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Furmańczyk-Zawiska A, Kubiak-Dydo A, Użarowska-Gąska E, Kotlarek-Łysakowska M, Salata K, Kolanowska M, Świerniak M, Gaj P, Leszczyńska B, Daniel M, Jażdżewski K, Durlik M, Wójcicka A. Compound Haplotype Variants in CFH and CD46 Genes Determine Clinical Outcome of Atypical Hemolytic Uremic Syndrome (aHUS)-A Series of Cases from a Single Family. J Pers Med 2021; 11:jpm11040304. [PMID: 33920896 PMCID: PMC8071215 DOI: 10.3390/jpm11040304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 04/11/2021] [Accepted: 04/12/2021] [Indexed: 11/16/2022] Open
Abstract
Atypical hemolytic uremic syndrome (aHUS) is a rare disease triggered by dysregulation of the alternative complement pathway, consisting of a characteristic triad of nonimmune hemolytic anemia, thrombocytopenia, and renal failure. The risk of aHUS onset, recurrence, and allograft loss depends on the genetic background of a patient. We show a series of cases from a single family whose five members were affected by aHUS and presented distinct clinical outcomes. Next-generation sequencing revealed combined mutations in both complement factor H and membrane cofactor protein CD46. Out of eight siblings, aHUS affected three adult brothers, and, subsequently, affected two children of an unaffected sister. The first patient died due to aHUS, and two other brothers underwent successful kidney transplantation with no aHUS recurrence. The younger, 10-month-old child presented with a severe course of the disease with cardiac involvement and persistent hemolytic anemia limited by eculizumab, while the 2-year-old recovered completely on eculizumab. The study shows a highly variable disease penetrance.
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Affiliation(s)
- Agnieszka Furmańczyk-Zawiska
- Department of Transplantation Medicine, Nephrology and Internal Diseases, Medical University of Warsaw, 02-006 Warsaw, Poland; (A.F.-Z.); (M.D.)
| | - Anna Kubiak-Dydo
- Warsaw Genomics INC, 01-682 Warsaw, Poland; (A.K.-D.); (E.U.-G.); (M.K.-Ł.); (K.S.); (M.K.); (M.Ś.); (P.G.); (K.J.)
| | - Ewelina Użarowska-Gąska
- Warsaw Genomics INC, 01-682 Warsaw, Poland; (A.K.-D.); (E.U.-G.); (M.K.-Ł.); (K.S.); (M.K.); (M.Ś.); (P.G.); (K.J.)
- Postgraduate School of Molecular Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Marta Kotlarek-Łysakowska
- Warsaw Genomics INC, 01-682 Warsaw, Poland; (A.K.-D.); (E.U.-G.); (M.K.-Ł.); (K.S.); (M.K.); (M.Ś.); (P.G.); (K.J.)
| | - Katarzyna Salata
- Warsaw Genomics INC, 01-682 Warsaw, Poland; (A.K.-D.); (E.U.-G.); (M.K.-Ł.); (K.S.); (M.K.); (M.Ś.); (P.G.); (K.J.)
| | - Monika Kolanowska
- Warsaw Genomics INC, 01-682 Warsaw, Poland; (A.K.-D.); (E.U.-G.); (M.K.-Ł.); (K.S.); (M.K.); (M.Ś.); (P.G.); (K.J.)
| | - Michał Świerniak
- Warsaw Genomics INC, 01-682 Warsaw, Poland; (A.K.-D.); (E.U.-G.); (M.K.-Ł.); (K.S.); (M.K.); (M.Ś.); (P.G.); (K.J.)
| | - Paweł Gaj
- Warsaw Genomics INC, 01-682 Warsaw, Poland; (A.K.-D.); (E.U.-G.); (M.K.-Ł.); (K.S.); (M.K.); (M.Ś.); (P.G.); (K.J.)
| | - Beata Leszczyńska
- Department of Pediatrics Nephrology, Medical University of Warsaw, 02-091 Warsaw, Poland; (B.L.); (M.D.)
| | - Maria Daniel
- Department of Pediatrics Nephrology, Medical University of Warsaw, 02-091 Warsaw, Poland; (B.L.); (M.D.)
| | - Krystian Jażdżewski
- Warsaw Genomics INC, 01-682 Warsaw, Poland; (A.K.-D.); (E.U.-G.); (M.K.-Ł.); (K.S.); (M.K.); (M.Ś.); (P.G.); (K.J.)
