1
|
Xie D, Wu J, Zhang W, Jin T, Wu P, An B, Huang S. A novel heterozygous mutation of the NPHS1 gene in a Chinese child with congenital nephrotic syndrome: A case report. Medicine (Baltimore) 2023; 102:e32970. [PMID: 36800604 PMCID: PMC9936045 DOI: 10.1097/md.0000000000032970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
RATIONALE Congenital nephrotic syndrome (CNS) is a heterogeneous disorder in which massive proteinuria, hypoproteinemia, and hyperlipidemia and marked edema are the main manifestations before 3 months-of-age. Here, we present a case involving the genetic diagnosis of a child with CNS. PATIENT CONCERNS A 31-day-old male infant with diarrhea for 25 days and generalized edema for more than 10 days. There was no family history of kidney disease. On proband whole exome sequencing, a compound heterozygous mutation of the NPHS1 gene was identified, including a novel in-frame mutation in exon 14 (c.1864_1866dupACC p. T622dup) and a missense mutation in exon 8 (c.928G>A p. D310N). DIAGNOSES Based on the clinical and genetic findings, this patient was finally diagnosed with CNS. INTERVENTIONS The main treatment options for the patient were 2-fold: anti-infective treatment and symptomatic treatment. OUTCOMES The patient died in follow-up 2 months later; the specific reason for death was unclear. LESSONS Whole exome sequencing and Sanger sequencing confirmed that the infant had CNS. Our study identified a novel mutation in an infant, thus expanding the gene-mutation spectrum of the NPHS1 gene, thus providing an efficient prenatal screening strategy and early genetic counseling.
Collapse
Affiliation(s)
- Dan Xie
- Medical College, Guizhou University, Guiyang, China
| | - Jiangfen Wu
- Medical College, Guizhou University, Guiyang, China
| | - Wenyi Zhang
- Medical College, Guizhou University, Guiyang, China
| | - Tingting Jin
- Department of Laboratory Medicine, Guizhou Provincial People’s Hospital, Guiyang, Guizhou, China
| | - Peng Wu
- Prenatal Diagnostic Center, Guizhou Provincial People’s Hospital, Guiyang, Guizhou, China
| | - Banquan An
- Discipline Inspection and Supervision Office, Guizhou Provincial People’s Hospital, Guiyang, Guizhou, China
| | - Shengwen Huang
- Medical College, Guizhou University, Guiyang, China
- Prenatal Diagnostic Center, Guizhou Provincial People’s Hospital, Guiyang, Guizhou, China
- * Correspondence: Shengwen Huang, Prenatal Diagnostic Center, Guizhou Provincial People’s Hospital, Guiyang, Guizhou 550025, China (e-mail: )
| |
Collapse
|
2
|
Agarwal S, Sudhini YR, Polat OK, Reiser J, Altintas MM. Renal cell markers: lighthouses for managing renal diseases. Am J Physiol Renal Physiol 2021; 321:F715-F739. [PMID: 34632812 DOI: 10.1152/ajprenal.00182.2021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Kidneys, one of the vital organs in our body, are responsible for maintaining whole body homeostasis. The complexity of renal function (e.g., filtration, reabsorption, fluid and electrolyte regulation, and urine production) demands diversity not only at the level of cell types but also in their overall distribution and structural framework within the kidney. To gain an in depth molecular-level understanding of the renal system, it is imperative to discern the components of kidney and the types of cells residing in each of the subregions. Recent developments in labeling, tracing, and imaging techniques have enabled us to mark, monitor, and identify these cells in vivo with high efficiency in a minimally invasive manner. In this review, we summarize different cell types, specific markers that are uniquely associated with those cell types, and their distribution in the kidney, which altogether make kidneys so special and different. Cellular sorting based on the presence of certain proteins on the cell surface allowed for the assignment of multiple markers for each cell type. However, different studies using different techniques have found contradictions in cell type-specific markers. Thus, the term "cell marker" might be imprecise and suboptimal, leading to uncertainty when interpreting the data. Therefore, we strongly believe that there is an unmet need to define the best cell markers for a cell type. Although the compendium of renal-selective marker proteins presented in this review is a resource that may be useful to researchers, we acknowledge that the list may not be necessarily exhaustive.
