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Departments of * Pediatrics and || Human Genetics, University of Michigan, Ann Arbor, Michigan;
Department of Pediatrics, University Children's Hospital, University of Munich, Munich, Germany; and
Hôpital Robert Debré, Pediatric Nephrology, AP-HP, and
INSERM, U574, Université Paris Descartes, Faculte de Médicine René Descartes, and Hôpital Necker-Enfants Malades, AP-HP, Department of Genetics, Paris, France
Correspondence: Dr. Friedhelm Hildebrandt, University of Michigan Health System, 8220C MSRB III, 1150 West Medical Center Drive, Ann Arbor, MI 48109-0646. Phone: 734-615-7285; Fax: 734-615-1386; E-mail: fhilde{at}umich.edu
Received for publication September 27, 2006. Accepted for publication June 2, 2007.
Nephronophthisis is a recessive cystic renal disease that leads to end-stage renal failure in the first two decades of life. Twenty-five percent of nephronophthisis cases are caused by large homozygous deletions of NPHP1, but six genes responsible for nephronophthisis have been identified. Because oligogenic inheritance has been described for the related Bardet-Biedl syndrome, we evaluated whether mutations in more than one gene may also be detected in cases of nephronophthisis. Because the nephrocystins 1 to 4 are known to interact, we examined patients with nephronophthisis from 94 different families and sequenced all exons of the NPHP1, NPHP2, NPHP3, and NPHP4 genes. In our previous studies involving 44 families, we detected two mutations in one of the NPHP1–4 genes. Here, we detected in six families two mutations in either NPHP1, NPHP3, or NPHP4, and identified a third mutation in one of the other NPHP genes. Furthermore, we found possible digenic disease by detecting one individual who carried one mutation in NPHP2 and a second mutation in NPHP3. Finally, we detected the presence of a single mutation in nine families, suggesting that the second recessive mutation may be in another as yet unidentified NPHP gene. Our findings suggest that oligogenicity may occur in cases of nephronophthisis.
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