Nephrol Dial Transplant (1994) 9: 1408-1411
© 1994 European Renal Association-European Dialysis and Transplant Association
research-article
De-novo COL4A5 gene mutations in Alport's syndrome
1Bambino Gesù Children's Hospital, National Medical Research Institute Rome 2Medical Genetics, Department of Molecular Biology, University of Siena 3Department of Pathology, University La Sapienza Rome, Italy
Correspondence and offprint requests to: Correspondence and offprint requests to: Gianfranco Rizzoni MD, Nephrology and Dialysis Department, Bambino Gesù Children's Hospital, National Medical Research Institute, Piazza S. Onofrio 4, 00165 Roma, Italy
Before the advent of direct molecular gene analysis the diagnosis of Alport syndrome was operationally based on three of the four classical clinical criteria. Recently, mutations have been identified in the COL4A5 gene, which is involved in X-linked Alport syndrome. Here we describe two de-novo mutations in two unrelated children, a male and a female, both with early onset of the nephropathy, but with only one of the diagnostic criteria, i.e. electron- microscopy alterations. Because of the significant estimated proportion of de-novo mutations this diagnosis should be considered in children with early signs of nephropathy, even without a suggestive family history or clinical picture (ocular or audiologic abnormal ities). In the future the diagnosis of Alport syndrome will probably be made on the basis of both clinical findings and molecular analysis. Now Alport syndrome is clearly underdiagnosed.
Keywords: Alport syndrome; hereditary nephritis
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