Collapse
Affiliation(s)
- Shivangi Agarwal
- Department of Internal Medicine, Rush University, Chicago, Illinois
| | | | - Onur K Polat
- Department of Internal Medicine, Rush University, Chicago, Illinois
| | - Jochen Reiser
- Department of Internal Medicine, Rush University, Chicago, Illinois
| | | |
Collapse
|
3
|
Möller-Kerutt A, Rodriguez-Gatica JE, Wacker K, Bhatia R, Siebrasse JP, Boon N, Van Marck V, Boor P, Kubitscheck U, Wijnholds J, Pavenstädt H, Weide T. Crumbs2 Is an Essential Slit Diaphragm Protein of the Renal Filtration Barrier. J Am Soc Nephrol 2021; 32:1053-1070. [PMID: 33687977 PMCID: PMC8259666 DOI: 10.1681/asn.2020040501] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 12/28/2020] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Crumbs2 is expressed at embryonic stages as well as in the retina, brain, and glomerular podocytes. Recent studies identified CRB2 mutations as a novel cause of steroid-resistant nephrotic syndrome (SRNS). METHODS To study the function of Crb2 at the renal filtration barrier, mice lacking Crb2 exclusively in podocytes were generated. Gene expression and histologic studies as well as transmission and scanning electron microscopy were used to analyze these Crb2podKO knockout mice and their littermate controls. Furthermore, high-resolution expansion microscopy was used to investigate Crb2 distribution in murine glomeruli. For pull-down experiments, live cell imaging, and transcriptome analyses, cell lines were applied that inducibly express fluorescent protein-tagged CRB2 wild type and mutants. RESULTS Crb2podKO mice developed proteinuria directly after birth that preceded a prominent development of disordered and effaced foot processes, upregulation of renal injury and inflammatory markers, and glomerulosclerosis. Pull-down assays revealed an interaction of CRB2 with Nephrin, mediated by their extracellular domains. Expansion microscopy showed that in mice glomeruli, Crb2 and Nephrin are organized in adjacent clusters. SRNS-associated CRB2 protein variants and a mutant that lacks a putative conserved O-glycosylation site were not transported to the cell surface. Instead, mutants accumulated in the ER, showed altered glycosylation pattern, and triggered an ER stress response. CONCLUSIONS Crb2 is an essential component of the podocyte's slit diaphragm, interacting with Nephrin. Loss of slit diaphragm targeting and increasing ER stress are pivotal factors for onset and progression of CRB2-related SRNS.
Collapse
Affiliation(s)
- Annika Möller-Kerutt
- Internal Medicine D, Department of Molecular Nephrology, University Hospital of Muenster, Muenster, Germany
| | - Juan E. Rodriguez-Gatica
- Institute of Physical and Theoretical Chemistry, Department of Biophysical Chemistry, Rheinische Friedrich Wilhelms University Bonn, Bonn, Germany
| | - Karin Wacker
- Internal Medicine D, Department of Molecular Nephrology, University Hospital of Muenster, Muenster, Germany
| | - Rohan Bhatia
- Institute of Physical and Theoretical Chemistry, Department of Biophysical Chemistry, Rheinische Friedrich Wilhelms University Bonn, Bonn, Germany
| | - Jan-Peter Siebrasse
- Institute of Physical and Theoretical Chemistry, Department of Biophysical Chemistry, Rheinische Friedrich Wilhelms University Bonn, Bonn, Germany
| | - Nanda Boon
- Leiden University Medical Center, Department of Ophthalmology, Leiden, The Netherlands
| | - Veerle Van Marck
- Gerhard-Domagk Institute of Pathology, University Hospital of Muenster, Muenster, Germany
| | - Peter Boor
- Institute of Pathology, Department of Nephrology and Immunology, RWTH Aachen University Hospital, Aachen, Germany,The Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
| | - Ulrich Kubitscheck
- Institute of Physical and Theoretical Chemistry, Department of Biophysical Chemistry, Rheinische Friedrich Wilhelms University Bonn, Bonn, Germany
| | - Jan Wijnholds
- Leiden University Medical Center, Department of Ophthalmology, Leiden, The Netherlands
| | - Hermann Pavenstädt
- Internal Medicine D, Department of Molecular Nephrology, University Hospital of Muenster, Muenster, Germany
| | - Thomas Weide
- Internal Medicine D, Department of Molecular Nephrology, University Hospital of Muenster, Muenster, Germany
| |
Collapse
|
4
|
Brazilian Network of Pediatric Nephrotic Syndrome (REBRASNI). Kidney Int Rep 2019; 5:358-362. [PMID: 32154457 PMCID: PMC7056848 DOI: 10.1016/j.ekir.2019.11.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 10/30/2019] [Accepted: 11/11/2019] [Indexed: 11/21/2022] Open
