title: Proteinuria and prenatal diagnosis of congenital nephrosis in fetal carriers of nephrin gene mutations.
abstract: High concentrations of alpha-fetoprotein (AFP) are used for prenatal diagnosis of the Finnish type of congenital nephrotic syndrome (NPHS1). We investigated the validity of this test. We retrospectively established fetal NPHS1 genotype and assessed renal pathology in 21 pregnancies that had been terminated because of raised concentrations of AFP in amniotic fluid. 12 fetuses were homozygous and nine were heterozygous (carriers) for NPHS1 mutations. Raised concentrations of AFP and similar proteinuric features in fetal kidneys were seen in both groups, indicating that these signs are unreliable for prenatal diagnosis of congenital nephrosis. We strongly recommend the use of mutation analysis of the NPHS1 gene to confirm the AFP results in prenatal diagnosis of NPHS1.
authors.affiliation: Hospital for Children and Adolescents and Biomedicum Helsinki, Electron Microscopy Unit, Institute of Biotechnology, University of Helsinki, Helsinki, Finland.
authors.forename: Jaakko
authors.initials: J
authors.lastname: Patrakka
authors.forename: Paula
authors.initials: P
authors.lastname: Martin
authors.forename: Riitta
authors.initials: R
authors.lastname: Salonen
authors.forename: Marjo
authors.initials: M
authors.lastname: Kestilä
authors.forename: Vesa
authors.initials: V
authors.lastname: Ruotsalainen
authors.forename: Minna
authors.initials: M
authors.lastname: Männikkö
authors.forename: Markku
authors.initials: M
authors.lastname: Ryynänen
authors.forename: Juhani
authors.initials: J
authors.lastname: Rapola
authors.forename: Christer
authors.initials: C
authors.lastname: Holmberg
authors.forename: Karl
authors.initials: K
authors.lastname: Tryggvason
authors.forename: Hannu
authors.initials: H
authors.lastname: Jalanko
mesh_terms: D000483:Alleles; D000653:Amniotic Fluid / Q000737:chemistry; D005260:Female; D005387:Finland; D005838:Genotype; D006801:Humans; D008565:Membrane Proteins; D009154:Mutation; D009401:Nephrosis / Q000151:congenital / Q000175:diagnosis / Q000235:genetics*; D011247:Pregnancy; D011296:Prenatal Diagnosis; D011506:Proteins / Q000235:genetics* / Q000378:metabolism; D011507:Proteinuria / Q000151:congenital* / Q000175:diagnosis; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D000509:alpha-Fetoproteins / Q000032:analysis*
chemical_list: D008565:Membrane Proteins; D011506:Proteins; D000509:alpha-Fetoproteins; C113267:nephrin