Diagnostic Imaging of the Child with Suspected Renal Disease

Loewen, Jonathan; Greenbaum, Larry A.

doi:10.1007/978-3-642-27843-3_21-1

Cited by 1 publication

(1 citation statement)

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“…Clinical prenatal and postnatal data including latest follow-up of the study cohort were recorded and analyzed. Fetal and postnatal kidney sonographic echogenicity was defined as normal or hyperechogenic by comparison to adjacent liver and/or spleen texture according to accepted age-adjusted standards (4)(5)(6)(7)22).…”

Section: Sample Collection and Work-upmentioning

confidence: 99%

Improving renal phenotype and evolving extra-renal features of 17q12 deletion encompassing the HNF1B gene

Cleper¹,

Reches²,

Shapira³

et al. 2021

Transl Pediatr

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Background: HNF1B deletion/intragenic mutations are the most commonly identified genetic cause of congenital anomalies of the kidney and urinary tract (CAKUT) suggested by fetal ultrasound findings such as: parenchymal hyperechogenicity, overt cystic changes or gross morphological urinary system (UT) abnormalities. The postnatal evolution of these 17q12 deletions encompassing the HNF1B gene-associated findings has not been assessed in depth. Methods:In this observational study, we present postnatal follow-up findings in 5 of 6 cases (one pregnancy was terminated on parental request) of fetal-onset cystic/hyperechogenic kidneys eventually diagnosed with 17q12 microdeletion encompassing the HNF1B gene between 2009 and 2017.Results: Complete normalization of kidney parenchymal abnormalities and of depressed neonatal renal function was observed in 4/5 and 5/5 patients within 2-4.9 years and 1.5-8 months, respectively. All 5 patients had preserved normal renal function at 3-11 years of follow-up. The evolving later-onset renal features included: hypomagnesemia, hyperuricemia, urinary tract infection (UTI), and bilateral grade 3-4 vesicoureteral reflux and bladder diverticula in 3, 3, 2, and 1 patient, respectively. HNF1B gene deletionassociated extra-renal manifestations with delayed presentation were global developmental delay/autistic spectrum disorder (ASD), rolandic-type seizures, overweight, and borderline fasting hyperglycemia observed in 1-2 patients each. Family history was positive for small-size or asymptomatic cystic kidneys with normal function, diabetes mellitus, seizures, and mental/psychiatric problems in 3/6 cases.Conclusions: Fetal-onset HNF1B deletion-associated kidneys' parenchymal abnormalities confirmed postnatally with initially depressed renal function might undergo complete resolution within several years and few months, respectively. However, later-onset urinary tract, metabolic, and neurodevelopmental features of this mutation might appear over years. Therefore, genetic molecular evaluation/diagnosis and continuous follow-up for evolving features are mandatory in affected children.

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