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Buffin-Meyer B, Richard J, Guigonis V, Weber S, König J, Heidet L, Moussaoui N, Vu JP, Faguer S, Casemayou A, Prakash R, Baudouin V, Hogan J, Alexandrou D, Bockenhauer D, Bacchetta J, Ranchin B, Pruhova S, Zieg J, Lahoche A, Okorn C, Antal-Kónya V, Morin D, Becherucci F, Habbig S, Liebau MC, Mauras M, Nijenhuis T, Llanas B, Mekahli D, Thumfart J, Tönshoff B, Massella L, Eckart P, Cloarec S, Cruz A, Patzer L, Roussey G, Vrillon I, Dunand O, Bessenay L, Taroni F, Zaniew M, Louillet F, Bergmann C, Schaefer F, van Eerde AM, Schanstra JP, Decramer S. Renal and Extrarenal Phenotypes in Patients With HNF1B Variants and Chromosome 17q12 Microdeletions. Kidney Int Rep 2024; 9:2514-2526. [PMID: 39156164 PMCID: PMC11328578 DOI: 10.1016/j.ekir.2024.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 04/09/2024] [Accepted: 05/06/2024] [Indexed: 08/20/2024] Open
Abstract
Introduction Hepatocyte nuclear factor 1-beta (HNF1B) gene variants or the chromosome 17q12 deletion (17q12del) represent the most common monogenic cause of developmental kidney disease. Although neurodevelopmental disorders have been associated with the 17q12del, specific genotype-phenotype associations with respect to kidney function evolution have not yet been fully defined. Here, we aimed to determine whether 17q12del or specific HNF1B variants were associated with kidney survival in a large patient population with HNF1B disease. Methods This was a retrospective observational study involving 521 patients with HNF1B disease from 14 countries using the European Reference Network for rare kidney diseases with detailed information on the HNF1B genotype (HNF1B variants or the 17q12del). Median follow-up time was 11 years with 6 visits per patient. The primary end point was progression to chronic kidney disease (CKD) stage 3 (estimated glomerular filtration rate [eGFR] < 60 ml/min per 1.73 m2). Secondary end points were the development of hypomagnesemia or extrarenal disorders, including hyperuricemia and hyperglycemia. Results Progression toward CKD stage 3 was significantly delayed in patients with the 17q12del compared to patients with HNF1B variants (hazard ratio [HR]: 0.29, 95% confidence interval [CI]: 0.19-0.44, P < 0.001). Progression toward CKD stage 3 was also significantly delayed when HNF1B variants involved the HNF1B Pit-1, Oct-1, and Unc-86 homeodomain (POUh) DNA-binding and transactivation domains rather than the POU-specific domain (POUs) DNA-binding domain (HR: 0.15 [95% CI: 0.06-0.37), P < 0.001 and HR: 0.25 (95% CI: 0.11-0.57), P = 0.001, respectively). Finally, the 17q12del was positively associated with hypomagnesemia and negatively associated with hyperuricemia, but not with hyperglycemia. Conclusion Patients with the 17q12del display a significantly better kidney survival than patients with other HNF1B variants; and for the latter, variants in the POUs DNA-binding domain lead to the poorest kidney survival. These are clinically relevant HNF1B kidney genotype-phenotype correlations that inform genetic counseling.