|
5
|
Guaragna MS, de Brito Lutaif ACG, de Souza ML, Maciel-Guerra AT, Belangero VMS, Guerra-Júnior G, de Mello MP. Promises and pitfalls of whole-exome sequencing exemplified by a nephrotic syndrome family. Mol Genet Genomics 2019; 295:135-142. [PMID: 31520189 DOI: 10.1007/s00438-019-01609-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 09/05/2019] [Indexed: 01/12/2023]
Abstract
High-throughput techniques such as whole-exome sequencing (WES) show promise for the identification of candidate genes that underlie Mendelian diseases such as nephrotic syndrome (NS). These techniques have enabled the identification of a proportion of the approximately 54 genes associated with NS. However, the main pitfall of using WES in clinical and research practice is the identification of multiple variants, which hampers interpretation during downstream analysis. One useful strategy is to evaluate the co-inheritance of rare variants in affected family members. Here, we performed WES of a patient with steroid-resistant NS (SRNS) and intermittent microhematuria. Currently, 15 years after kidney transplantation, this patient presents normal kidney function. The patient was found to be homozygous for a rare MYO1E stop-gain variant, and was heterozygous for rare variants in NS-associated genes, COL4A4, KANK1, LAMB2, ANLN, E2F3, and APOL1. We evaluated the presence or absence of these variants in both parents and 11 siblings, three of whom exhibited a milder phenotype of the kidney disease. Analysis of variant segregation in the family, indicated the MYO1E stop-gain variant as the putative causal variant underlying the kidney disease in the patient and two of her affected sisters. Two secondary variants in COL4A4-identified in some other affected family members-require further functional studies to determine whether they play a role in the development of microhematuria in affected family members. Our data illustrate the difficulties in distinguishing the causal pathogenic variants from incidental findings after WES-based variant analysis, especially in heterogenous genetic conditions, such as NS.
Collapse
Affiliation(s)
- Mara Sanches Guaragna
- Laboratory of Human Molecular Genetics, Center for Molecular Biology and Genetic Engineering (CBMEG), State University of Campinas, UNICAMP, Caixa Postal 6010, 13083-875, Campinas, SP, Brazil.
| | - Anna Cristina Gervásio de Brito Lutaif
- Integrated Center of Pediatric Nephrology (CIN), Department of Pediatrics, School of Medical Sciences (FCM), State University of Campinas, UNICAMP, Campinas, Brazil
| | - Marcela Lopes de Souza
- Laboratory of Human Molecular Genetics, Center for Molecular Biology and Genetic Engineering (CBMEG), State University of Campinas, UNICAMP, Caixa Postal 6010, 13083-875, Campinas, SP, Brazil
| | | | - Vera Maria Santoro Belangero
- Integrated Center of Pediatric Nephrology (CIN), Department of Pediatrics, School of Medical Sciences (FCM), State University of Campinas, UNICAMP, Campinas, Brazil.,Department of Pediatrics, School of Medical Sciences (FCM), UNICAMP, Campinas, SP, Brazil
| | - Gil Guerra-Júnior
- Department of Pediatrics, School of Medical Sciences (FCM), UNICAMP, Campinas, SP, Brazil.,Growth and Development Laboratory, Center for Investigation in Pediatrics (CIPED), School of Medical Sciences (FCM), UNICAMP, Campinas, SP, Brazil
| | - Maricilda Palandi de Mello
- Laboratory of Human Molecular Genetics, Center for Molecular Biology and Genetic Engineering (CBMEG), State University of Campinas, UNICAMP, Caixa Postal 6010, 13083-875, Campinas, SP, Brazil
| |
Collapse
|
6
|
Zhuo L, Huang L, Yang Z, Li G, Wang L. A comprehensive analysis of NPHS1 gene mutations in patients with sporadic focal segmental glomerulosclerosis. BMC MEDICAL GENETICS 2019; 20:111. [PMID: 31216994 PMCID: PMC6585123 DOI: 10.1186/s12881-019-0845-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Accepted: 06/06/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Focal segmental glomerulosclerosis (FSGS) is still one of the common causes of refractory nephrotic syndrome. Nephrin, encoded by podocyte-specific NPHS1 gene, participated in the pathogenesis of FSGS. The sites of NPHS1 mutations in FSGS is not clarified very well. In this study, we investigated the specific mutations of NPHS1 gene in Chinese patients with