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Primary coenzyme Q10 Deficiency-6 (COQ10D6): Two siblings with variable expressivity of the renal phenotype.

Authors
  • Yuruk Yildirim, Zeynep1
  • Toksoy, Guven2
  • Uyguner, Oya2
  • Nayir, Ahmet3
  • Yavuz, Sevgi4
  • Altunoglu, Umut2
  • Turkkan, Ozde Nisa3
  • Sevinc, Burcu2
  • Gokcay, Gulden5
  • Kurkcu Gunes, Dilek5
  • Kiyak, Aysel4
  • Yilmaz, Alev3
  • 1 Istanbul University, Istanbul Faculty of Medicine, Pediatric Nephrology Department, Istanbul, Turkey. Electronic address: [email protected] , (Turkey)
  • 2 Istanbul University, Istanbul Faculty of Medicine, Department of Medical Genetics, Istanbul, Turkey. , (Turkey)
  • 3 Istanbul University, Istanbul Faculty of Medicine, Pediatric Nephrology Department, Istanbul, Turkey. , (Turkey)
  • 4 Kanuni Sultan Suleyman Research and Training Hospital, Pediatric Nephrology Department, Istanbul, Turkey. , (Turkey)
  • 5 Istanbul University, Istanbul Faculty of Medicine, Pediatric Nutrition and Metabolism Department, Istanbul, Turkey. , (Turkey)
Type
Published Article
Journal
European journal of medical genetics
Publication Date
Jan 01, 2020
Volume
63
Issue
1
Pages
103621–103621
Identifiers
DOI: 10.1016/j.ejmg.2019.01.011
PMID: 30682496
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Primary coenzyme Q10 deficiency-6 (COQ10D6) is a rare autosomal recessive disorder caused by COQ6 mutations. The main clinical manifestations are infantile progressive nephrotic syndrome (NS) leading to end-stage renal disease and sensorineural deafness. A 7-year-old girl was diagnosed with steroid-resistant NS (SRNS) and an audiological work-up revealed bilateral sensorineural deafness. A renal biopsy demonstrated focal segmental glomerulosclerosis. Despite immunosuppressive therapy, her serum levels of creatinine increased and haemodialysis was indicated within 1 year after the diagnosis. Living-donor kidney transplantation was performed in the eighth month of haemodialysis. A diagnostic custom-designed panel-gene test including 30 genes for NS revealed homozygous c.1058C > A [rs397514479] in exon nine of COQ6. Her older brother, who had sensorineural hearing loss with no renal or neurological involvement, had the same mutation in homozygous form. COQ6 mutations should be considered not only in patients with SRNS with sensorineural hearing loss but also in patients with isolated sensorineural hearing loss with a family history of NS. The reported p.His174 variant of COQ8B was suggested to be a risk factor for secondary CoQ deficiency, while p.Arg174 appeared to improve the condition in a yeast model. Family segregation and the co-occurrence of biallelic p.Arg174 of COQ8B in a brother with hearing loss implied that the interaction of the altered COQ8B with the mutant COQ6 alleviated the symptoms in this family. CoQ10 replacement therapy should be initiated for these patients, as primary CoQ10 deficiency is considered the only known treatable mitochondrial disease. Copyright © 2019 Elsevier Masson SAS. All rights reserved.

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