Riedhammer, K.M.* ; Braunisch, M.C.* ; Günthner, R.* ; Wagner, M. ; Hemmer, C.* ; Strom, T.M. ; Schmaderer, C.* ; Renders, L.* ; Tasic, V.* ; Gucev, Z.* ; Nushi-Stavileci, V.* ; Putnik, J.* ; Stajić, N.* ; Weidenbusch, M.* ; Uetz, B.* ; Montoya, C.* ; Strotmann, P.* ; Ponsel, S.* ; Lange-Sperandio, B.* ; Hoefele, J.*
     
 
    
        
Exome sequencing and identification of phenocopies in patients with clinically presumed hereditary nephropathies.
    
    
        
    
    
        
        Am. J. Kidney Dis. 76, 460-470 (2020)
    
    
    
		
		
			
				Rationale & Objective: Hereditary nephropathies are clinically and genetically heterogeneous disorders. For some patients, the clinical phenotype corresponds to a specific hereditary disease but genetic testing reveals that the expected genotype is not present (phenocopy). The aim of this study was to evaluate the spectrum and frequency of phenocopies identified by using exome sequencing in a cohort of patients who were clinically suspected to have hereditary kidney disorders.Study Design: Cross-sectional cohort study.Setting & Participants: 174 unrelated patients were recruited for exome sequencing and categorized into 7 disease groups according to their clinical presentation. They included autosomal dominant tubulointerstitial kidney disease, Alport syndrome, congenital anomalies of the kidney and urinary tract, ciliopathy, focal segmental glomerulosclerosis/steroid-resistant nephrotic syndrome, VACTERL association, and "other."Results: A genetic diagnosis (either likely pathogenic or pathogenic variant according to the guidelines of the American College of Medical Genetics) was established using exome sequencing in 52 of 174 (30%) cases. A phenocopy was identified for 10 of the 52 exome sequencing-solved cases (19%), representing 6% of the total cohort. The most frequent phenocopies (n = 5) were associated with genetic Alport syndrome presenting clinically as focal segmental glomerulosclerosis/steroidresistant nephrotic syndrome. Strictly targeted gene panels (<25 kilobases) did not identify any of the phenocopy cases.Limitations: The spectrum of described phenocopies is small. Selection bias may have altered the diagnostic yield within disease groups in our study population. The study cohort was predominantly of non-Finnish European descent, limiting generalizability. Certain hereditary kidney diseases cannot be diagnosed by using exome sequencing (eg, MUC1-autosomal dominant tubulointerstitial kidney disease).Conclusions: Phenocopies led to the recategorization of disease and altered clinical management. This study highlights that exome sequencing can detect otherwise occult genetic heterogeneity of kidney diseases.
			
			
				
			
		 
		
			
				
					
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        Publikationstyp
        Artikel: Journalartikel
    
 
    
        Dokumenttyp
        Wissenschaftlicher Artikel
    
 
    
        Typ der Hochschulschrift
        
    
 
    
        Herausgeber
        
    
    
        Schlagwörter
        Alport Syndrome (as) ; Autosomal Dominant Tubulointerstitial Kidney Disease (adtkd) ; Ciliopathy ; Clinical Phenotype ; Congenital Anomalies Of The Kidney And Urinary Tract (cakut) ; Exome ; Focal Segmental Glomerulosclerosis (fsgs) ; Genetic Diagnosis ; Hereditary Kidney Disease ; Misdiagnosis ; Next-generation Sequencing (ngs) ; Phenocopy ; Steroid-resistant Nephrotic Syndrome (srns) ; Vacterl; Kidney-disease; Medical Genetics; American-college; Mutations; Association; Variants; Database; Guidelines; Standards; Diagnosis
    
 
    
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        Sprache
        englisch
    
 
    
        Veröffentlichungsjahr
        2020
    
 
    
        Prepublished im Jahr 
        
    
 
    
        HGF-Berichtsjahr
        2020
    
 
    
    
        ISSN (print) / ISBN
        0272-6386
    
 
    
        e-ISSN
        1523-6838
    
 
    
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	    Band: 76,  
	    Heft: 4,  
	    Seiten: 460-470 
	    Artikelnummer: ,  
	    Supplement: ,  
	
    
 
  
        
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            Verlag
            Elsevier
        
 
        
            Verlagsort
            1600 John F Kennedy Boulevard, Ste 1800, Philadelphia, Pa 19103-2899 Usa
        
 
	
        
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        Begutachtungsstatus
        Peer reviewed
    
 
     
    
        POF Topic(s)
        30205 - Bioengineering and Digital Health
30501 - Systemic Analysis of Genetic and Environmental Factors that Impact Health
    
 
    
        Forschungsfeld(er)
        Genetics and Epidemiology
    
 
    
        PSP-Element(e)
        G-503200-001
G-500700-001
    
 
    
        Förderungen
        Baxter, USA
German Research Foundation (Deutsche Forschungsgemeinschaft, DFG)
    
 
    
        Copyright
        
    
 	
    
    
    
    
    
        Erfassungsdatum
        2020-05-28