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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">medgen</journal-id><journal-title-group><journal-title xml:lang="ru">Медицинская генетика</journal-title><trans-title-group xml:lang="en"><trans-title>Medical Genetics</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2073-7998</issn><publisher><publisher-name>Publishing House «Genius Media» LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.25557/2073-7998.2024.10.38-49</article-id><article-id custom-type="elpub" pub-id-type="custom">medgen-2561</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>КЛИНИЧЕСКИЙ СЛУЧАЙ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>CLINICAL CASE</subject></subj-group></article-categories><title-group><article-title>Значение медико-генетического консультирования при планировании деторождения  у пациентки с цистинурией и нарушением репродуктивной функции</article-title><trans-title-group xml:lang="en"><trans-title>The importance of genetic counseling within planning of pregnancy  by a patient with cystinuria and reproductive dysfunction</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Литвинова</surname><given-names>М. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Litvinova M.M.</surname><given-names>M. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>119048, г. Москва,  ул. Трубецкая, д. 8/2</p><p>111123, г. Москва,  шоссе Энтузиастов, д. 86</p></bio><bio xml:lang="en"><p>Maria M. Litvinova</p><p>8/2 Trubetskaya st., Moscow, 119048</p><p>86, Shosse Entuziastov st., Moscow, 111123</p></bio><email xlink:type="simple">Litvinova_m_m@staff.sechenov.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Филиппова</surname><given-names>Т. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Filippova</surname><given-names>T. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>119048, г. Москва, ул. Трубецкая, д. 8/2</p></bio><bio xml:lang="en"><p>8/2 Trubetskaya st., Moscow, 119048</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гудкова</surname><given-names>А. П.</given-names></name><name name-style="western" xml:lang="en"><surname>Gudkova</surname><given-names>A. P.</given-names></name></name-alternatives><bio xml:lang="ru"><p>119048, г. Москва,  ул. Трубецкая, д. 8/2</p></bio><bio xml:lang="en"><p>8/2 Trubetskaya st., Moscow, 119048</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Карнаушкина</surname><given-names>М. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Karnaushkina</surname><given-names>M. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>117198, г. Москва,  ул. Миклухо-Маклая, д.6</p></bio><bio xml:lang="en"><p>6, Milukho-Maklaya st., Moscow, 117198</p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Цапкова</surname><given-names>Л. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Tsapkova</surname><given-names>L. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>111123, г. Москва,  шоссе Энтузиастов, д. 86</p></bio><bio xml:lang="en"><p>86, Shosse Entuziastov st., Moscow, 111123</p></bio><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Субботина</surname><given-names>Т. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Subbotina</surname><given-names>T. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>119048, г. Москва,  ул. Трубецкая, д. 8/2</p></bio><bio xml:lang="en"><p>8/2 Trubetskaya st., Moscow, 119048</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Чеботарёва</surname><given-names>Н. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Chebotareva</surname><given-names>N. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>119048, г. Москва, ул. Трубецкая, д. 8/2</p></bio><bio xml:lang="en"><p>8/2 Trubetskaya st., Moscow, 119048</p><p> </p></bio><xref ref-type="aff" rid="aff-2"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет); ГБУЗ Московский клинический научно-практический центр имени А.С. Логинова Департамента</institution><country>Россия</country></aff><aff xml:lang="en"><institution>I.M. Sechenov First Moscow State Medical University (Sechenov University); The Loginov Moscow Clinical Scientific Center of Moscow Health Department</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет)</institution><country>Россия</country></aff><aff xml:lang="en"><institution>I.M. Sechenov First Moscow State Medical University (Sechenov University)</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>ФГАОУ ВО Российский университет дружбы народов имени Патриса Лумумбы (РУДН)</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Peoples’ Friendship University of Russia (RUDN University)</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>ГБУЗ Московский клинический научно-практический центр имени А.С. Логинова Департамента здравоохранения г. Москвы</institution><country>Россия</country></aff><aff xml:lang="en"><institution>The Loginov Moscow Clinical Scientific Center of Moscow Health Department</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2024</year></pub-date><pub-date pub-type="epub"><day>07</day><month>12</month><year>2024</year></pub-date><volume>23</volume><issue>10</issue><fpage>38</fpage><lpage>49</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Литвинова М.М., Филиппова Т.В., Гудкова А.П., Карнаушкина М.А., Цапкова Л.А., Субботина Т.И., Чеботарёва Н.В., 2024</copyright-statement><copyright-year>2024</copyright-year><copyright-holder xml:lang="ru">Литвинова М.М., Филиппова Т.В., Гудкова А.П., Карнаушкина М.А., Цапкова Л.А., Субботина Т.И., Чеботарёва Н.В.</copyright-holder><copyright-holder xml:lang="en">Litvinova M.M. M.M., Filippova T.V., Gudkova A.P., Karnaushkina M.A., Tsapkova L.A., Subbotina T.I., Chebotareva N.V.