常染色体显性遗传性肾小管间质性肾病病例,活动时急性肾损伤严重,超出常规:非同寻常的疾病表现

Fereshteh Saddadi, Fateme Elahi, Azin Ghaffari
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摘要

简介常染色体显性肾小管间质性肾病(ADTKD)与多种基因突变有关,有多种名称,包括髓质囊性肾病 2 型、家族性幼年高尿酸血症肾病、尿调节蛋白相关性肾病和髓质囊性肾病 2 型。对这些罕见疾病的全面了解可以帮助人们了解在各种慢性肾病中观察到的肾小管间质纤维化模式。病例展示:这里介绍的病例是一名患者在剧烈运动后出现急性肾损伤(AKI),这也是这种遗传性疾病的非典型表现。通常情况下,ADTKD 会导致肾功能逐渐丧失,但该患者却出现了急性肾损伤。经过适当治疗后,患者的肾功能恢复正常。患者的兄弟在参加体育活动后也出现了类似的肾病病史,这让人怀疑他们有共同的遗传疾病。研究结论进行了全基因组关联研究(GWAS),结果显示存在粘蛋白 1(MUC1)突变,确诊为 ADTKD。该病例强调了识别遗传性疾病的非典型表现以及利用先进的遗传学研究进行准确诊断和管理的重要性。
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Autosomal Dominant Tubulointerstitial Kidney Disease Case with Sever Acute Kidney Injury in Activities Beyond the Usual: An Unusual Presentation of the Disease
Introduction: Autosomal dominant tubulointerstitial kidney disease (ADTKD) is associated with multiple gene mutations and is recognized under various names, including medullary cystic kidney disease type 2, familial juvenile hyperuricemic nephropathy, uromodulin-associated kidney disease, and medullary cystic kidney disease type 2. A comprehensive understanding of these rare disorders can shed light on the pattern of tubulointerstitial fibrosis observed in various forms of chronic kidney disease. Case Presentation: Here, a case of a patient is presented who experienced acute kidney injury (AKI) following severe physical activity and an atypical manifestation of this genetic disorder. Typically, ADTKD leads to a gradual loss of kidney function, but the patient presented with AKI. The patient's renal function returned to normal following appropriate therapy. The patient's brother had a similar history of renal disease following physical activities, prompting suspicion of a shared genetic disorder. Conclusions: A genome-wide association study (GWAS) was conducted, and the results revealed the presence of the mucin 1 (MUC1) mutation, confirming the diagnosis of ADTKD. This case highlights the importance of recognizing atypical presentations of genetic disorders and utilizing advanced genetic studies for accurate diagnosis and management.
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