Open AccessIncompletely Penetrant PKD1 Alleles Mimic the Renal Manifestations of ARPKD
Author(s) -
Mihailo Vujic,
Christina M. Heyer,
Elisabet Ars,
Katharina Hopp,
Arseni Markoff,
Charlotte Örndal,
Bengt Rudenhed,
Samih H. Nasr,
Vicente E. Torres,
Roser Torra,
Nadja Bogdanova,
Peter C. Harris
Publication year - 2010
Publication title -
journal of the american society of nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.451
H-Index - 279
eISSN - 1533-3450
pISSN - 1046-6673
DOI - 10.1681/asn.2009101070
Subject(s) - pkd1 , autosomal recessive polycystic kidney disease , allele , genetics , autosomal dominant polycystic kidney disease , medicine , biology , pathology , disease , gene
Autosomal dominant polycystic kidney disease (ADPKD), caused by mutation in PKD1 or PKD2, is usually an adult-onset disorder but can rarely manifest as a neonatal disease within a family characterized by otherwise typical ADPKD. Coinheritance of a hypomorphic PKD1 allele in trans with an inactivating PKD1 allele is one mechanism that can cause early onset ADPKD. Here, we describe two pedigrees without a history of cystic kidney disease that each contain two patients with onset of massive PKD in utero. The presentations were typical of autosomal recessive PKD (ARPKD) but they were not linked to the known ARPKD gene, PKHD1. Mutation analysis of the ADPKD genes provided strong evidence that both families inherited, in trans, two incompletely penetrant PKD1 alleles. These patients illustrate that PKD1 mutations can manifest as a phenocopy of ARPKD with respect to renal involvement and highlight the perils of linkage-based diagnostics in ARPKD without positive PKHD1 mutation data. Furthermore, the phenotypic overlap between ARPKD and these patients resulting from incomplete penetrant PKD1 alleles support a common pathogenesis for these diseases.