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.medgen-journal.ru/jour/article/view/2561">https://www.medgen-journal.ru/jour/article/view/2561</self-uri><abstract><p>Мочекаменная болезнь (МКБ) – часто встречаемое заболевание мочевыделительной системы. Актуальной проблемой для пациентов с МКБ является решение вопроса здоровья их будущих детей. В то же время немаловажным аспектом является планирование деторождения и подготовка к вынашиванию беременности при уролитиазе у женщины.</p><p>Представлено описание медико-генетического консультирования 37-летней пациентки с цистинурией и нарушением репродуктивной функции при планировании беременности. Женщине и её супругу проведено комплексное лабораторно[<xref ref-type="bibr" rid="cit1">1</xref>]инструментальное и молекулярно-генетическое исследование. Генетическая диагностика осуществлена методом массового параллельного секвенирования с последующей верификацией обнаруженных находок секвенированием по Сэнгеру.</p><p>На этапе обращения на консультацию супружеской паре уже были выполнены некоторые генетические исследования: кариотипирование обоих супругов (результат 46,XX и 46,XY) и генетическое тестирование женщины на наличие полиморфизмов генов F2 и F5, предрасполагающих к развитию тромбофилии. В результате анализа у пациентки выявлен полиморфизм rs1799963 гена F2 в гетерозиготном состоянии. В ходе консультации для определения генетической причины цистинурии ей назначено секвенирование экзома. В гене SLC7A9, ответственном за развитие цистинурии типа В, был выявлен патогенный вариант с.313G&gt;A (p.Gly105Arg) в гомозиготном состоянии, что уточнило причину редкой формы МКБ. Помимо этого, у женщины обнаружены патогенные варианты в генах АВСА4, GPR179, С2, GALC, связанные с рядом наследственных заболеваний. По результатам секвенирования экзома у супруга пациентки патогенных вариантов в генах, ответственных за развитие цистинурии, не выявлено. Совпадений по вариантам в одних и тех же генах других аутосомно-рецессивных заболеваний также не обнаружено. Даны персонализированные рекомендации по подготовке и ведению беременности у пациентки, назначено лечение цистинурии, а также сформулированы рекомендации по профилактике развития осложнений у пациентки в будущем.</p></abstract><trans-abstract xml:lang="en"><p>Kidney stone disease (KSD) is a common disease of the urinary system. It is important to determine the risk of transmitting the disease to the next generation for the patients suffering from the severe forms of urolithiasis. At the same time, an important aspect is to prepare a woman with KSD for the pregnancy. In the current article we describe a case of genetic counseling of a 37-year-old patient with cystinuria and infertility problem who came for consultation because of pregnancy planning. The woman and her husband underwent comprehensive laboratory and instrumental investigation together with molecular genetic analyses. Genetic diagnostics were carried out using the next generation sequencing method (NGS, from the English Next Generation Sequencing) with subsequent verification of the detected findings using the Sanger sequencing method. Before genetic counseling the couple had already undergone several genetic tests: karyotyping of both spouses (results 46,XX and 46,XY) and genetic testing of the woman for the presence of polymorphisms in the F2 and F5 genes, predisposing to the development of thrombophilia. As a result of genotyping, the patient was determined to have the rs1799963 polymorphism of the F2gene in a heterozygous state. During the consultation, to identify the genetic cause of cystinuria, the patient was prescribed whole exome sequencing. In the SLC7A9 gene, attributable for the development of cystinuria type B, a pathogenic variant c.313G&gt;A (p.Gly105Arg) was identified in a homozygous form. The diagnosis of rare form of KSD was confirmed. In addition, the woman also had other findings associated with a number of hereditary diseases (genes ABCA4, GPR179, C2, GALC). Based on the results of exome sequencing of the patient’s husband, no matches were found for variants in the same genes of autosomal recessive diseases. Personalized recommendations were given for preparing and managing pregnancy, as well as preventing the development of complications of health condition in the future. Treatment of cystinuria was prescribed to the woman. The importance of medical genetic counseling is shown when planning childbearing in a patient with a rare form of KSD, who is additionally a heterozygous carrier of pathogenic variants in the genes of a number of monogenic diseases and genetically predisposed to thrombosis.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>мочекаменная болезнь</kwd><kwd>цистинурия</kwd><kwd>SLC7A9</kwd><kwd>c.313G&gt;A</kwd><kwd>p.Gly105Arg</kwd><kwd>медико-генетическое консультирование</kwd><kwd>молекулярно-генетическая диагностика</kwd><kwd>секвенирование экзома</kwd><kwd>лечение</kwd><kwd>планирование беременности</kwd><kwd>тромбозы</kwd></kwd-group><kwd-group xml:lang="en"><kwd>kidney stone disease</kwd><kwd>urolithiasis</kwd><kwd>cystinuria</kwd><kwd>SLC7A9</kwd><kwd>c.313G&gt;A</kwd><kwd>p.Gly105Arg</kwd><kwd>genetic counseling</kwd><kwd>molecular genetic  diagnostics</kwd><kwd>whole exome sequencing</kwd><kwd>treatment</kwd><kwd>pregnancy planning</kwd><kwd>thrombosis</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Palsson R., Indridason O.S., Edvardsson V.O., Oddsson A. 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