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- Dokumenttyp:
- Journal Article
- Autor(en):
- Ćomić, Jasmina; Riedhammer, Korbinian M; Günthner, Roman; Schaaf, Christian W; Richthammer, Patrick; Simmendinger, Hannes; Kieffer, Donald; Berutti, Riccardo; Tasic, Velibor; Abazi-Emini, Nora; Nushi-Stavileci, Valbona; Putnik, Jovana; Stajic, Nataša; Lungu, Adrian; Gross, Oliver; Renders, Lutz; Heemann, Uwe; Braunisch, Matthias C; Meitinger, Thomas; Hoefele, Julia
- Titel:
- The multifaceted phenotypic and genotypic spectrum of type-IV-collagen-related nephropathy-A human genetics department experience.
- Abstract:
- Disease-causing variants in COL4A3-5 are associated with type-IV-collagen-related nephropathy, a genetically and phenotypically multifaceted disorder comprising Alport syndrome (AS) and thin basement membrane nephropathy (TBMN) and autosomal, X-linked and a proposed digenic inheritance. Initial symptoms of individuals with AS are microscopic hematuria followed by proteinuria leading to kidney failure (90% on dialysis < age 40 years). In contrast, individuals with TBMN, an outdated histology-derived term, present with microscopic hematuria, only some of them develop kidney failure (>50 years of age). An early diagnosis of type-IV-collagen-related nephropathy is essential for optimized therapy and slowing of the disease. Sixty index cases, in whom exome sequencing had been performed and with disease-causing variant(s) in COL4A3-5, were evaluated concerning their clinical tentative diagnosis and their genotype. Of 60 reevaluated individuals with type-IV-collagen-related nephropathy, 72% had AS, 23% TBMN and 5% focal segmental glomerulosclerosis (FSGS) as clinical tentative diagnosis. The FSGS cases had to be re-classified as having type-IV-collagen-related nephropathy. Twelve percent of cases had AS as clinical tentative diagnosis and a monoallelic disease-causing variant in COL4A3/4 but could not be classified as autosomal dominant AS because of limited or conflicting clinical data. This study illustrates the complex clinical and genetic picture of individuals with a type IV-collagen-related nephropathy indicating the need of a refined nomenclature and the more interdisciplinary teamwork of clinicians and geneticists as the key to optimized patient care.
- Zeitschriftentitel:
- Front Med (Lausanne)
- Jahr:
- 2022
- Band / Volume:
- 9
- Volltext / DOI:
- doi:10.3389/fmed.2022.957733
- PubMed:
- http://view.ncbi.nlm.nih.gov/pubmed/36117978
- TUM Einrichtung:
- Institut für Humangenetik; Professur für Nephrologie (Prof. Heemann)
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