Abstract
Background: CUBN gene mutation is extremely rare and thought to only presented as tubular proteinuria without glomerular involvement. Here, we present 3 patients with prominent proteinuria and FSGS in renal pathologies caused by novel CUBN gene mutations.Method: Whole exome sequencing was performed in three children. CUBN gene mutations were found and then verified by sanger sequencing. Their clinical, pathological and molecular genetic characteristics were analyzed and correlated accordingly. Results: All three children presented with prominent proteinuria but normal or slightly higher levels of urine β2 microglobulin, without megaloblastic anemia. Renal biopsies showed segmental glomerular sclerosis, glomerular mesangial cells proliferation, effacement of foot processes, podocyte microvillation and interstitial fibrosis. There were four novel CUBN gene mutations in our study, including c.9287T>C (p.L3096P), c.122+1G>A, c.7906C>T (p.R2636*), c.10233G>A (p.W3411*). Except for intron splice-site mutation, all other variants are located in highly conserved sites of CUB domain. Conclusion: In this study, four novel pathogenic mutations of CUBN gene were identified in three prominent proteinuric children. The results demonstrate that CUBN gene mutations may cause pathological changes of podocytes and FSGS, which was not previously reported. Our cases extend the spectrum of renal manifestation and genotype of CUBN gene mutation.