Mutations in TTC21B cause different phenotypes in two childhood cases in China

Nephrology (Carlton). 2018 Apr;23(4):371-376. doi: 10.1111/nep.13008.

Abstract

Aim: The TTC21B gene is now known as causative of nephronophthisis-related ciliopathies (NPHP-RC). We reported two Chinese paediatric cases with end-stage renal disease and other phenotypes caused by the TTC21B gene mutations.

Methods: The clinical features of Chinese paediatric cases with NPHP-RC were summarized. Mutation analysis of the TTC21B gene was performed using next-generation sequencing.

Results: The two cases both had nephrotic proteinuria, renal failure, hypertension and abnormal liver function (or hepatic fibrosis). One case also presented situs inversus and short phalanges. They developed end-stage renal disease (ESRD) at 1 year old and 8 years old, respectively, when renal pathology both showed focal segmental glomerular sclerosis (FSGS) with tubulointerstitial lesions including interstitial fibrosis and atrophic tubules. Three novel disease-causing TTC21B mutations were identified. One case carried homozygous mutation c.2211 + 3A > G, while the other case carried compound heterozygous mutations c.1552 T > C (p.C518R) and c.1456dupA (p.R486KfsX22).

Conclusion: Mutations in TTC21B cause a range of ciliopathy phenotypes in humans. We identified 3 novel TTC21B mutations in two Chinese paediatric cases that both presented end-stage renal disease and other different features. This is the first TTC21B mutations ever reported in China.

Keywords: TTC21B; ciliopathies; end-stage renal disease; nephronophthisis.

Publication types

  • Case Reports

MeSH terms

  • Child
  • China
  • Ciliopathies / complications
  • Ciliopathies / diagnosis
  • Ciliopathies / genetics*
  • DNA Mutational Analysis / methods
  • Disease Progression
  • Fatal Outcome
  • Female
  • Genetic Predisposition to Disease
  • Glomerulosclerosis, Focal Segmental / etiology
  • Heterozygote
  • High-Throughput Nucleotide Sequencing
  • Homozygote
  • Humans
  • Infant
  • Kidney Diseases, Cystic / complications
  • Kidney Diseases, Cystic / diagnosis
  • Kidney Diseases, Cystic / genetics*
  • Kidney Failure, Chronic / etiology
  • Male
  • Microtubule-Associated Proteins / genetics*
  • Mutation*
  • Phenotype
  • Time Factors

Substances

  • Microtubule-Associated Proteins
  • TTC21B protein, human