背景:肾性低尿酸血症(RHUC),一种罕见的遗传性疾病,其特征是尿酸重吸收受损和随后的严重低尿酸血症,主要是由于SLC22A12或SLC2A9的变异。在中国人群中,仅报道了轶事病例和一项小规模的RHUC筛查研究。
方法:从我们中心招募来自17个无关家庭的19例RHUC患者。病史,临床表现,生化检查,并收集临床结果.进行基于下一代测序的靶向基因测序或全外显子测序。
结果:在19例患者中发现SLC22A12或SLC2A9共有22个变异体。变体c.944G>A(p。在三名患者中发现了SLC2A9中的W315X)。三个变体c.165C>A(p。D55E),c.1549_1555delGAGACCC(p。E517Rfs*17),和c.1483T>C(p。W495R)在SLC22A12和三个变体c.12151G>A(剪接变体)中,c.643A>C(p。T215P),和c.227C>A(p。S76X)在SLC2A9中是新颖的。19例患者中有10例出现运动性急性肾损伤(EIAKI)。肾脏预后良好。五名患者患有肾结石症,其中三人患有高钙尿症。
结论:目前的研究报道了中国RHUC患者SLC22A12和SLC2A9基因的6个新变异。变体c.944G>A(p。SLC2A9中的W315X)可能在中国患者中很常见。EIAKI是我们队列中与RHUC相关的主要临床表型,一个有利的结果。一些RHUC患者出现的高钙尿是一个新发现。
Renal hypouricemia (RHUC), a rare inherited disorder characterized by impaired uric acid reabsorption and subsequent profound hypouricemia, occurs mainly due to variants in SLC22A12 or SLC2A9. Only anecdotal cases and one small-scale RHUC screening study have been reported in the Chinese population.
A total of 19 patients with RHUC from 17 unrelated families were recruited from our center. The medical history, clinical manifestations, biochemical exam, and clinical outcomes were collected. Next-generation sequencing-based targeted gene sequencing or whole exon sequencing was performed.
A total of 22 variants in SLC22A12 or SLC2A9 were found in 19 patients. The variant c.944G>A (p.W315X) in SLC2A9 was identified in three patients. Three variants c.165C>A (p.D55E), c.1549_1555delGAGACCC (p.E517Rfs*17), and c.1483T>C (p.W495R) in SLC22A12 and three variants c.1215+1G>A (splicing variant), c.643A>C (p.T215P), and c.227C>A (p.S76X) in SLC2A9 were novel. A proportion of 10 out of 19 patients presented with exercise-induced acute kidney injury (EIAKI). The renal outcome was favorable. Five patients had nephrolithiasis, in whom three had hypercalciuria.
The current study reported six novel variants in SLC22A12 and SLC2A9 genes of Chinese patients with RHUC. The variant c.944G>A (p.W315X) in SLC2A9 may be common in Chinese patients. EIAKI is the main clinical phenotype associated with RHUC in our cohort, with a favorable outcome. Hypercalciuria presented in some RHUC patients is a new finding.