您的位置:山东大学 -> 科技期刊社 -> 《山东大学学报(医学版)》

山东大学学报 (医学版) ›› 2023, Vol. 61 ›› Issue (5): 73-78.doi: 10.6040/j.issn.1671-7554.0.2022.1239

• 临床医学 • 上一篇    

寡而大肾发育不良合并PAX2基因突变1例并文献复习

殷秋霞,赵非,丁桂霞,韩媛,赵三龙,成学琴   

  1. 南京医科大学附属儿童医院肾脏科, 江苏 南京 210008
  • 发布日期:2023-05-15
  • 通讯作者: 成学琴. E-mail:duoer417@126.com

A case of oligomeganephronia with PAX2 gene mutation and review of literature

YIN Qiuxia, ZHAO Fei, DING Guixia, HAN Yuan, ZHAO Sanlong, CHENG Xueqin   

  1. Department of Nephrology, Childrens Hospital of Nanjing Medical University, Nanjing 210008, Jiangsu, China
  • Published:2023-05-15

摘要: 目的 探究寡而大肾发育不良合并配对盒基因2(PAX2)基因突变病例临床特点。 方法 回顾分析1例肾活检病理为寡而大肾发育不良,基因示PAX2错义突变患儿的临床资料,并复习相关文献。 结果 患儿,男,9岁8个月,表现为非肾病水平蛋白尿,肾功能不全,肾活检病理提示:(1)寡而大肾发育不良;(2)局灶节段性肾小球硬化。二代测序发现PAX2基因c.94C>T(p.P32S)杂合变异,Sanger测序验证示变异来自患儿父亲。 结论 考虑可能是来源于患儿父亲的PAX2基因杂合突变致病,导致患儿肾发育不良。寡而大肾发育不良起病隐匿,临床中孤立性蛋白尿伴有肾功能不全需警惕此病,及时行肾活检。

关键词: 寡而大肾发育不良, 配对盒基因2, 突变, 蛋白尿, 局灶节段性肾小球硬化

Abstract: Objective To explore the clinical characteristics of oligomeganephronia with paired box2(PAX2)gene mutation. Methods Clinical data of a child diagnosed with oligomeganephronia by renal biopsy and PAX2 gene missense mutation by genetic testing were retrospectively analyzed, and relevant literature was reviewed. Results A boy aged 9 years and 8 months presented with non-nephrotic proteinuria and renal insufficiency. Pathological diagnosis of renal biopsy showed oligomeganephronia and focal segmental glomerulosclerosis. Genetic testing showed a heterozygous mutation of c.94C>T(p.P32S)in PAX2 gene, and Sanger sequencing verified that the mutation was from the father. Conclusion The heterozygous mutation of PAX2 gene from the father may cause the disease, leading to renal dysplasia. The onset of oligomeganephronia is insidious. In clinical practice, solitary proteinuria with renal insufficiency should be warned of this disease, and timely renal biopsy should be performed.

Key words: Oligomeganephronia, Paired box2 gene, Mutation, Proteinuria, Focal segmental glomerulosclerosis

中图分类号: 