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Affiliation(s)
- Bénédicte Buffin-Meyer
- National Institute of Health and Medical Research (INSERM), UMR 1297, Institute of Cardiovascular and Metabolic Disease, Toulouse, France
- University Paul Sabatier, Toulouse-III, Toulouse, France
| | - Juliette Richard
- Department of Pediatric Internal Medicine, Rheumatology and Nephrology, Toulouse University Hospital, Toulouse, France
- Centre De Référence Des Maladies Rénales Rares du Sud-Ouest (SORARE), Toulouse University Hospital, Toulouse, France
| | - Vincent Guigonis
- Department of Pediatrics, Hôpital Mère-Enfant, University Hospital of Limoges, Limoges, France
| | - Stefanie Weber
- Pediatric Nephrology, University Children's Hospital Marburg, Marburg, Germany
| | - Jens König
- Department of General Pediatrics, University Children's Hospital, Münster, Germany
| | - Laurence Heidet
- APHP, Service de Néphrologie Pédiatrique, Hôpital Universitaire Necker-Enfants malades, Paris, France
- Centre De Référence Des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte (MARHEA), Paris, France
| | - Nabila Moussaoui
- National Institute of Health and Medical Research (INSERM), UMR 1297, Institute of Cardiovascular and Metabolic Disease, Toulouse, France
- Centre De Référence Des Maladies Rénales Rares du Sud-Ouest (SORARE), Toulouse University Hospital, Toulouse, France
- Filière ORphan KIdney Disease (ORKiD), Montpellier, France
| | - Jeanne-Pierrette Vu
- National Institute of Health and Medical Research (INSERM), UMR 1297, Institute of Cardiovascular and Metabolic Disease, Toulouse, France
- University Paul Sabatier, Toulouse-III, Toulouse, France
| | - Stanislas Faguer
- National Institute of Health and Medical Research (INSERM), UMR 1297, Institute of Cardiovascular and Metabolic Disease, Toulouse, France
- University Paul Sabatier, Toulouse-III, Toulouse, France
- Centre De Référence Des Maladies Rénales Rares du Sud-Ouest (SORARE), Toulouse University Hospital, Toulouse, France
- Department of Nephrology and Organ Transplantation, University Hospital of Toulouse, and French Intensive Care Renal Network, Toulouse, France
| | - Audrey Casemayou
- National Institute of Health and Medical Research (INSERM), UMR 1297, Institute of Cardiovascular and Metabolic Disease, Toulouse, France
- University Paul Sabatier, Toulouse-III, Toulouse, France
- Centre De Référence Des Maladies Rénales Rares du Sud-Ouest (SORARE), Toulouse University Hospital, Toulouse, France
- Department of Nephrology and Organ Transplantation, University Hospital of Toulouse, and French Intensive Care Renal Network, Toulouse, France
| | - Richa Prakash
- APHP, Service de Néphrologie Pédiatrique, Hôpital Universitaire Necker-Enfants malades, Paris, France
- Centre De Référence Des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte (MARHEA), Paris, France
| | - Véronique Baudouin
- Nephrology Department, Robert Debré Hospital, APHP Nord, Paris University, Paris, France
| | - Julien Hogan
- Nephrology Department, Robert Debré Hospital, APHP Nord, Paris University, Paris, France
| | | | - Detlef Bockenhauer
- University College London, Department of Renal Medicine, London, UK
- Renal Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
- Department of Pediatric Nephrology, University Hospitals Leuven, Leuven, Belgium
| | - Justine Bacchetta
- Centre de Référence des Maladies Rénales Rares, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France
- INSERM 1033, Faculté de Médecine Lyon Est, Lyon, France
| | - Bruno Ranchin
- Centre de Référence des Maladies Rénales Rares, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France
| | - Stepanka Pruhova
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jakub Zieg
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Annie Lahoche
- Unité de néphrologie, Hôpital Jeanne de Flandre, CHU Lille, Lille, France
| | - Christine Okorn
- Department of Pediatrics II, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Violetta Antal-Kónya
- MTA-SE Lendület Nephrogenetic Laboratory, Budapest, Hungary
- Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Denis Morin
- Néphrologie Pédiatrique, CHU de Montpellier, Montpellier, France
- Centre De Référence Des Maladies Rénales Rares du Sud-Ouest (SORARE), Montpellier, France
- Université de Montpellier, Montpellier, France
| | | | - Sandra Habbig
- Department of Pediatrics, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Max C. Liebau
- Department of Pediatrics and Center for Family Health, Center for Rare Diseases and Center for Molecular Medicine, University Hospital Cologne and Medical Faculty, University of Cologne, Cologne, Germany
| | - Mathilde Mauras
- Department of Pediatrics, Hôpital Nord, CHU de Saint-Etienne, Saint-Etienne, France
| | - Tom Nijenhuis
- Department of Nephrology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Brigitte Llanas
