1. The HNF1B score is a simple tool to select patients for HNF1B gene analysis
- Author
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Stanislas Faguer, Dominique Chauveau, Antoine Huart, Joost P. Schanstra, Nicolas Chassaing, Flavio Bandin, Audrey Casemayou, Patrick Calvas, Stéphane Decramer, Arnaud Garnier, Cathie Prouheze, Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre de Référence du Sud Ouest des Maladies Rénales Rares, Institut National de la Santé et de la Recherche Médicale (INSERM), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées, Unité différenciation épidermique et auto-immunité rhumatoïde (UDEAR), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), CARBILLET, Véronique, Hôpital de Rangueil, CHU Toulouse [Toulouse], CHU Toulouse [Toulouse]-Hôpital des Enfants, and Hôpital Purpan [Toulouse]
- Subjects
Oncology ,medicine.medical_specialty ,Pathology ,MESH: Kidney Diseases / diagnosis ,MESH: Mutation ,MESH: Biomarkers / blood ,MESH: Pedigree ,MESH: Phenotype ,MESH: Heredity ,MESH: Risk Factors ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Pathognomonic ,Internal medicine ,MESH: Liver Function Tests ,MESH: Gene Frequency ,medicine ,MESH: Patient Selection ,MESH: Kidney Diseases / blood ,MESH: DNA Mutational Analysis ,Family history ,Genetic testing ,Cystic kidney ,MESH: Humans ,medicine.diagnostic_test ,MESH: Diagnostic Imaging ,business.industry ,MESH: Blood Chemical Analysis ,MESH: Genetic Predisposition to Disease ,MESH: Decision Support Techniques ,Gold standard (test) ,MESH: ROC Curve ,MESH: Hepatocyte Nuclear Factor 1-beta / genetics ,HNF1B ,MESH: Kidney Diseases / pathology ,MESH: Predictive Value of Tests ,3. Good health ,MESH: Reproducibility of Results ,MESH: France ,MESH: Kidney Diseases / genetics ,Nephrology ,Predictive value of tests ,[SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,MESH: Area Under Curve ,business ,Liver function tests - Abstract
International audience; HNF1B-related disease is an emerging condition characterized by an autosomal-dominant inheritance, a 50% rate of de novo mutations, and a highly variable phenotype (renal involvement, maturity-onset diabetes of the young type 5, pancreatic hypoplasia, and urogenital tract and liver test abnormalities). Given the current lack of pathognomonic characteristics and the wide overlap with other conditions, a genetic test is the diagnostic gold standard. However, pre-genetic screening is mandatory because genetic testing has substantial costs. Our aim was to develop a HNF1B score, based on clinical, imaging, and biological variables, as a pivotal tool for rational genetic testing. A score was created using a weighted combination of the most discriminative characteristics based on the frequency and specificity in published series. The HNF1B score is calculated upon 17 items including antenatal discovery, family history, and organ involvement (kidney, pancreas, liver, and genital tract). The performance of the score was assessed by a ROC curve analysis in a 433-individual cohort containing 56 HNF1B cases. The HNF1B score efficiently and significantly discriminated between mutated and nonmutated cases (AUC 0.78). The optimal cutoff threshold for the negative predictive value to rule out HNF1B mutations in a suspected individual was 8 (sensitivity 98.2%, specificity 41.1%, and negative predictive value over 99%). Thus, the HNF1B score is a simple and accurate tool to provide a more rational approach to select patients for HNF1B screening.
- Published
- 2014
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