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2018 monogenic causes of steroid resistant nephrotic syndrome

2018 monogenic causes of steroid resistant nephrotic syndrome
  Gene product or protein Renal histology Additional notes or associated extrarenal features OMIM number*
Autosomal recessive
NPHS1 Nephrin FSGS   #256300/
#603278
NPHS2 Podocin FSGS   #600995
PLCE1 Phospholipase C, epsilon1 FSGS or DMS   #610725
CD2AP CD2-associated protein FSGS   #607832
PTPRO Protein-tyrosine phosphatase receptor-type O (or glomerular epithelial protein 1/GLEPP1) FSGS   #614196
MYO1E Myosin 1E FSGS   #614131
TTC21B Intraflagellar transport protein 139 FSGS Ciliary gene #612014
CRB2 Crumbs homolog 2 protein FSGS, congenital nephrotic syndrome Renal microcysts and cerebral ventriculomegaly #616220
CUBN Cubilin Renal histology not described Might be associated with megaloblastic anaemia as cubilin facilitates intestinal absorption of the vitamin B12 or intrinsic factor complex #602997
NEIL1 Endonuclease VIII-like 1 FSGS   #608844
NUP107 Nucleoporin 107 kDa FSGS   #607617
NUP93, NUP205 XP05 Nuclear pore protein 93, nuclear pore protein 205 (interacts with NUP93) and nuclear export protein exportin 5 (also interacts with nucleoporins) FSGS or DMS

Nucleoporins mediate transport of proteins or RNA from cell cytoplasm to nucleus

SRNS with ESRD in childhood

Might have partial response to cyclosporine
#614351/
#614352/
#607845
Autosomal dominant
ACTN4 Actinin-alpha4 FSGS   #603278
TRPC6 Transient receptor potential cation channel, subfamily C, member 6 FSGS    
INF2 Inverted formin 2 FSGS Charcot-Marie-Tooth neuropathy and deafness #613237
ARHGAP24 Rho-GTPase-activating protein 24 FSGS   #610586
ANLN Anillin FSGS Childhood or adult onset #616032
PAX2 Paired box protein 2 FSGS Adult onset and no overt extrarenal involvement  
Syndromic forms of nephrotic syndrome
WT1 (AD) Wilms tumor protein

Denys-Drash syndrome: DMS

Frasier syndrome: FSGS

Denys-Drash syndrome: nephrotic syndrome, renal failure, Wilms

Tumor risk 90%

Frasier syndrome: childhood SRNS, ambiguous genitalia (male pseudohermaphroditism), FSGS, amenorrhoea, streak gonads and increased risk of gonadoblastoma, 46XY karyotype
#256370
LAMB2 (AR) Laminin subunit beta2 DMS Pierson syndrome: congenital nephrotic syndrome, DMS, microcoria and buphthalmos, severe neurodevelopmental delay #609049
LMX1B (AD) LIM homeobox transcription factor 1-beta FSGS Nail-patella syndrome: absent or displaced patella, absent or pitted nails, small nails, renal tubular defects, renal dysplasia, haematuria, proteinuria, nephrotic syndrome in 10 to 15% (frequently relapsing steroid responsive) #614199
SMARCAL1 (AR) Swi/Snf-related matrix-associated actin-dependent regulator of chromatin subfamily a-like protein FSGS Schimke immuno-osseous dysplasia: short stature, spondyloepiphyseal dysplasia, SRNS, renal insufficiency, and T-cell immunodeficiency, hypothyroidism, abnormal dentition, bone marrow failure, thin hair, corneal opacities, arteriosclerosis, headache #242900
SCARB2 (AR) Scavenger receptor class b member 2 FSGS Action myoclonus-renal failure syndrome: FSGS, renal failure, fine tremor, progressive myoclonus epilepsy #254900
WDR73 (AR) WD repeat containing protein 73 FSGS (collapsing) or DMS Galloway-Mowat syndrome: Microcephaly, gyral abnormalities (polymicrogyria), hypotonia, seizures, developmental delay, hiatus hernia, rapidly progresses to ESRD #251300
MYH9 (AD) Non-muscle myosin heavy chain IIA FSGS

May-Hegglin: giant platelets, thrombocytopenia

Fechtner: sensorineural deafness, cataracts, giant platelets, thrombocytopenia, ESRD in 28%

Epstein: sensorineural deafness, giant platelets, thrombocytopenia, nephritis
#612551
ITGA3 (AR) Integrin alpha3 subunit FSGS, congenital nephrotic syndrome Interstitial lung disease and epidermolysis bullosa #614748
ARHGDIA Rho-GDP dissociation inhibitor alpha Congenital or infantile NS, DMS Intellectual disability #615244
INF2 Inverted formin 2 FSGS Charcot-Marie-Tooth neuropathy and deafness #613237
Mitochondrial podocytopathies
ADCK aarF domain containing kinase 4 FSGS (collapsing) CoQ10 deficiency, autosomal recessive #615573
COQ6 Coenzyme Q10 biosynthesis mono-oxygenase 6 FSGS or DMS Seizures and sensorineural deafness #614650
COQ2 Coenzyme Q10 biosynthesis mono-oxygenase 2 FSGS Seizures, hypotonia, lactic acidosis, encephalomyopathy #609825
MTTL1 Mitochondrial tRNALeu(UUR) FSGS

MELAS: myopathy, encephalopathy, lactic acidosis, stroke-like episode

Diabetes and deafness
#590050
PDSS2 Decaprenyl-diphosphate synthase subunit 2 Renal histology not described Leigh syndrome: growth retardation, ataxia, deafness #614652
OMIM: Online Medelian Inheritance in Man; FSGS: focal segmental glomerulosclerosis; DMS: diffuse mesangial sclerosis; RNA: ribonucleic acid; SRNS: steroid-resistant nephrotic syndrome; ESRD: end-stage renal disease.
* Please refer to www.omim.org for more information on the aforementioned genes.
Reproduced from: Noone DG, Iijima K, Parekh R. Idiopathic nephrotic syndrome in children. Lancet 2018; 392:61. Table used with the permission of Elsevier Inc. All rights reserved.
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