sporadic FSGS. METHODS A total of 309 patients with sporadic FSGS were collected and screened for NPHS1 mutations by second-generation sequencing. The variants were compared with those extracted from 2504 healthy controls in the 1000 Genomes Project. The possible pathogenic roles of missense variants were predicted by three different software. We also compared these candidate causal mutations with those summarized from the previous studies. RESULTS Thirty-two genetic mutations of NPHS1 gene were identified in FSGS patients, including 12 synonymous mutations, 17 missense mutations, 1 splicing mutation, and 2 intron mutations, of which c.G3315A (p.S1105S) was the most common variant (261/309). A novel missense mutation c.G2638 T (p.V880F) and a novel splicing mutation 35830957 C > T were identified in FSGS patients. The frequencies of the four synonymous mutations (c.C294T [p.I98I], c.C2223T [p.T741 T], c.C2289T [p.V763 V], c.G3315A [p.S1105S]) were much higher in FSGS patients than in controls. The frequencies of the four missense mutations (c.G349A [p.E117K], c.G1339A [p.E447K], c.G1802C [p.G601A], c.C2398T [p.R800C]) were much higher and one (c.A3230G [p.N1077S]) was lower in FSGS patients than in controls. Five missense mutations, c.C616A (p.P206T), c.G1802C (p.G601A), c.C2309T (p.P770L), c.G2869C (p.V957 L), and c.C3274T (p.R1092C), were predicted to be pathogenic mutations by software analysis. CONCLUSIONS NPHS1 gene mutations were quite common in sporadic FSGS patients. We strongly recommend mutation analysis of the NPHS1 gene in the clinical management of FSGS patients.
Collapse
Affiliation(s)
- Ling Zhuo
- Renal Department and Institute of Nephrology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, No. 32, West 2nd Duan, 1st Circle Road, Qingyang District, Chengdu, Sichuan, 610072, People's Republic of China
| | - Lulin Huang
- Key Laboratory for Human Disease Gene Study, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Zhenglin Yang
- Key Laboratory for Human Disease Gene Study, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Guisen Li
- Renal Department and Institute of Nephrology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, No. 32, West 2nd Duan, 1st Circle Road, Qingyang District, Chengdu, Sichuan, 610072, People's Republic of China.
| | - Li Wang
- Renal Department and Institute of Nephrology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, No. 32, West 2nd Duan, 1st Circle Road, Qingyang District, Chengdu, Sichuan, 610072, People's Republic of China
| |
Collapse
|
7
|
Cooper CJ, Dutta NT, Martin CE, Piscione TD, Thorner PS, Jones N. Characterization of a novel disease-associated mutation within NPHS1 and its effects on nephrin phosphorylation and signaling. PLoS One 2018; 13:e0203905. [PMID: 30212551 PMCID: PMC6136785 DOI: 10.1371/journal.pone.0203905] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 08/29/2018] [Indexed: 12/22/2022] Open
Abstract
Mutations in the transmembrane protein nephrin (encoded by NPHS1) underlie nearly half of all cases of congenital nephrotic syndrome (CNS), which is caused by aberrations in the blood filtering function of glomerular podocytes. Nephrin directly contributes to the structure of the filtration barrier, and it also serves as a signaling scaffold in podocytes, undergoing tyrosine phosphorylation on its cytoplasmic tail to recruit intracellular effector proteins. Nephrin phosphorylation is lost in several human and experimental models of glomerular disease, and genetic studies have confirmed its importance in maintenance of the filtration barrier. To date, however, the effect of CNS-associated NPHS1 variants on nephrin phosphorylation remains to be determined, which hampers genotype-phenotype correlations. Here, we have characterized a novel nephrin sequence variant, A419T, which is expressed along with C623F in a patient presenting with CNS. Nephrin localization is altered in kidney biopsies, and we further demonstrate reduced surface expression and ER retention of A419T and C623F in cultured cells. Moreover, we show that both mutations impair nephrin tyrosine phosphorylation, and they exert dominant negative effects on wildtype nephrin signaling. Our findings thus reveal that missense mutations in the nephrin extracellular region can impact nephrin signaling, and they uncover a potential pathomechanism to explain the spectrum of clinical severity seen with mild NPHS1 mutations.
