**Core Concept**
Alport syndrome is a genetic disorder characterized by glomerulonephritis, end-stage kidney disease, and hearing loss. It is caused by mutations in the COL4A3, COL4A4, and COL4A5 genes, which encode type IV collagen. The classic form of Alport syndrome is associated with X-linked inheritance.
**Why the Correct Answer is Right**
The classic form of Alport syndrome is inherited in an X-linked pattern, meaning the mutated gene is located on the X chromosome. This results in almost all affected males expressing the disease, while females are typically asymptomatic carriers, unless they inherit two mutated alleles, one from each parent. The COL4A5 gene, which encodes the alpha-5 chain of type IV collagen, is the primary gene affected in the X-linked form of Alport syndrome.
**Why Each Wrong Option is Incorrect**
* **Option A:** This option is incorrect because Alport syndrome is not typically associated with autosomal dominant inheritance.
* **Option B:** This option is incorrect because Alport syndrome is not typically associated with autosomal recessive inheritance.
* **Option D:** This option is incorrect because Alport syndrome is not typically associated with mitochondrial inheritance.
**Clinical Pearl / High-Yield Fact**
The classic triad of Alport syndrome includes hematuria (blood in the urine), sensorineural hearing loss, and end-stage kidney disease. Early recognition and genetic counseling are essential for affected families.
**Correct Answer: C. X-linked inheritance.**
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