WT1 mutations cause a wide spectrum of renal and extrarenal manifestations. Here we evaluated disease prevalence, phenotype spectrum, and genotype-phenotype correlations of 61 patients with WT1-related steroid-resistant nephrotic syndrome relative to 700 WT1-negative patients, all with steroid-resistant nephrotic syndrome. WT1 patients more frequently presented with chronic kidney disease and hypertension at diagnosis and exhibited more rapid disease progression. Focal segmental glomerulosclerosis was equally prevalent in both cohorts, but diffuse mesangial sclerosis was largely specific for WT1 disease and was present in 34% of cases. Sex reversal and/or urogenital abnormalities (52%), Wilms tumor (38%), and gonadoblastoma (5%) were almost exclusive to WT1 disease. Missense substitutions affecting DNA-binding residues were associated with diffuse mesangial sclerosis (74%), early steroid-resistant nephrotic syndrome onset, and rapid progression to ESRD. Truncating mutations conferred the highest Wilms tumor risk (78%) but typically late-onset steroid-resistant nephrotic syndrome. Intronic (KTS) mutations were most likely to present as isolated steroid-resistant nephrotic syndrome (37%) with a median onset at an age of 4.5 years, focal segmental glomerulosclerosis on biopsy, and slow progression (median ESRD age 13.6 years). Thus, there is a wide range of expressivity, solid genotype-phenotype associations, and a high risk and significance of extrarenal complications in WT1-associated nephropathy. We suggest that all children with steroid-resistant nephrotic syndrome undergo WT1 gene screening.

• MeSH
• časové faktory MeSH
• chronická renální insuficience diagnóza   epidemiologie   genetika   terapie   MeSH
• dítě MeSH
• fenotyp MeSH
• fokálně segmentální glomeruloskleróza diagnóza   epidemiologie   genetika   terapie   MeSH
• genetická predispozice k nemoci MeSH
• genetické asociační studie MeSH
• genetické testování metody   MeSH
• incidence MeSH
• kojenec MeSH
• lidé MeSH
• mutace * MeSH
• mutační analýza DNA MeSH
• nefrotický syndrom vrozené   diagnóza   epidemiologie   genetika   terapie   MeSH
• předškolní dítě MeSH
• prevalence MeSH
• prognóza MeSH
• progrese nemoci MeSH
• proteiny WT1 genetika   MeSH
• registrace MeSH
• rizikové faktory MeSH
• věk při počátku nemoci MeSH
• Check Tag
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• práce podpořená grantem MeSH