دورية
Clinical and subclinical findings in heterozygous ABCC6carriers: results from a Belgian cohort and clinical practice guidelines
| العنوان: | Clinical and subclinical findings in heterozygous ABCC6carriers: results from a Belgian cohort and clinical practice guidelines |
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| المؤلفون: | Nollet, Lukas, Campens, Laurence, De Zaeytijd, Julie, Leroy, Bart, Hemelsoet, Dimitri, Coucke, Paul J, Vanakker, Olivier M |
| المصدر: | Journal of Medical Genetics (JMG); 2022, Vol. 59 Issue: 5 p496-504, 9p |
| مستخلص: | BackgroundBiallelic pathogenic variants in the ATP-binding cassette subfamily C member 6(ABCC6) gene cause pseudoxanthoma elasticum, a multisystemic ectopic calcification disorder, while heterozygous ABCC6variants are associated with an increased risk of cardiovascular and cerebrovascular disease. As the prevalence of pathogenic ABCC6variants in the general population is estimated at ~1%, identifying additional ABCC6-related (sub)clinical manifestations in heterozygous carriers is of the utmost importance to reduce this burden of disease. Here, we present a large Belgian cohort of heterozygous ABCC6carriers with comprehensive clinical, biochemical and imaging data. Based on these results, we formulate clinical practice guidelines regarding screening, preventive measures and follow-up of ABCC6carriers.MethodsThe phenotype of 56 individuals carrying heterozygous pathogenic ABCC6variants was assessed using clinical (eg, detailed ophthalmological examinations), biochemical, imaging (eg, cardiovascular and abdominal ultrasound) and genetic data. Clinical practice guidelines were then drawn up.ResultsWe found that ABCC6heterozygosity is associated with distinct retinal alterations (‘comet-like’) (24%), high prevalence of hypercholesterolaemia (>75%) and diastolic dysfunction (33%), accelerated lower limb atherosclerosis and medial vascular disease, abdominal organ calcification (26%) and testicular microlithiasis (28%), though with highly variable expression.ConclusionIn this study, we delineated the multisystemic ABCC6heterozygosity phenotype characterised by retinal alterations, aberrant lipid metabolism, diastolic dysfunction and increased vascular, abdominal and testicular calcifications. Our clinical practice guidelines aimed to improve early diagnosis, treatment and follow-up of ABCC6-related health problems. |
| قاعدة البيانات: | Supplemental Index |
| تدمد: | 00222593 14686244 |
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| DOI: | 10.1136/jmedgenet-2020-107565 |