- Laboratory of Human Cancer Genetics, University of Warsaw, 02-089 Warsaw, Poland
| | - Magdalena Durlik
- Department of Transplantation Medicine, Nephrology and Internal Diseases, Medical University of Warsaw, 02-006 Warsaw, Poland; (A.F.-Z.); (M.D.)
| | - Anna Wójcicka
- Warsaw Genomics INC, 01-682 Warsaw, Poland; (A.K.-D.); (E.U.-G.); (M.K.-Ł.); (K.S.); (M.K.); (M.Ś.); (P.G.); (K.J.)
- Correspondence:
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Bednarek M, Trybus M, Kolanowska M, Koziej M, Kiec-Wilk B, Dobosz A, Kotlarek-Łysakowska M, Kubiak-Dydo A, Użarowska-Gąska E, Staręga-Rosłan J, Gaj P, Górzyńska I, Serwan K, Świerniak M, Kot A, Jażdżewski K, Wójcicka A. BMPR1B gene in brachydactyly type 2-A family with de novo R486W mutation and a disease phenotype. Mol Genet Genomic Med 2021; 9:e1594. [PMID: 33486847 PMCID: PMC8104157 DOI: 10.1002/mgg3.1594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 12/02/2020] [Accepted: 12/15/2020] [Indexed: 12/29/2022] Open
Abstract
Background Brachydactylies are a group of inherited conditions, characterized mainly by the presence of shortened fingers and toes. Based on the patients’ phenotypes, brachydactylies have been subdivided into 10 subtypes. In this study, we have identified a family with two members affected by brachydactyly type A2 (BDA2). BDA2 is caused by mutations in three genes: BMPR1B, BMP2 or GDF5. So far only two studies have reported the BDA2 cases caused by mutations in the BMPR1B gene. Methods We employed next‐generation sequencing to identify mutations in culpable genes. Results and Conclusion In this paper, we report a case of BDA2 resulting from the presence of a heterozygous c.1456C>T, p.Arg486Trp variant in BMPR1B, which was previously associated with BDA2. The next generation sequencing analysis of the patients’ family revealed that the mutation occurred de novo in the proband and was transmitted to his 26‐month‐old son. Although the same variant was confirmed in both patients, their phenotypes were different with more severe manifestation of the disease in the adult.
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Affiliation(s)
- Marcin Bednarek
- 2nd Department of General Surgery, Jagiellonian University Medical College, Krakow, Poland.,University Hospital, Krakow, Poland
| | - Marek Trybus
- 2nd Department of General Surgery, Jagiellonian University Medical College, Krakow, Poland.,University Hospital, Krakow, Poland
| | | | - Mateusz Koziej
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Beata Kiec-Wilk
- 2nd Department of General Surgery, Jagiellonian University Medical College, Krakow, Poland.,Department of Metabolic Diseases, Jagiellonian University Medical College, Krakow, Poland
| | - Artur Dobosz
- Department of Medical Genetics, Jagiellonian University Medical College, Krakow, Poland
| | | | | | | | | | - Paweł Gaj
- Warsaw Genomics INC., Warszawa, Poland
| | | | | | | | - Adam Kot
- Warsaw Genomics INC., Warszawa, Poland
| | - Krystian Jażdżewski
- Warsaw Genomics INC., Warszawa, Poland.,Laboratory of Human Cancer Genetics, University of Warsaw, Warsaw, Poland
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