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PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
10
pubmed:dateCreated
2006-8-25
pubmed:abstractText
WT1 mutations have been considered a rare cause of nephrotic syndrome but recent reports challenge this assumption. Exclusion of inherited forms is a basic point in any therapeutic strategy to nephrotic syndrome since they do not respond to drugs. We screened for WT1 mutations in 200 patients with nephrotic syndrome: 114 with steroid resistance (SRNS) and 86 with steroid dependence (SDNS) for whom other inherited forms of nephrotic syndrome (NPHS2, CD2AP) had been previously excluded. Three girls out of 32 of the group with steroid resistance under 18 years presented classical WT1 splice mutations (IVS9+5G>A, IVS9+4C>T) of Frasier syndrome. Another one presented a mutation coding for an amino acid change (D396N) at exon 9 that is typical of Denys-Drash syndrome. All presented resistance to drugs and developed end stage renal failure within 15 years. Two girls of the Frasier group presented a 46 XY karyotype with streak gonads while one was XX and had normal gonad morphology. In the two cases with IVS9+5G>A renal pathology was characterized by capillary wall thickening with deposition of IgG and C3 in one that was interpreted as a membrane pathology. Foam cells were diffuse in tubule-interstitial areas. In conclusion, WT1 splice mutations are not rare in females under 18 years with SRNS. This occurs in absence of a clear renal pathology picture and frequently in absence of phenotype change typical of Frasier syndrome. In adults and children with SDNS, screening analysis is of no clinical value. WT1 hot spot mutation analysis should be routinely done in children with SRNS; if the molecular screening anticipates any further therapeutic approach it may modify the long term therapeutic strategy.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Oct
pubmed:issn
0931-041X
pubmed:author
pubmed:issnType
Print
pubmed:volume
21
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
1393-8
pubmed:dateRevised
2009-11-19
pubmed:meshHeading
pubmed-meshheading:16909243-Adolescent, pubmed-meshheading:16909243-Adult, pubmed-meshheading:16909243-Age Factors, pubmed-meshheading:16909243-Child, pubmed-meshheading:16909243-Child, Preschool, pubmed-meshheading:16909243-DNA Mutational Analysis, pubmed-meshheading:16909243-Denys-Drash Syndrome, pubmed-meshheading:16909243-Drug Resistance, pubmed-meshheading:16909243-Exons, pubmed-meshheading:16909243-Female, pubmed-meshheading:16909243-Frasier Syndrome, pubmed-meshheading:16909243-Genetic Testing, pubmed-meshheading:16909243-Humans, pubmed-meshheading:16909243-Karyotyping, pubmed-meshheading:16909243-Kidney, pubmed-meshheading:16909243-Male, pubmed-meshheading:16909243-Mutation, pubmed-meshheading:16909243-Nephrotic Syndrome, pubmed-meshheading:16909243-Phenotype, pubmed-meshheading:16909243-Prevalence, pubmed-meshheading:16909243-Sex Factors, pubmed-meshheading:16909243-Steroids, pubmed-meshheading:16909243-WT1 Proteins
pubmed:year
2006
pubmed:articleTitle
WT1 mutations in nephrotic syndrome revisited. High prevalence in young girls, associations and renal phenotypes.
pubmed:affiliation
Nephrology Unit, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.
pubmed:publicationType
Journal Article, Research Support, Non-U.S. Gov't