Bilateral aniridia and congenital ureteral valve: Role of genetic testing

Abstract Background Congenital aniridia involves total or partial hypoplasia of the iris and is due to a deficiency in PAX6 gene expression. WAGR syndrome is comprised of Wilms tumor, aniridia, genitourinary abnormalities, and intellectual disability. Numerous genitourinary pathologies may be associ...

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Main Authors: Lisa B. E. Shields, Dennis S. Peppas, Eran Rosenberg
Format: Article
Language:English
Published: Wiley 2020-04-01
Series:Molecular Genetics & Genomic Medicine
Subjects:
Online Access:https://doi.org/10.1002/mgg3.1183
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author Lisa B. E. Shields
Dennis S. Peppas
Eran Rosenberg
author_facet Lisa B. E. Shields
Dennis S. Peppas
Eran Rosenberg
author_sort Lisa B. E. Shields
collection DOAJ
description Abstract Background Congenital aniridia involves total or partial hypoplasia of the iris and is due to a deficiency in PAX6 gene expression. WAGR syndrome is comprised of Wilms tumor, aniridia, genitourinary abnormalities, and intellectual disability. Numerous genitourinary pathologies may be associated with WAGR syndrome, necessitating an evaluation of the genitourinary anatomy. The WT1 is vital for the development of kidneys, ovaries in females, and testes in males. WT1 gene mutations result in a WT1 protein with a decreased ability to bind to DNA, leading to uncontrolled growth, and cell division in the kidney which permits the development of Wilms tumor. A congenital ureteral valve is an exceedingly rare cause of obstructive uropathy. Results A renal and bladder ultrasound demonstrated a renal cyst. A voiding cystourethrogram revealed grade 3 vesicoureteral reflux, and a MAG3 renal scan showed ureteropelvic junction obstruction and hydronephrosis. A ureteral stent was inserted at 3 months of age after which the renal cyst resolved. The patient was urinary tract infection‐free at 27 months of age. Genetic testing confirmed a heterozygous alteration in PAX6 (c.495delG, p.Thr166Leufs*41) and no abnormalities of WT1, excluding WAGR syndrome. Conclusion The genitourinary risks potentially associated with aniridia necessitate prompt genetic analysis to evaluate for WAGR syndrome.
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spelling doaj.art-474dbbbac7b645b9a7fa051fcc4446b62024-02-21T10:29:43ZengWileyMolecular Genetics & Genomic Medicine2324-92692020-04-0184n/an/a10.1002/mgg3.1183Bilateral aniridia and congenital ureteral valve: Role of genetic testingLisa B. E. Shields0Dennis S. Peppas1Eran Rosenberg2Norton Neuroscience Institute Norton Healthcare Louisville KY USANorton Children's Urology Norton Healthcare Louisville KY USANorton Children's Urology Norton Healthcare Louisville KY USAAbstract Background Congenital aniridia involves total or partial hypoplasia of the iris and is due to a deficiency in PAX6 gene expression. WAGR syndrome is comprised of Wilms tumor, aniridia, genitourinary abnormalities, and intellectual disability. Numerous genitourinary pathologies may be associated with WAGR syndrome, necessitating an evaluation of the genitourinary anatomy. The WT1 is vital for the development of kidneys, ovaries in females, and testes in males. WT1 gene mutations result in a WT1 protein with a decreased ability to bind to DNA, leading to uncontrolled growth, and cell division in the kidney which permits the development of Wilms tumor. A congenital ureteral valve is an exceedingly rare cause of obstructive uropathy. Results A renal and bladder ultrasound demonstrated a renal cyst. A voiding cystourethrogram revealed grade 3 vesicoureteral reflux, and a MAG3 renal scan showed ureteropelvic junction obstruction and hydronephrosis. A ureteral stent was inserted at 3 months of age after which the renal cyst resolved. The patient was urinary tract infection‐free at 27 months of age. Genetic testing confirmed a heterozygous alteration in PAX6 (c.495delG, p.Thr166Leufs*41) and no abnormalities of WT1, excluding WAGR syndrome. Conclusion The genitourinary risks potentially associated with aniridia necessitate prompt genetic analysis to evaluate for WAGR syndrome.https://doi.org/10.1002/mgg3.1183aniridiageneticspediatric urologyureteral valvewilms tumor
spellingShingle Lisa B. E. Shields
Dennis S. Peppas
Eran Rosenberg
Bilateral aniridia and congenital ureteral valve: Role of genetic testing
Molecular Genetics & Genomic Medicine
aniridia
genetics
pediatric urology
ureteral valve
wilms tumor
title Bilateral aniridia and congenital ureteral valve: Role of genetic testing
title_full Bilateral aniridia and congenital ureteral valve: Role of genetic testing
title_fullStr Bilateral aniridia and congenital ureteral valve: Role of genetic testing
title_full_unstemmed Bilateral aniridia and congenital ureteral valve: Role of genetic testing
title_short Bilateral aniridia and congenital ureteral valve: Role of genetic testing
title_sort bilateral aniridia and congenital ureteral valve role of genetic testing
topic aniridia
genetics
pediatric urology
ureteral valve
wilms tumor
url https://doi.org/10.1002/mgg3.1183
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AT eranrosenberg bilateralaniridiaandcongenitalureteralvalveroleofgenetictesting