A novel heterozygous mutation of the NPHS1 gene in a Chinese child with congenital nephrotic syndrome: A case report

Abstract

Rationale: Congenital nephrotic syndrome (CNS) is a heterogeneous disorder in which massive proteinuria, hypoproteinemia, and hyperlipidemia and marked edema are the main manifestations before 3 months-of-age. Here, we present a case involving the genetic diagnosis of a child with CNS.Patient concerns: A 31-day-old male infant with diarrhea for 25 days and generalized edema for more than 10 days. There was no family history of kidney disease. On proband whole exome sequencing, a compound heterozygous mutation of the NPHS1 gene was identified, including a novel in-frame mutation in exon 14 (c.1864_1866dupACC p. T622dup) and a missense mutation in exon 8 (c.928G>A p. D310N).Diagnoses: Based on the clinical and genetic findings, this patient was finally diagnosed with CNS. Interventions:The main treatment options for the patient were 2-fold: anti-infective treatment and symptomatic treatment.Outcomes: The patient died in follow-up 2 months later; the specific reason for death was unclear.Lessons: Whole exome sequencing and Sanger sequencing confirmed that the infant had CNS. Our study identified a novel mutation in an infant, thus expanding the gene-mutation spectrum of the NPHS1 gene, thus providing an efficient prenatal screening strategy and early genetic counseling.Abbreviations: AFP = alpha-fetoprotein, CNF = CNS of the Finnish type, CNS = congenital nephrotic syndrome, WES = whole exome sequencing.