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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 BMC+Nephrol
2018 ; 19
(1
): 181
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Familial hypomagnesaemia, Hypercalciuria and Nephrocalcinosis associated with a
novel mutation of the highly conserved leucine residue 116 of Claudin 16 in a
Chinese patient with a delayed diagnosis: a case report
#MMPMID30005619
Lu J
; Zhao X
; Paiardini A
; Lang Y
; Bottillo I
; Shao L
BMC Nephrol
2018[Jul]; 19
(1
): 181
PMID30005619
show ga
BACKGROUND: Sixty mutations of claudin 16 coding gene have been reported in
familial hypomagnesemia with hypercalciuria and nephrocalcinosis (FHHNC)
patients. Recent investigations revealed that a highly conserved
glycine-leucine-tryptophan ((115)G-L-W(117)) motif in the first extracellular
segment (ESC1) of claudin 16 might be essential for stabilization of the
appropriately folded ECS1 structure and conservation of normal claudin 16
function. However, neither missense nor nonsense mutation has ever been described
in this motif. Our study aimed at identifying mutations in a Chinese patient with
FHHNC and exploring the association between genotype and phenotype. CASE
PRESENTATION: A 33-year-old female presented with 4 years history of recurrent
acute pyelonephritis without other notable past medical history. Her healthy
parents, who aged 56 and 53 respectively, were second cousins, and her only
sibling died from renal failure without definite cause at age 25. Renal
ultrasound imaging demonstrated atrophic kidneys and bilateral nephrocalcinosis.
The laboratory workup revealed impaired renal function (Stage CKD IV),
hypocalcemia and mild hypomagnesemia, accompanied with marked renal loss of
magnesium and hypercalciuria. During the follow-up, treatment with calcitriol and
calcium but not with magnesium was difficult to achieve normal serum calcium
levels, whereas her serum magnesium concentration fluctuated within normal
ranges. In the end, the patient unavoidably reached ESRD at 36 years old. The
clinical features and family history suggested the diagnosis of FHHNC. To make a
definite diagnosis, we use whole-exome sequencing to identify the disease-causing
mutations and Sanger sequencing to confirm the mutation co-segregation in the
family. As a result, a novel homozygous mutation (c.346C?>?G, p.Leu116Val) in
(115)G-L-W(117) motif of claudin 16 was identified. Her parents, grandmother and
one of her cousins carried heterozygous p.Leu116Val, whereas 200 unrelated
controls did not carry this mutation. CONCLUSIONS: We described a delayed
diagnosis patient with FHHNC in the Chinese population and identified a novel
missense mutation in the highly conserved (115)G-L-W(117) motif of claudin 16 for
the first time. According to the reported data and the information deduced from
3D modeling, we speculate that this mutation probably reserve partial residual
function which might be related to the slight phenotype of the patient.