在三胞胎中鉴定CUBN变异,三胞胎有20年的蛋白尿病史
Natsumi Yamamura-Miyazaki1, Nana Sakakibara2, Kandai Nozu2
1Department of Pediatric Nephrology and Metabolism, Osaka Women's and Children's Hospital, 840 Murodo-Cho, Izumi, Osaka, 594-1101, Japan. yamamur@wch.opho.jp.
CEN case reports
|August 5, 2024
概括
库比林 (CUBN) 基因中的遗传变异导致慢性良性蛋白尿症,这是20年来三胞胎中以前未被诊断的疾病. 与CUBN相关的蛋白尿的分子诊断有助于避免不必要的治疗和脏预后问题.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 医学遗传学 医学遗传学
- 分子生物学分子生物学
背景情况:
- 库比林 (CUBN) 对于在附近的管中重新吸收过的白蛋白至关重要.
- 与CUBN相关的蛋白尿是最近公认的疾病实体,可能解释了以前未被诊断的蛋白尿病例.
- 早期诊断具有挑战性,因为症状可能是微妙的,遗传原因最初被忽视.
研究的目的:
- 报告一个独特的三胞胎病例,诊断出由于CUBN变异导致的慢性良性蛋白尿症.
- 为了突出诊断旅程和最终的分子确认CUBN相关的蛋白尿.
- 强调基因诊断在管理CUBN相关蛋白尿的临床实用性.
主要方法:
- 临床病例报告三胞胎与持续的蛋白尿.
- 脏活检和基因分析,包括NPHS1/2和WT1基因.
- 重新分析DNA样本以识别CUBN基因中的复合异构体变异体.
主要成果:
- 从新生儿期开始,三胞胎呈现出持续的,非脏性范围蛋白尿.
- 脏活检显示了轻微的淋巴细胞异常,初始遗传检测结果为阴性.
- 在这三个三胞胎中都发现了CUBN基因的复合异构变异,证实了与CUBN相关的蛋白尿症.
结论:
- 与CUBN相关的蛋白尿可以呈现为慢性良性蛋白尿与微妙的脏发现.
- 延迟分子诊断可能导致长期的诊断不确定性和潜在的不必要的治疗.
- 识别CUBN变异提供了明确的诊断,防止进一步的调查和指导患者管理.
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