  • R725.9
[1] Moerman P, Damme BV, Proesmans W, et al. Oligomeganephronic renal hypoplasia in two siblings [J]. J Pediatr, 1984, 105(1): 75-77.
[2] Weir MR, Salinas JA, Rawlings PC. Intrauterine twin demise and oligomeganephronia [J]. Nephron, 1985, 40(4): 482-484.
[3] Salomon R, Tellier AL, Attie-Bitach T, et al. PAX2 mutations in oligomeganephronia [J]. Kidney Int, 2001, 59(2): 457-462.
[4] Park SH, Chi JG. Oligomeganephronia associated with 4p deletion type chromosomal anomaly [J]. Pediatr Pathol, 1993, 13(6): 731-740.
[5] Gatto A, Ferrara P, Leoni C, et al. Oligonephronia and Wolf-Hirschhorn syndrome: a further observation [J]. Am J Med Genet A, 2018, 176(2): 409-414.
[6] Abdelhak S, Kalatzis V, Heilig R, et al. A human homologue of the Drosophila eyes absent gene underlies Branchio-Oto-Renal(BOR)syndrome and identifies a novel gene family [J]. Nat Genet, 1997, 15(2): 157-164.
[7] Holzmüller M. Branchio-oto-renal syndrome(BOR syndrome). A dysplasia syndrome with branchial abnormalities, deafness and kidney disease [J]. HNO, 2000, 48(11): 839-842.
[8] Kiefer SM, Ohlemiller KK, Yang J, et al. Expression of a truncated Sall1 transcriptional repressor is responsible for Townes-Brocks syndrome birth defects [J]. Hum Mol Genet, 2003, 12(17): 2221-2227.
[9] 张琰琴, 丁洁, 赵丹, 等. 寡而大肾发育不良患儿HNF-1β基因及PAX2基因的突变分析[J]. 临床儿科杂志, 2011, 29(5): 441-445. ZHANG Yanqin, DING Jie, ZHAO Dan, et al. Detection of HNF-1β gene and PAX2 gene mutation in a child with oligomeganephronia [J]. Journal of Clinical Pediatrics, 2011, 29(5): 441-445.
[10] Schimmenti LA. Renal coloboma syndrome [J]. Eur J Hum Genet, 2011, 19(12): 1207-1212.
[11] Bitó L, Kalmár T, Maróti Z, et al. PAX2 mutation-related oligomeganephronia in a young adult patient [J]. Case Rep Nephrol Dial, 2020, 10(3): 163-173.
[12] Royer P, Habib R, Mathieu H, et al. Congenital bilateral renal hyperplasia with reduction of the number and hypertrophy of the nephrons in children [J]. Ann Pediatr(Paris), 1962, 9: 133-146.
[13] Habib R, Courtecuisse V, Mathieu H, et al. A peculiar anatomo-clinical type of chronic renal insufficiency in the child: bilateral congenital oligonephronic hypoplasia [J]. J Urol Nephrol(Paris), 1962, 68(3): 139-143.
[14] Drukker A. Oligonephropathy: from a rare childhood disorder to a possible health problem in the adult [J]. Isr Med Assoc J, 2002, 4(3): 191-195.
[15] Bonsib SM. Renal hypoplasia, from grossly insufficient to not quite enough: consideration for expanded concepts based upon the authors perspective with historical review [J]. Adv Anat Pathol, 2020, 27(5): 311-330.
[16] Ferrè S, Igarashi P. New insights into the role of HNF-1β in kidney(patho)physiology [J]. Pediatr Nephrol, 2019, 34(8): 1325-1335.
[17] Sagen JV, Bostad L, Njlstad PR, et al. Enlarged nephrons and severe nondiabetic nephropathy in hepatocyte nuclear factor-1beta(HNF-1beta)mutation carriers [J]. Kidney Int, 2003, 64(3): 793-800.
[18] Nagano C, Nozu K, Yamamura T, et al. TGFBI-associated corneal dystrophy and nephropathy: a novel syndrome?[J]. CEN Case Rep, 2019, 8(1): 14-17.
[19] Favor J, Sandulache R, Neuhauser-Klaus A. The mouse Pax2(1Neu)mutation is identical to a human PAX2 mutation in a family with renal-coloboma syndrome and results in developmental defects of the brain, ear, eye, and kidney[J]. Proc Natl Acad Sci U S A, 1996, 93(24): 13870-13875.
[20] Yamamura Y, Furuichi K, Murakawa Y, et al. Identification of candidate PAX2-regulated genes implicated in human kidney development[J]. Sci Rep, 2021, 11(1): 9123.
[21] 侯晓明, 陈星, 王玉林. Pax2在肾脏发育和肾疾病中的调控作用[J]. 遗传, 2011, 33(9): 931-938. HOU Xiaoming, CHEN Xing, WANG Yulin. The role of Pax2 in regulation of kidney development and kidney disease [J]. Hereditas(Beijing), 2011, 33(9): 931-938.