Collapse
Affiliation(s)
- C. James Cooper
- Department of Molecular and Cellular Biology, University of Guelph, Guelph, ON, Canada
| | - Nikkita T. Dutta
- Department of Molecular and Cellular Biology, University of Guelph, Guelph, ON, Canada
| | - Claire E. Martin
- Department of Molecular and Cellular Biology, University of Guelph, Guelph, ON, Canada
| | - Tino D. Piscione
- Division of Nephrology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Paul S. Thorner
- Department of Pathology and Laboratory Medicine, The Hospital for Sick Children and University of Toronto, Toronto, ON, Canada
| | - Nina Jones
- Department of Molecular and Cellular Biology, University of Guelph, Guelph, ON, Canada
- * E-mail:
| |
Collapse
|
8
|
Martin CE, Jones N. Nephrin Signaling in the Podocyte: An Updated View of Signal Regulation at the Slit Diaphragm and Beyond. Front Endocrinol (Lausanne) 2018; 9:302. [PMID: 29922234 PMCID: PMC5996060 DOI: 10.3389/fendo.2018.00302] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 05/22/2018] [Indexed: 12/11/2022] Open
Abstract
Podocytes are a major component of the glomerular blood filtration barrier, and alterations to the morphology of their unique actin-based foot processes (FP) are a common feature of kidney disease. Adjacent FP are connected by a specialized intercellular junction known as the slit diaphragm (SD), which serves as the ultimate barrier to regulate passage of macromolecules from the blood. While the link between SD dysfunction and reduced filtration selectivity has been recognized for nearly 50 years, our understanding of the underlying molecular circuitry began only 20 years ago, sparked by the identification of NPHS1, encoding the transmembrane protein nephrin. Nephrin not only functions as the core component of the extracellular SD filtration network but also as a signaling scaffold via interactions at its short intracellular region. Phospho-regulation of several conserved tyrosine residues in this region influences signal transduction pathways which control podocyte cell adhesion, shape, and survival, and emerging studies highlight roles for nephrin phospho-dynamics in mechanotransduction and endocytosis. The following review aims to summarize the last 5 years of advancement in our knowledge of how signaling centered at nephrin directs SD barrier formation and function. We further provide insight on promising frontiers in podocyte biology, which have implications for SD signaling in the healthy and diseased kidney.
Collapse
|
9
|
Li P. Novel NPHS1 Gene Mutations in two Chinese Infants with Congenital Nephrotic Syndrome. Indian J Pediatr 2017; 84:489-490. [PMID: 28160156 DOI: 10.1007/s12098-017-2296-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 01/17/2017] [Indexed: 10/20/2022]
Affiliation(s)
- Peng Li
- Department of Pediatrics, Beijing Chaoyang Hospital, Capital Medical University, Gongti South Road No. 8, Beijing, 100020, China.
| |
Collapse
|
10
|
Grover SB, Kumar N, Grover H, Taneja DK, Katyan A. Sonographic Diagnosis in a Rare Aetiology of Neonatal Scrotal Swellings: A Case Report of Congenital Nephrotic Syndrome. Pol J Radiol 2016; 81:465-468. [PMID: 27757175 PMCID: PMC5045919 DOI: 10.12659/pjr.898088] [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: 02/17/2016] [Accepted: 03/13/2016] [Indexed: 02/05/2023] Open
Abstract
Background Common etiologies of scrotal swelling in neonates include hydrocoele, inguinal hernia and testicular torsion; less common is epididymo-orchitis. Congenital nephrotic syndrome (CNS), a rare entity, is known to present as progressive renal failure and its leading presentation with scrotal involvement has not been reported. Material/Methods We report a rare case of CNS with primary clinical presentation as scrotal cellulitis and epididymo-orchitis. In this neonate, scrotal and abdominal ultrasound examination was performed and the laboratory data were obtained. Results Sonography revealed bilaterally enlarged echogenic kidneys, testis and epididymis with echogenic peritoneal fluid tracking into both scrotal sacs. Laboratory data revealed proteinuria and severe depletion of serum IgG. Culture of the peritoneal fluid showed gram-negative organisms. A final diagnosis of CNS, complicated with peritonitis tracking into the scrotal sacs was arrived at. Conclusions CNS may have a rare presentation with distracting symptoms of scrotal cellulitis and epididymo-orchitis, as seen in our patient. However, diligent use of abdomino-scrotal sonography, supported by relevant laboratory data can clinch the accurate diagnosis.
Collapse
Affiliation(s)
- Shabnam Bhandari Grover
- Department of Radiology and Imaging, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Nishith Kumar
- Department of Radiology and Imaging, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Hemal Grover
- At time of study: Radiology Resident Deputed to Department of Radiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, from Institute of Nuclear Medicine and Allied Sciences, Delhi, India, currently, Research Associate Department of Neuro Radiology, New York Medical University, New York, NY, U.S.A
| | - Dinesh Kumar Taneja
- Department of Radiology and Imaging, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Amit Katyan
- Department of Radiology and Imaging, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| |
Collapse
|