- Unité de Néphrologie Pédiatrique, Hôpital Pellegrin-Enfants, CHU de Bordeaux, Centre de Références des Maladies rénales rares du Sud-Ouest (SORARE), Bordeaux, France
| | - Djalila Mekahli
- Department of Pediatric Nephrology, University Hospitals, Leuven, Belgium
- PKD Research Group, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium
| | - Julia Thumfart
- Department of Pediatric Gastroenterology, Nephrology and Metabolic Diseases, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Burkhard Tönshoff
- Department of Pediatrics I, University Children's Hospital Heidelberg, Heidelberg, Germany
| | - Laura Massella
- Division of Nephrology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Philippe Eckart
- Department of Pediatrics, University Hospital of Caen, Caen, France
| | - Sylvie Cloarec
- Service de Néphrologie Pédiatrique, Hôpital Clocheville, CHRU, Tours, France
- Centre De Compétence Maladies Rénales Rares, Filière ORphan KIdney Disease (ORKiD), France
| | - Alejandro Cruz
- Pediatric Nephrology, University Hospital Vall d’Hebron, Barcelona, Spain
| | - Ludwig Patzer
- Klinik für Kinder- und Jugendmedizin, Krankenhaus St. Elisabeth und St. Barbara, Halle/Saale, Germany
| | - Gwenaelle Roussey
- Service des Maladies Chroniques de l'Enfant, Hopital Mère Enfant, CHU Nantes, Nantes, France
- Centre De Référence Des Maladies Rénales Rares du Sud-Ouest (SORARE), Nantes, France
| | - Isabelle Vrillon
- Service de Néphrologie Pédiatrique, Hôpital des Enfants, CHRU Nancy, Vandoeuvre les Nancy, France
| | - Olivier Dunand
- Service de Néphrologie Pédiatrique, CHU Réunion site Félix GUYON, St Denis, Ile de La Réunion, France
| | - Lucie Bessenay
- Department of Pediatric Nephrology, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Francesca Taroni
- Pediatric Nephrology, Dialysis and Transplantation Unit Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Marcin Zaniew
- Department of Pediatrics, University of Zielona Góra, Zielona Góra, Poland
| | - Ferielle Louillet
- Département de Pédiatrie, Unité de Néphrologie-Hémodialyse, CHU Charles Nicolle, Rouen, France
| | - Carsten Bergmann
- Medizinische Genetik Mainz, Limbach Genetics, Mainz, Germany
- Department of Medicine IV, Faculty of Medicine, Medical Center-University of Freiburg, Freiburg, Germany
| | - Franz Schaefer
- Division of Pediatric Nephrology, Heidelberg University Center for Pediatrics and Adolescent Medicine, Heidelberg, Germany
| | | | - Joost P. Schanstra
- National Institute of Health and Medical Research (INSERM), UMR 1297, Institute of Cardiovascular and Metabolic Disease, Toulouse, France
- University Paul Sabatier, Toulouse-III, Toulouse, France
| | - Stéphane Decramer
- National Institute of Health and Medical Research (INSERM), UMR 1297, Institute of Cardiovascular and Metabolic Disease, Toulouse, France
- Department of Pediatric Internal Medicine, Rheumatology and Nephrology, Toulouse University Hospital, Toulouse, France
- Centre De Référence Des Maladies Rénales Rares du Sud-Ouest (SORARE), Toulouse University Hospital, Toulouse, France
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Lee R, Choi JE, Mun E, Kim KH, Choi SA, Kim HS. A Case of Chromosome 17q12 Deletion Syndrome with Type 2 Mayer-Rokitansky-Küster-Hauser Syndrome and Maturity-Onset Diabetes of the Young Type 5. CHILDREN (BASEL, SWITZERLAND) 2024; 11:404. [PMID: 38671621 PMCID: PMC11049139 DOI: 10.3390/children11040404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 03/26/2024] [Accepted: 03/26/2024] [Indexed: 04/28/2024]
Abstract
Chromosome 17q12 deletion syndrome (OMIM #614527) is a rare genetic disorder associated with a heterozygous 1.4-1.5 Mb deletion at chromosome 17q12, leading to a spectrum of clinical manifestations, including kidney abnormalities, neurodevelopmental delay, maturity-onset diabetes of the young type 5 (MODY5), and Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome. We present the case of a 14-year-old Korean female diagnosed with chromosome 17q12 deletion syndrome, confirmed by chromosomal microarray analysis. The patient exhibited MODY5 with pancreatic agenesis, MRKH syndrome, dysmorphic facial features, developmental delay, kidney rotation anomaly, portal vein thrombosis with liver hypoplasia, short stature, and scoliosis. Management involved the initiation of multiple daily insulin injections for diabetes control, gynecological evaluation for MRKH syndrome, and multidisciplinary care for associated complications. This case highlights the complexity and varied organ involvement in chromosome 17q12 deletion syndrome. A comprehensive and multidisciplinary approach is crucial for the management of affected individuals, including regular monitoring, tailored interventions across various medical specialties, and providing psychosocial support.
