Clinical and molecular characterization of primary hyperoxaluria in Egypt

Abstract

Primary hyperoxaluria (PH) is an autosomal recessive disorder of oxalate metabolism caused by pathogenic variants in either of three genes (AGXT, GRHPR or HOGA1). The study aimed at characterizing the clinical phenotypes as well as the genotypic spectrum of PH in Egypt. We screened 25 Egyptian patients suspected of PH for the three responsible genes by Sanger sequencing. We diagnosed 20 patients from 18 unrelated families, in which the natural history, family history, clinical features and genotypes were evaluated. PH patients were 15 males and 5 females ranging in age from 4 months to 31 years (median 8 years). Fifteen families were consanguineous (83%) and familial clustering was reported in six families (33%). Pathogenic variants in all 40 alleles were in AGXT, with none detected in GRHPR or HOGA1. We detected two novel pathogenic variants c.166-1_172dupGATCATGG (p.Asp58Glyfs*65) and c.766delC (p.Gln256fs*16) and seven previously reported variants in our cohort. This is the first study reporting the genotype of a considerable number of PH1 patients from Egypt. Our detected variants in the AGXT gene could form the basis for future genetic counseling and prenatal diagnosis in Egypt and surrounding populations.

Clinical practice recommendations for primary hyperoxaluria: an expert consensus statement from ERKNet and OxalEurope

“…The genetic landscape of PH1 in LMICs varies according to the geographical region 96,[120][121][122][123][124][125][126] . Diagnosis is challenging, and diverse diagnostic tools are often unavailable 12,96 .…”

Targeting the Liver with Nucleic Acid Therapeutics for the Treatment of Systemic Diseases of Liver Origin

“…This genetically inherited disorder is rare with an incidence rate approximately 1-2 cases per 100,000 in the US population (Shah et al, 2023) and 1-3 cases per 100,000 in the European populations (Cochat et al, 1995;Kopp and Leumann, 1995;van Woerden, 2003). It is also reported to be more predominant in countries where consanguineous marriages are common, particularly in regions of Northern Africa and the Middle East (Soliman et al, 2022). There are 3 types of PH: PH1, PH2, and PH3.…”