ABSTRACT
Prune belly syndrome is a rare congenital disorder characterized by deficiency of abdominal wall muscles, cryptorchidism, and urinary tract anomalies. We have had the opportunity to study a baby with prune belly syndrome associated with an apparently de novo 1.3-megabase interstitial 17q12 microdeletion that includes the hepatocyte nuclear factor-1-β gene at 17q12. One previous patient, an adult, has been reported with prune belly syndrome and a hepatocyte nuclear factor-1-β microdeletion. Hepatocyte nuclear factor-1-β is a widely expressed transcription factor that regulates tissue-specific gene expression and is expressed in numerous tissues including mesonephric duct derivatives, the renal tubule of the metanephros, and the developing prostate of the mouse. Mutations in hepatocyte nuclear factor-1-β cause the “renal cysts and diabetes syndrome,” isolated renal cystic dysplasia, and a variety of other malformations. Based on its expression pattern and the observation of two affected cases, we propose that haploinsufficiency of hepatocyte nuclear factor-1-β may be causally related to the production of the prune belly syndrome phenotype through a mechanism of prostatic and ureteral hypoplasia that results in severe obstructive uropathy with urinary tract and abdominal distension.
KEYWORDS
Prune belly syndrome - Eagle-Barrett syndrome - Obrinsky syndrome - Fröhlich's syndrome - triad syndrome - chromosome 17q - CGH -
HNF1B
-
vHnf1
-
TCF2
REFERENCES
1
Hubinois P, Valayer J, Cendron J.
[A series of 34 cases of prune belly syndrome in children].
Sem Hop.
1983;
59
2769-2777
2 Hall J G. Muscle . In: Stevenson RE, Hall JG Human Malformations and Related Anomalies. 2nd ed. New York; Oxford University Press 2006: 783-802
3
Jennings R W.
Prune belly syndrome.
Semin Pediatr Surg.
2000;
9
115-120
4
Baird P A, MacDonald E C.
An epidemiologic study of congenital malformations of the anterior abdominal wall in more than half a million consecutive live births.
Am J Hum Genet.
1981;
33
470-478
5
Druschel C M.
A descriptive study of prune belly in New York State, 1983 to 1989.
Arch Pediatr Adolesc Med.
1995;
149
70-76
6
Amacker E A, Grass F S, Hickey D E, Hisley J C.
An association of prune belly anomaly with trisomy 21.
Am J Med Genet.
1986;
23
919-923
7
Fryns J P, Vandenberghe K, Van den Berghe H.
Prune-belly anomaly and large interstitial deletion of the long arm of chromosome 6.
Ann Genet.
1991;
34
127
8
Mefford H C, Clauin S, Sharp A J et al..
Recurrent reciprocal genomic rearrangements of 17q12 are associated with renal disease, diabetes, and epilepsy.
Am J Hum Genet.
2007;
81
1057-1069
9
Murray P J, Thomas K, Mulgrew C J, Ellard S, Edghill E L, Bingham C.
Whole gene deletion of the hepatocyte nuclear factor-1β gene in a patient with the prune-belly syndrome.
Nephrol Dial Transplant.
2008;
23
2412-2415
10
Sutherland R S, Mevorach R A, Kogan B A.
The prune-belly syndrome: current insights.
Pediatr Nephrol.
1995;
9
770-778
11
Volmar K E, Fritsch M K, Perlman E J, Hutchins G M.
Patterns of congenital lower urinary tract obstructive uropathy: relation to abnormal prostate and bladder development and the prune belly syndrome.
Pediatr Dev Pathol.
2001;
4
467-472
12
Moerman P, Fryns J P, Goddeeris P, Lauweryns J M.
Pathogenesis of the prune-belly syndrome: a functional urethral obstruction caused by prostatic hypoplasia.
Pediatrics.
1984;
73
470-475
13
Popek E, Tyson R, Miller G, Caldwell S.
Prostate development in prune belly syndrome (PBS) and posterior urethral valves (PUV): etiology of PBS–lower urinary tract obstruction or primary mesenchymal defect?.
Pediatr Pathol.
1991;
11
1-29
14
Coffinier C, Thépot D, Babinet C, Yaniv M, Barra J.
Essential role for the homeoprotein vHNF1/HNF1beta in visceral endoderm differentiation.
Development.
1999;
126
4785-4794
15
Bingham C, Hattersley A T.
Renal cysts and diabetes syndrome resulting from mutations in hepatocyte nuclear factor-1beta.
Nephrol Dial Transplant.
2004;
19
2703-2708
16
Decramer S, Parant O, Beaufils S et al..
Anomalies of the TCF2 gene are the main cause of fetal bilateral hyperechogenic kidneys.
J Am Soc Nephrol.
2007;
18
923-933
17
Ballif B C, Theisen A, McDonald-McGinn D M et al..
Identification of a previously unrecognized microdeletion syndrome of 16q11.2q12.2
Clin Genet.
2008;
74
469-475
18
Coffinier C, Barra J, Babinet C, Yaniv M.
Expression of the vHNF1/HNF1beta homeoprotein gene during mouse organogenesis.
Mech Dev.
1999;
89
211-213
19
Kato N, Motoyama T.
Expression of hepatocyte nuclear factor-1β in human urogenital tract during the embryonic stage.
Anal Quant Cytol Histol.
2009;
31
34-40
20
Reber M, Cereghini S.
Variant hepatocyte nuclear factor 1 expression in the mouse genital tract.
Mech Dev.
2001;
100
75-78
21
Niikura H, Okamoto S, Nagase S et al..
Fetal development of the human gubernaculum with special reference to the fasciae and muscles around it.
Clin Anat.
2008;
21
547-557
22
Kobayashi A, Kwan K M, Carroll T J, McMahon A P, Mendelsohn C L, Behringer R R.
Distinct and sequential tissue-specific activities of the LIM-class homeobox gene Lim1 for tubular morphogenesis during kidney development.
Development.
2005;
132
2809-2823
23
Chen Y T, Kobayashi A, Kwan K M, Johnson R L, Behringer R R.
Gene expression profiles in developing nephrons using Lim1 metanephric mesenchyme-specific conditional mutant mice.
BMC Nephrol.
2006;
7
1-13
Sina HaeriM.D. M.H.S.A.
University of North Carolina School of Medicine, Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine
3010 Old Clinic Building, CB# 7516, Chapel Hill, NC 27599-7516
eMail: SinaHaeri@Gmail.com