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Affiliation(s)
- Rosie Lee
- Department of Pediatrics, Keimyung University Dongsan Hospital, Daegu 42601, Republic of Korea;
| | - Jung Eun Choi
- Department of Pediatrics, Ewha Womans University College of Medicine, Seoul 07804, Republic of Korea; (J.E.C.); (E.M.); (K.h.K.); (S.A.C.)
| | - Eunji Mun
- Department of Pediatrics, Ewha Womans University College of Medicine, Seoul 07804, Republic of Korea; (J.E.C.); (E.M.); (K.h.K.); (S.A.C.)
| | - Kyung hee Kim
- Department of Pediatrics, Ewha Womans University College of Medicine, Seoul 07804, Republic of Korea; (J.E.C.); (E.M.); (K.h.K.); (S.A.C.)
| | - Sun Ah Choi
- Department of Pediatrics, Ewha Womans University College of Medicine, Seoul 07804, Republic of Korea; (J.E.C.); (E.M.); (K.h.K.); (S.A.C.)
| | - Hae Soon Kim
- Department of Pediatrics, Ewha Womans University College of Medicine, Seoul 07804, Republic of Korea; (J.E.C.); (E.M.); (K.h.K.); (S.A.C.)
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Huang R, Fu F, Guo F, Zhou H, Yu Q, Yan S, Liu L, Lu J, Ma C, Wang Y, Chen H, Wang D, Zhang Y, Jing X, Li F, Han J, Li D, Li R, Liao C. Prenatal diagnosis of polycystic renal diseases: diagnostic yield, novel disease-causing variants, and genotype-phenotype correlations. Am J Obstet Gynecol MFM 2024; 6:101228. [PMID: 37984685 DOI: 10.1016/j.ajogmf.2023.101228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 11/04/2023] [Accepted: 11/15/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND Polycystic renal disease is a frequent congenital anomaly of the kidneys, but research using chromosomal microarray analysis and exome sequencing in fetuses with polycystic renal disease remains sparse, with most studies focusing on the multisystem or genitourinary system. OBJECTIVE This study aimed to assess the detection rate of detectable genetic causes of fetal polycystic renal disease at different levels, novel disease-causing variants, and genotype-phenotype correlations. STUDY DESIGN This study included 220 fetal polycystic renal disease cases from January 2014 to June 2022. Cases were divided into the following 3 groups: isolated multicystic dysplastic kidneys, nonisolated multicystic dysplastic kidneys, and suspected polycystic kidney disease group. We reviewed data on maternal demographics, ultrasonographic results, chromosomal microarray analysis/exome sequencing results, and pregnancy outcomes. RESULTS In our cohort, chromosomal microarray analysis identified 19 (8.6%) fetuses carrying chromosomal abnormalities, and the most common copy number variation was 17q12 microdeletion (7/220; 3.2%). Furthermore, 94 families chose to perform trio-exome sequencing testing, and 21 fetuses (22.3%) were found to harbor pathogenic/likely pathogenic variants. There was a significant difference in the live birth rate among the 3 groups (91/130 vs 46/80 vs 1/10; P<.001). Among 138 live birth cases, 106 (78.5%) underwent postnatal ultrasound review, of which 95 (89.6%) had a consistent prenatal-postnatal ultrasound diagnosis. CONCLUSION For both isolated and nonisolated polycystic renal disease, our data showed high detection efficiency with both testing tools. The detection of novel pathogenic variants expands the known disease spectrum of polycystic renal disease-associated genes while enriching our understanding of the genotype-phenotype correlation. Therefore, we consider it feasible to perform chromosomal microarray analysis+exome sequencing testing in fetal polycystic renal disease. Moreover, prenatal-postnatal ultrasound concordance was greater, the live birth rate was higher, and prognosis was better when known genetic disorders were excluded, indicating that genetic testing results significantly influenced pregnancy decisions.
