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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 Clin+Kidney+J
2018 ; 11
(2
): 198-203
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Mutations in membrane cofactor protein (CD46) gene in Indian children with
hemolytic uremic syndrome
#MMPMID29644059
Khandelwal P
; Birla S
; Bhatia D
; Puraswani M
; Saini H
; Sinha A
; Hari P
; Sharma A
; Bagga A
Clin Kidney J
2018[Apr]; 11
(2
): 198-203
PMID29644059
show ga
BACKGROUND: Mutations in the CD46 gene account for an important proportion of
patients with atypical hemolytic uremic syndrome (aHUS) who characteristically
show multiple relapses, no response to plasma exchange and low recurrence risk in
allograft. We screened for mutations in CD46 in patients with and without
circulating anti-factor H (FH) antibodies-associated aHUS. METHODS: We estimated
CD46 surface expression by flow cytometry and sequenced the CD46 gene in 23 and
56 patients with and without circulating anti-FH antibodies, respectively. Human
Splicing Finder and PolyPhen2 were used for in silico prediction of
pathogenicity. RESULTS: Two novel and three known (c.286?+2T?>?G, c.104G?>?A and
c.565T?>?G) mutations in CD46 were found in nine (11.4%) patients; one patient
had a variant of unknown significance and two patients presented during the first
year of life. Novel intronic (c.1127?+?46C?>?G) and exonic (c.911C?>?T) mutations
are proposed to activate cryptic splicing sites or alter protein conformation.
Markedly reduced CD46 surface expression was found in homozygous states in five
patients. CONCLUSION: Patients with mutations in CD46 present at all ages,
including the first year of life. Mutations in intron 2, (c.286?+2T?>?G) may be a
potential hot spot in Indian children. Flow cytometry for CD46 expression is a
satisfactory screening tool enabling early diagnosis.