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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Am+J+Hum+Genet
2015 ; 96
(1
): 162-9
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CRB2 mutations produce a phenotype resembling congenital nephrosis, Finnish type,
with cerebral ventriculomegaly and raised alpha-fetoprotein
#MMPMID25557780
Slavotinek A
; Kaylor J
; Pierce H
; Cahr M
; DeWard SJ
; Schneidman-Duhovny D
; Alsadah A
; Salem F
; Schmajuk G
; Mehta L
Am J Hum Genet
2015[Jan]; 96
(1
): 162-9
PMID25557780
show ga
We report five fetuses and a child from three families who shared a phenotype
comprising cerebral ventriculomegaly and echogenic kidneys with histopathological
findings of congenital nephrosis. The presenting features were greatly elevated
maternal serum alpha-fetoprotein (MSAFP) or amniotic fluid alpha-fetoprotein
(AFAFP) levels or abnormalities visualized on ultrasound scan during the second
trimester of pregnancy. Exome sequencing revealed deleterious sequence variants
in Crumbs, Drosophila, Homolog of, 2 (CRB2) consistent with autosomal-recessive
inheritance. Two fetuses with cerebral ventriculomegaly and renal microcysts were
compound heterozygotes for p.Asn800Lys and p.Trp759Ter, one fetus with renal
microcysts was a compound heterozygote for p.Glu643Ala and p.Asn800Lys, and one
child with cerebral ventriculomegaly, periventricular heterotopias, echogenic
kidneys, and renal failure was homozygous for p.Arg633Trp in CRB2. Examination of
the kidneys in one fetus showed tubular cysts at the corticomedullary junction
and diffuse effacement of the epithelial foot processes and microvillous
transformation of the renal podocytes, findings that were similar to those
reported in congenital nephrotic syndrome, Finnish type, that is caused by
mutations in nephrin (NPHS1). Loss of function for crb2b and nphs1 in Danio rerio
were previously shown to result in loss of the slit diaphragms of the podocytes,
leading to the hypothesis that nephrosis develops from an inability to develop a
functional glomerular barrier. We conclude that the phenotype associated with
CRB2 mutations is pleiotropic and that the condition is an important
consideration in the evaluation of high MSAFP/AFAFP where a renal cause is
suspected.