学 儿科脏病学
- 临床遗传学 临床遗传学
- 病的遗传学 病的遗传学
背景情况:
- 单一的变体显著影响类固醇耐药性性综合征 (SRNS) 的治疗策略.
- 之前的研究报告了更高的单基变异检测率 (约. 30%) 在SRNS队列中,但这些包括更广泛的患者群体.
- 需要澄清符合严格诊断标准的SRNS患者中单一原因的流行情况.
研究的目的:
- 确定严格符合诊断标准的儿科SRNS患者中致病性单一基因变异的比例.
- 在这个定义的SRNS队列中调查与单一原因相关的临床特征.
主要方法:
- 对接受基因检测的儿科SRNS病例的回顾性分析.
- 纳入标准:年龄1-18岁,血清白蛋白≤2.5g/dL,持续重蛋白尿,在单独使用类固醇治疗4周后没有缓解.
- 基于临床表现的变种检测率的评估,包括的存在或不存在.
主要成果:
- 在符合严格SRNS标准的12% (22/185) 患者中检测到单基变异.
- 与没有的患者相比,发病时的患者 (7%) 的变异检测明显较低 (38%,p<0.0001).
- 在急性损伤 (1%) 或之前完全缓解 (4%) 的SRNS病例中,很少发现单基因变异.
结论:
- 严格定义的儿科SRNS的单一原因比以前建议的比例 (12%) 低.
- 发病时的存在或不存在是区分SRNS与单一原因的关键临床特征.
- 这些发现完善了我们对SRNS亚型的理解,这些亚型归因于单一的病因.
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