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2017 ; 18
(1
): 325
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Phenotype variability in a large Spanish family with Alport syndrome associated
with novel mutations in COL4A3 gene
#MMPMID29089023
Cervera-Acedo C
; Coloma A
; Huarte-Loza E
; Sierra-Carpio M
; Domínguez-Garrido E
BMC Nephrol
2017[Oct]; 18
(1
): 325
PMID29089023
show ga
BACKGROUND: Alport syndrome is an inherited renal disorder characterized by
glomerular basement membrane lesions with hematuria, proteinuria and frequent
hearing defects and ocular abnormalities. The disease is associated with
mutations in genes encoding ?3, ?4, or ?5 chains of type IV collagen, namely
COL4A3 and COL4A4 in chromosome 2 and COL4A5 in chromosome X. In contrast to the
well-known X-linked and autosomal recessive phenotypes, there is very little
information about the autosomal dominant. In view of the wide spectrum of
phenotypes, an exact diagnosis is sometimes difficult to achieve. METHODS: We
investigated a Spanish family with variable phenotype of autosomal dominant
Alport syndrome using clinical, histological, and genetic analysis. RESULTS:
Mutational analysis of COL4A3 and COL4A4 genes showed a novel heterozygous
mutation (c. 998G > A; p.G333E) in exon 18 of the COL4A3 gene. Among relatives
carrying the novel mutation, the clinical phenotype was variable. Two additional
COL4A3 mutations were found, a Pro-Leu substitution in exon 48 (p.P1461L) and a
Ser-Cys substitution in exon 49 (p.S1492C), non-pathogenics alone. CONCLUSION:
Carriers of p.G333E and p.P1461L or p.S1492C mutations in COL4A3 gene appear to
be more severely affected than carriers of only p.G333E mutation, and the
clinical findings has an earlier onset. In this way, we could speculate on a
synergistic effect of compound heterozygosity that could explain the different
phenotype observed in this family.