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Affiliation(s)
- Ruibin Huang
- Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China (Mr Huang, Dr Fu, Mr Guo, Mr Zhou, Ms Yu, Dr Yan, Ms Liu, Dr Lu, Ms Ma, Ms Y Wang, Ms Chen, Dr D Wang, Ms Zhang, Ms Jing, Dr F Li, Dr Han, Dr D Li, Dr R Li, and Ms Liao)
| | - Fang Fu
- Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China (Mr Huang, Dr Fu, Mr Guo, Mr Zhou, Ms Yu, Dr Yan, Ms Liu, Dr Lu, Ms Ma, Ms Y Wang, Ms Chen, Dr D Wang, Ms Zhang, Ms Jing, Dr F Li, Dr Han, Dr D Li, Dr R Li, and Ms Liao)
| | - Fei Guo
- Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China (Mr Huang, Dr Fu, Mr Guo, Mr Zhou, Ms Yu, Dr Yan, Ms Liu, Dr Lu, Ms Ma, Ms Y Wang, Ms Chen, Dr D Wang, Ms Zhang, Ms Jing, Dr F Li, Dr Han, Dr D Li, Dr R Li, and Ms Liao)
| | - Hang Zhou
- Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China (Mr Huang, Dr Fu, Mr Guo, Mr Zhou, Ms Yu, Dr Yan, Ms Liu, Dr Lu, Ms Ma, Ms Y Wang, Ms Chen, Dr D Wang, Ms Zhang, Ms Jing, Dr F Li, Dr Han, Dr D Li, Dr R Li, and Ms Liao)
| | - Qiuxia Yu
- Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China (Mr Huang, Dr Fu, Mr Guo, Mr Zhou, Ms Yu, Dr Yan, Ms Liu, Dr Lu, Ms Ma, Ms Y Wang, Ms Chen, Dr D Wang, Ms Zhang, Ms Jing, Dr F Li, Dr Han, Dr D Li, Dr R Li, and Ms Liao)
| | - Shujuan Yan
- Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China (Mr Huang, Dr Fu, Mr Guo, Mr Zhou, Ms Yu, Dr Yan, Ms Liu, Dr Lu, Ms Ma, Ms Y Wang, Ms Chen, Dr D Wang, Ms Zhang, Ms Jing, Dr F Li, Dr Han, Dr D Li, Dr R Li, and Ms Liao)
| | - Liyuan Liu
- Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China (Mr Huang, Dr Fu, Mr Guo, Mr Zhou, Ms Yu, Dr Yan, Ms Liu, Dr Lu, Ms Ma, Ms Y Wang, Ms Chen, Dr D Wang, Ms Zhang, Ms Jing, Dr F Li, Dr Han, Dr D Li, Dr R Li, and Ms Liao); The First Clinical Medical College, Southern Medical University, Guangzhou, China (Ms Liu and Ms Ma)
| | - Jianqin Lu
- Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China (Mr Huang, Dr Fu, Mr Guo, Mr Zhou, Ms Yu, Dr Yan, Ms Liu, Dr Lu, Ms Ma, Ms Y Wang, Ms Chen, Dr D Wang, Ms Zhang, Ms Jing, Dr F Li, Dr Han, Dr D Li, Dr R Li, and Ms Liao)
| | - Chunling Ma
- Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China (Mr Huang, Dr Fu, Mr Guo, Mr Zhou, Ms Yu, Dr Yan, Ms Liu, Dr Lu, Ms Ma, Ms Y Wang, Ms Chen, Dr D Wang, Ms Zhang, Ms Jing, Dr F Li, Dr Han, Dr D Li, Dr R Li, and Ms Liao); The First Clinical Medical College, Southern Medical University, Guangzhou, China (Ms Liu and Ms Ma)
| | - You Wang
- Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China (Mr Huang, Dr Fu, Mr Guo, Mr Zhou, Ms Yu, Dr Yan, Ms Liu, Dr Lu, Ms Ma, Ms Y Wang, Ms Chen, Dr D Wang, Ms Zhang, Ms Jing, Dr F Li, Dr Han, Dr D Li, Dr R Li, and Ms Liao)
| | - Huanyi Chen
- Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China (Mr Huang, Dr Fu, Mr Guo, Mr Zhou, Ms Yu, Dr Yan, Ms Liu, Dr Lu, Ms Ma, Ms Y Wang, Ms Chen, Dr D Wang, Ms Zhang, Ms Jing, Dr F Li, Dr Han, Dr D Li, Dr R Li, and Ms Liao)
| | - Dan Wang
- Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China (Mr Huang, Dr Fu, Mr Guo, Mr Zhou, Ms Yu, Dr Yan, Ms Liu, Dr Lu, Ms Ma, Ms Y Wang, Ms Chen, Dr D Wang, Ms Zhang, Ms Jing, Dr F Li, Dr Han, Dr D Li, Dr R Li, and Ms Liao)
