家族性非典型溶血性尿毒症伴CFH基因p.S1191L阳性(c.3572C>T)突变:单中心经验

IF 0.5 4区 医学 Q4 GENETICS & HEREDITY
Balkan Journal of Medical Genetics Pub Date : 2021-07-27 eCollection Date: 2021-06-01 DOI:10.2478/bjmg-2021-0007
F Ersoy Dursun, G Yesil, G Sasak, H Dursin
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引用次数: 1

摘要

不典型溶血性尿毒症综合征(aHUS)以血小板减少、微血管病性溶血性贫血和急性肾损伤(AKI)为特征,预后较差。补体因子H (CFH)基因突变在这种疾病中起关键作用,可能是散发的或家族性的。我们研究了来自同一家庭的13人,在一名家庭成员因aHUS来到我们的急诊诊所并报告有慢性肾衰竭家族史后,调查家族性aHUS的基因突变。在患有aHUS的患者家族中的6人中,CFH基因的p.S1191L突变是杂合的。其中一名家庭成员是我们的急性肾损伤患者,另外两名因慢性肾衰竭在土耳其伊斯坦布尔的Medeniyat大学Goztepe培训和研究医院肾内科诊所接受随访。其他三名家庭成员没有显示出肾功能衰竭的迹象。指示病例有6例兄弟姐妹死亡史;其中三人死于慢性肾衰竭。采用血浆置换和新鲜冷冻血浆治疗。当患者对这种治疗没有反应时,开始使用ECZ治疗。该研究表明,对aHUS患者应采取全面的家族史。这些患者可能患有家族性疾病,他们应该进行遗传筛查。依珠单抗应是血浆置换治疗的首选药物。应该记住,在移植后治疗中使用ECZ作为预防对于预防排斥反应是极其重要的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Familial Atypical Hemolytic Uremic Syndrome with Positive p.S1191L (c.3572C>T) Mutation on the <i>CFH</i> Gene: A Single-center Experience.

Familial Atypical Hemolytic Uremic Syndrome with Positive p.S1191L (c.3572C>T) Mutation on the CFH Gene: A Single-center Experience.

The atypical hemolytic uremic syndrome (aHUS) is characterized by thrombocytopenia, microangiopathic hemolytic anemia and acute kidney injury (AKI), which can exhibit a poor prognosis. Complement factor H (CFH) gene mutations play a key role in this disease, which may be sporadic or familial. We studied 13 people from the same family, investigated for gene mutations of the familial aHUS after a family member presented to our emergency clinic with the aHUS and reported a family history of chronic renal failure. The p.S1191L mutation on the CFH gene was heterozygous in six people from the patient's family with the aHUS. One of these family members is our patient with acute kidney injury, and the other two are followed at the Nephrology Clinic, Medeniyat University, Goztepe Training and Research Hospital, Istanbul, Turkey, due to chronic renal failure. The other three family members showed no evidence of renal failure. The index case had a history of six sibling deaths; three died of chronic renal failure. Plasmapheresis and fresh frozen plasma treatment were administered to our patient. When the patient showed no response to this treatment, eculizumab (ECZ) therapy was started. The study demonstrated that thorough family history should be taken in patients with the aHUS. These patients may have the familial type of the disease, and they should be screened genetically. Eculizumab should be the first choice in the treatment with plasmapheresis. It should be kept in mind that the use of ECZ as prophylaxis in posttransplant therapy is extremely important for preventing rejection.

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来源期刊
CiteScore
1.00
自引率
0.00%
发文量
0
审稿时长
>12 weeks
期刊介绍: Balkan Journal of Medical Genetics is a journal in the English language for publication of articles involving all branches of medical genetics: human cytogenetics, molecular genetics, clinical genetics, immunogenetics, oncogenetics, pharmacogenetics, population genetics, genetic screening and diagnosis of monogenic and polygenic diseases, prenatal and preimplantation genetic diagnosis, genetic counselling, advances in treatment and prevention.
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