[22] Bower M, Salomon R, Allanson J, et al. Update of PAX2 mutations in renal coloboma syndrome and establishment of a locus-specific database [J]. Hum Mutat, 2012, 33(3): 457-466.
[23] Fletcher J, Hu M, Berman Y, et al. Multicystic dysplastic kidney and variable phenotype in a family with a novel deletion mutation of PAX2 [J]. J Am Soc Nephrol, 2005, 16(9): 2754-2761.
[24] Okumura T, Furuichi K, Higashide T, et al. Association of PAX2 and other gene mutations with the clinical manifestations of renal coloboma syndrome [J]. PLoS One, 2015, 10(11): e0142843. doi: 10.1371/journal.pone.0142843.
[25] Choi DJ, Wallace EC, Fraire AE, et al. Best cases from the AFIP: intrarenal teratoma [J]. Radiographics, 2005, 25(2): 481-485.
[26] Zhang L, Zhai SB, Zhao LY, et al. New PAX2 heterozygous mutation in a child with chronic kidney disease: a case report and review of the literature [J]. BMC Nephrol, 2018, 19(1): 245-250.
[27] DAgati VD, Kaskel FJ, Falk RJ. Focal segmental glomerulosclerosis [J]. N Engl J Med, 2011, 365(25): 2398-2411.
[28] McGraw M, Poucell S, Sweet J, et al. The significance of focal segmental glomerulosclerosis in oligomeganephronia [J]. Int J Pediatr Nephrol, 1984, 5(2): 67-72.
[29] Brenner BM, Lawler EV, Mackenzie HS. The hyperfiltration theory: a paradigm shift in nephrology [J]. Kidney Int, 1996, 49(6): 1774-1777.
[30] Ohtaka A, Ootaka T, Sato H, et al. Phenotypic change of glomerular podocytes in primary focal segmental glomerulosclerosis: developmental paradigm? [J]. Nephrol Dial Transplant, 2002, 17(suppl 9): 11-15.
[31] Gebeshuber CA, Kornauth C, Dong L, et al. Focal segmental glomerulosclerosis is induced by microRNA-193a and its downregulation of WT1 [J]. Nat Med, 2013, 19(4): 481-487.
[32] Barua M, Stellacci E, Stella L, et al. Mutations in PAX2 associate with adult-onset FSGS [J]. J Am Soc Nephrol, 2014, 25(9): 1942-1953.
[33] Miyazawa T, Nakano M, Takemura Y, et al. A case of renal-coloboma syndrome associated with mental developmental delay exhibiting a novel PAX2 gene mutation [J]. Clin Nephrol, 2009, 72(6): 497-500.
[34] Schimmenti LA, Cunliffe HE, Mcnoe LA, et al. Further delineation of renal-coloboma syndrome in patients with extreme variability of phenotype and identical PAX2 mutations [J]. Am J Hum Genet, 1997, 60(4): 869-878.
[35] Latropoulos P, Daina E, Mele C, et al. Discordant phenotype in monozygotic twins with renal coloboma syndrome and a PAX2 mutation [J]. Pediatr Nephrol, 2012, 27(10): 1989-1993.
[1] 唐钦连,张玉超,赵蕙琛,马小莉,于民民,刘元涛. 携带成对盒4基因突变早发糖尿病1例报道并文献复习[J]. 山东大学学报 (医学版), 2022, 60(5): 104-108.
[2] 田敏,曹丽丽,宋承远. 神经纤维瘤病Ⅰ型:新发突变1例并文献复习[J]. 山东大学学报 (医学版), 2022, 60(4): 128-132.
[3] 任红,王伟,林岩,娄建伟,纪坤乾,赵玉英,焉传祝. Barth综合征1例报道[J]. 山东大学学报 (医学版), 2022, 60(4): 123-127.
[4] 薛美娟,石艳,邵琳琳,王琳,张昀,张阿敏. 遗传性血栓性血小板减少性紫癜1例并文献复习[J]. 山东大学学报 (医学版), 2022, 60(3): 121-124.
[5] 潘鹏飞,徐立升,纪坤乾,王得翔,李玉. 以呼吸衰竭起病的线粒体肌病1例及文献回顾[J]. 山东大学学报 (医学版), 2022, 60(2): 54-59.
[6] 亓梦雨,周敏然,孙洺山,李世洁,陈春燕. T大颗粒淋巴细胞白血病合并原发性骨髓纤维化1例[J]. 山东大学学报 (医学版), 2022, 60(2): 118-120.
[7] 史本康,陈守臻,曲思凤,王勇,刘磊. 临床常见快速进展前列腺癌临床特点及研究进展[J]. 山东大学学报 (医学版), 2021, 59(9): 110-116.
[8] 赵怀龙,吕燕,赵红,赵宝添,韩莹,潘晶,丁小满,王春荣,韩秀云,刘岚铮. 济南市人鼻病毒B83型基因组特征及分子变异分析[J]. 山东大学学报 (医学版), 2021, 59(5): 68-72, 81.
[9] 孙宇,陈娜,马爱华. SLC35A2基因突变致先天性糖基化障碍1例[J]. 山东大学学报 (医学版), 2021, 59(4): 113-116.
[10] 黄秀丽,刘丙菊,孙立锋. PIK3CD基因突变致PI3Kδ过度活化综合征1例并文献复习[J]. 山东大学学报 (医学版), 2021, 59(3): 107-112.
[11] 王正阳,夏艳,师凯旋,陶琨,王小杰. 曲美替尼在卵巢癌中对PAX8的表达作用[J]. 山东大学学报 (医学版), 2021, 59(10): 25-31.
[12] 胡思翠,孙清,王一冰,孙莉莉,隋炎希,李堂. Bartter综合征二例家系报告与CLCNKB基因突变分析[J]. 山东大学学报 (医学版), 2020, 1(9): 64-70.
[13] 徐继禧,陈伟健. 髓内弥漫性中线胶质瘤伴H3 K27M突变1例[J]. 山东大学学报 (医学版), 2020, 1(7): 96-101.
[14] 刘娜,刘奇迹,牟凯,程翠云. EBF3基因杂合突变导致1例神经发育障碍综合征[J]. 山东大学学报 (医学版), 2020, 58(4): 105-109.
[15] 刘晓曼,李虹, 杨广, 金翠香. 心脏型肌球蛋白结合蛋白C p.L808M和c.2417_2419delACA基因突变与家族性肥厚型心肌病的关系[J]. 山东大学学报 (医学版), 2019, 57(9): 83-87.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!