| | - Yongling Zhang
- Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China (Mr Huang, Dr Fu, Mr Guo, Mr Zhou, Ms Yu, Dr Yan, Ms Liu, Dr Lu, Ms Ma, Ms Y Wang, Ms Chen, Dr D Wang, Ms Zhang, Ms Jing, Dr F Li, Dr Han, Dr D Li, Dr R Li, and Ms Liao)
| | - Xiangyi Jing
- Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China (Mr Huang, Dr Fu, Mr Guo, Mr Zhou, Ms Yu, Dr Yan, Ms Liu, Dr Lu, Ms Ma, Ms Y Wang, Ms Chen, Dr D Wang, Ms Zhang, Ms Jing, Dr F Li, Dr Han, Dr D Li, Dr R Li, and Ms Liao)
| | - Fucheng Li
- Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China (Mr Huang, Dr Fu, Mr Guo, Mr Zhou, Ms Yu, Dr Yan, Ms Liu, Dr Lu, Ms Ma, Ms Y Wang, Ms Chen, Dr D Wang, Ms Zhang, Ms Jing, Dr F Li, Dr Han, Dr D Li, Dr R Li, and Ms Liao)
| | - Jin Han
- Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China (Mr Huang, Dr Fu, Mr Guo, Mr Zhou, Ms Yu, Dr Yan, Ms Liu, Dr Lu, Ms Ma, Ms Y Wang, Ms Chen, Dr D Wang, Ms Zhang, Ms Jing, Dr F Li, Dr Han, Dr D Li, Dr R Li, and Ms Liao)
| | - Dongzhi Li
- Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China (Mr Huang, Dr Fu, Mr Guo, Mr Zhou, Ms Yu, Dr Yan, Ms Liu, Dr Lu, Ms Ma, Ms Y Wang, Ms Chen, Dr D Wang, Ms Zhang, Ms Jing, Dr F Li, Dr Han, Dr D Li, Dr R Li, and Ms Liao)
| | - Ru Li
- Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China (Mr Huang, Dr Fu, Mr Guo, Mr Zhou, Ms Yu, Dr Yan, Ms Liu, Dr Lu, Ms Ma, Ms Y Wang, Ms Chen, Dr D Wang, Ms Zhang, Ms Jing, Dr F Li, Dr Han, Dr D Li, Dr R Li, and Ms Liao)
| | - Can Liao
- Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China (Mr Huang, Dr Fu, Mr Guo, Mr Zhou, Ms Yu, Dr Yan, Ms Liu, Dr Lu, Ms Ma, Ms Y Wang, Ms Chen, Dr D Wang, Ms Zhang, Ms Jing, Dr F Li, Dr Han, Dr D Li, Dr R Li, and Ms Liao).
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Morton A, Li L, Wilson C. Pregnancy outcome with maternal HNF1B gene mutations and 17q12 deletions. Obstet Med 2023; 16:78-82. [PMID: 37441663 PMCID: PMC10334039 DOI: 10.1177/1753495x221109734] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 05/30/2022] [Accepted: 06/08/2022] [Indexed: 02/12/2024] Open
Abstract
There is an increasing body of literature regarding monogenic diabetes, particularly the more common forms of glucokinase and HNF1-alpha mutations (MODY2 and MODY3). There is relatively little published literature regarding rarer mutations. HNF1-beta mutations and 17q12 deletions may be associated with a broad range of organ dysfunction, renal disease and diabetes in particular resulting in high-risk pregnancies. This manuscript describes pregnancy outcomes in a woman with an HNF1-beta mutation and 2 women with an HNF1B/17q12 deletion and reviews the previously published literature. It highlights the significant rate of adverse maternal and fetal outcomes, and the maternal features suggestive of the diagnosis which should be considered in preconception counselling.
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Affiliation(s)
- Adam Morton
- Adam Morton, Obstetric Medicine, Mater Health, Raymond Terrace, South Brisbane, Queensland, Australia.
| | - Ling Li
- Obstetric Medicine, Mater Health, South Brisbane, Australia
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Nitte CM, Dobelke F, König J, Konrad M, Becker K, Kamp-Becker I, Weber S. Review of neurodevelopmental disorders in patients with HNF1B gene variations. Front Pediatr 2023; 11:1149875. [PMID: 36969268 PMCID: PMC10034397 DOI: 10.3389/fped.2023.1149875] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 02/20/2023] [Indexed: 03/25/2023] Open
Abstract
This review investigates the association between neurodevelopmental disorders (NDD) and variations of the gene HNF1B. Heterozygous intragenetic mutations or heterozygous gene deletions (17q12 microdeletion syndrome) of HNF1B are the cause of a multi-system developmental disorder, termed renal cysts and diabetes syndrome (RCAD). Several studies suggest that in general, patients with genetic variation of HNF1B have an elevated risk for additional neurodevelopmental disorders, especially autism spectrum disorder (ASD) but a comprehensive assessment is yet missing. This review provides an overview including all available studies of patients with HNF1B mutation or deletion with comorbid NDD with respect to the prevalence of NDDs and in how they differ between patients with an intragenic mutation or 17q12 microdeletion. A total of 31 studies was identified, comprising 695 patients with variations in HNF1B, (17q12 microdeletion N = 416, mutation N = 279). Main results include that NDDs are present in both groups (17q12 microdeletion 25.2% vs. mutation 6.8%, respectively) but that patients with 17q12 microdeletions presented more frequently with any NDDs and especially with learning difficulties compared to patients with a mutation of HNF1B. The observed prevalence of NDDs in patients with HNF1B variations seems to be higher than in the general population, but the validity of the estimated prevalence must be deemed insufficient. This review shows that systematical research of NDDs in patients with HNF1B mutations or deletions is lacking. Further studies regarding neuropsychological characteristics of both groups are needed. NDDs might be a concomitant of HFN1B-related disease and should be considered in clinical routine and scientific reports.
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Affiliation(s)
- Clara Marie Nitte
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps University, Marburg, Germany
- Correspondence: Clara Nittel
| | - Frederike Dobelke
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps University, Marburg, Germany
| | - Jens König
- Department of General Pediatrics, University Children’s Hospital, Münster, Germany
| | - Martin Konrad
- Department of General Pediatrics, University Children’s Hospital, Münster, Germany
| | - Katja Becker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps University, Marburg, Germany
| | - Inge Kamp-Becker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps University, Marburg, Germany
| | - Stefanie Weber
- Department of Pediatric and Adolescent Medicine, Philipps University, Marburg, Germany
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Yu QX, Jing XY, Li DZ. Prenatal Diagnosis of Intragenic HNF1B Variant-Associated Renal Disease by Exome Sequencing. Mol Syndromol 2023; 14:59-64. [PMID: 36777702 PMCID: PMC9911988 DOI: 10.1159/000526394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 08/05/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction HNF1B-associated diseases are a group of genetic conditions that affect the kidney as well as other organ systems. Kidney anomalies are the most common symptoms. Other defects may include early-onset diabetes, genital abnormalities, and abnormalities of pancreas and liver function. Renal involvement has emerged as the earliest finding in HNF1B disease, even in prenatal life, with the most common feature being hyperechogenic kidneys. Case Presentation In this study, we present 3 fetuses with bilateral renal hyperechogenicity identified by ultrasound in the second trimester. No pathogenic copy number variations were revealed by amniocentesis with chromosomal microarray analysis (CMA). Heterozygous variants in HNF1B were detected in all 3 fetuses by further investigation with exome sequencing (ES). Two pregnancies were terminated, and one was continued to term. Discussion and Conclusion Because of the known high frequency of HNF1B aberrations in fetal hyperechogenic kidneys, HNF1B screening should be an integral part of prenatal diagnosis for such fetuses. ES should be recommended following or concurrently with CMA for rapid prenatal detection. The ES results would improve the diagnostic yield and are beneficial in guiding counseling and management.
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7
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Framework From a Multidisciplinary Approach for Transitioning Variants of Unknown Significance From Clinical Genetic Testing in Kidney Disease to a Definitive Classification. Kidney Int Rep 2022; 7:2047-2058. [PMID: 36090499 PMCID: PMC9459028 DOI: 10.1016/j.ekir.2022.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 06/20/2022] [Indexed: 11/21/2022] Open
Abstract
Introduction Monogenic causes in over 300 kidney-associated genes account for approximately 12% of end stage kidney disease (ESKD) cases. Advances in sequencing and large customized panels enable the noninvasive diagnosis of monogenic kidney disease at relatively low cost, thereby allowing for more precise management for patients and their families. A major challenge is interpreting rare variants, many of which are classified as variants of unknown significance (VUS). We present a framework in which we thoroughly evaluated and provided evidence of pathogenicity for HNF1B-p.Arg303His, a VUS returned from clinical diagnostic testing for a kidney transplant candidate. Methods A blueprint was designed by a multidisciplinary team of clinicians, molecular biologists, and diagnostic geneticists. The blueprint included using a health system-based cohort with genetic and clinical information to perform deep phenotyping of VUS heterozygotes to identify the candidate VUS and rule out other VUS, examination of existing genetic databases, as well as functional testing. Results Our approach demonstrated evidence for pathogenicity for HNF1B-p.Arg303His by showing similar burden of kidney manifestations in this variant to known HNF1B pathogenic variants, and greater burden compared to noncarriers. Conclusion Determination of a molecular diagnosis for the example family allows for proper surveillance and management of HNF1B-related manifestations such as kidney disease, diabetes, and hypomagnesemia with important implications for safe living-related kidney donation. The candidate gene-variant pair also allows for clinical biomarker testing for aberrations of linked pathways. This working model may be applicable to other diseases of genetic etiology.
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8
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Phenotypic Variability of 17q12 Microdeletion Syndrome – Three Cases and Review of Literature. Balkan J Med Genet 2022; 24:71-82. [PMID: 36249519 PMCID: PMC9524179 DOI: 10.2478/bjmg-2021-0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract
Chromosome 17q12 microdeletion syndrome is a contiguous gene deletion syndrome caused by an 1–2 Mb loss, characterized by multicystic dysplastic kidneys or other urinary system anomalies starting in utero, including autism or maturity-onset diabetes of the young in its postnatal phenotype. Here, we report on three cases (two prenatal and one postnatal) with distinct and novel clinical presentations as compared with a large number of reviewed patients, thus emphasizing the phenotypic variability of this syndrome and the consequent difficulties in genetic counselling. Prenatal hyperechogenic multicystic kidneys, as well as other urinary tract anomalies, should be considered a marker, therefore indicating the necessity of comprehensive genetic testing, and autism should also be acknowledged as a possible clinical presentation, postnatally.
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9
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Knoers N, Antignac C, Bergmann C, Dahan K, Giglio S, Heidet L, Lipska-Ziętkiewicz BS, Noris M, Remuzzi G, Vargas-Poussou R, Schaefer F. Genetic testing in the diagnosis of chronic kidney disease: recommendations for clinical practice. Nephrol Dial Transplant 2021; 37:239-254. [PMID: 34264297 PMCID: PMC8788237 DOI: 10.1093/ndt/gfab218] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Indexed: 11/20/2022] Open
Abstract
The overall diagnostic yield of massively parallel sequencing–based tests in patients with chronic kidney disease (CKD) is 30% for paediatric cases and 6–30% for adult cases. These figures should encourage nephrologists to frequently use genetic testing as a diagnostic means for their patients. However, in reality, several barriers appear to hinder the implementation of massively parallel sequencing–based diagnostics in routine clinical practice. In this article we aim to support the nephrologist to overcome these barriers. After a detailed discussion of the general items that are important to genetic testing in nephrology, namely genetic testing modalities and their indications, clinical information needed for high-quality interpretation of genetic tests, the clinical benefit of genetic testing and genetic counselling, we describe each of these items more specifically for the different groups of genetic kidney diseases and for CKD of unknown origin.
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Affiliation(s)
- Nine Knoers
- Department of Genetics, University Medical Centre Groningen, The Netherlands
| | - Corinne Antignac
- Institut Imagine (Inserm U1163) et Département de Génétique, 24 bd du Montparnasse, 75015, Paris, France
| | - Carsten Bergmann
- Medizinische Genetik Mainz, Limbach Genetics, Mainz, Germany.,Department of Medicine, Nephrology, University Hospital Freiburg, Germany
| | - Karin Dahan
- Division of Nephrology, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, B-1200, Brussels, Belgium.,Center of Human Genetics, Institut de Pathologie et de Génétique, Avenue Lemaître, 25, B-6041, Gosselies, Belgium
| | - Sabrina Giglio
- Unit of Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Laurence Heidet
- Service de Néphrologie Pédiatrique, Hôpital Universitaire Necker-Enfants Malades, 149 rue de Sèvres, 75743, Paris, Cedex 15, France
| | - Beata S Lipska-Ziętkiewicz
- BSL-Z - ORCID 0000-0002-4169-9685, Centre for Rare Diseases, Medical University of Gdansk, Gdansk, Poland.,Clinical Genetics Unit, Department of Biology and Medical Genetics, Medical University of Gdansk, Gdansk, Poland
| | - Marina Noris
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Aldo & Cele Daccò Clinical Research Center for Rare Diseases, Bergamo, Italy
| | - Giuseppe Remuzzi
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Aldo & Cele Daccò Clinical Research Center for Rare Diseases, Bergamo, Italy
| | - Rosa Vargas-Poussou
- Département de Génétique, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75908, Paris, Cedex 15, France
| | - Franz Schaefer
- Division of Pediatric Nephrology, Center for Pediatrics and Adolescent Medicine, University of Heidelberg, Germany
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