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Baronciani L, Peake I, Schneppenheim R, Goodeve A, Ahmadinejad M, Badiee Z, Baghaipour MR, Benitez O, Bodó I, Budde U, Cairo A, Castaman G, Eshghi P, Goudemand J, Hassenpflug W, Hoorfar H, Karimi M, Keikhaei B, Lassila R, Leebeek FWG, Lopez Fernandez MF, Mannucci PM, Marino R, Nikšić N, Oyen F, Santoro C, Tiede A, Toogeh G, Tosetto A, Trossaert M, Zetterberg EMK, Eikenboom J, Federici AB, Peyvandi F. Genotypes of European and Iranian patients with type 3 von Willebrand disease enrolled in 3WINTERS-IPS. Blood Adv 2021; 5:2987-3001. [PMID: 34351388 PMCID: PMC8361454 DOI: 10.1182/bloodadvances.2020003397] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 03/02/2021] [Indexed: 12/12/2022] Open
Abstract
Type 3 von Willebrand disease (VWD3) is a rare and severe bleeding disorder characterized by often undetectable von Willebrand factor (VWF) plasma levels, a recessive inheritance pattern, and heterogeneous genotype. The objective of this study was to identify the VWF defects in 265 European and Iranian patients with VWD3 enrolled in 3WINTERS-IPS (Type 3 Von Willebrand International Registries Inhibitor Prospective Study). All analyses were performed in centralized laboratories. The VWF genotype was studied in 231 patients with available DNA (121 [115 families] from Europe [EU], and 110 [91 families] from Iran [IR]). Among 206 unrelated patients, 134 were homozygous (EU/IR = 57/77) and 50 were compound heterozygous (EU/IR = 43/7) for VWF variants. In 22 patients, no or only one variant was found. A total of 154 different VWF variants (EU/IR = 101/58 [5 shared]) were identified among the 379 affected alleles (EU/IR = 210/169), of which 48 (EU/IR = 18/30) were novel. The variants p.Arg1659*, p.Arg1853*, p.Arg2535*, p.Cys275Ser, and delEx1_Ex5 were found in both European and Iranian VWD3 patients. Sixty variants were identified only in a single allele (EU/IR = 50/10), whereas 18 were recurrent (≥3 patients) within 144 affected alleles. Nine large deletions and one large insertion were found. Although most variants predicted null alleles, 21% of patients carried at least 1 missense variant. VWD3 genotype was more heterogeneous in the European population than in the Iranian population, with nearly twice as many different variants. A higher number of novel variants were found in the Iranian VWD3 patients.
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Affiliation(s)
- Luciano Baronciani
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center and Fondazione Luigi Villa, Milan, Italy
| | - Ian Peake
- Faculty of Medicine, Dentistry and Health, University of Sheffield, Sheffield, United Kingdom
| | - Reinhard Schneppenheim
- Department of Pediatric Hematology and Oncology, University Medical Centre, Hamburg-Eppendorf, Hamburg, Germany
| | - Anne Goodeve
- Faculty of Medicine, Dentistry and Health, University of Sheffield, Sheffield, United Kingdom
| | - Minoo Ahmadinejad
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
- Pediatric Congenital Hematologic Disorders Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Zahra Badiee
- Hemophilia-Thalassemia Center, Mashhad University of Medical Science, Mashad, Islamic Republic of Iran
| | | | - Olga Benitez
- Hemophilia Unit, University Vall d'Hebron Hospital, Barcelona, Spain
| | - Imre Bodó
- Department of Internal Medicine and Hematology-Semmelweis University, Budapest, Hungary
| | - Ulrich Budde
- Hemostaseology Medilys Laborgesellschaft mbH, Hamburg, Germany
| | - Andrea Cairo
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center and Fondazione Luigi Villa, Milan, Italy
| | - Giancarlo Castaman
- Center for Bleeding Disorders and Coagulation, Careggi University Hospital, Florence, Italy
| | - Peyman Eshghi
- Pediatric Congenital Hematologic Disorders Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Jenny Goudemand
- Univ. Lille, CHU Lille, Haematology and Transfusion, Lille, France
| | - Wolf Hassenpflug
- Department of Pediatric Hematology and Oncology, University Medical Centre, Hamburg-Eppendorf, Hamburg, Germany
| | - Hamid Hoorfar
- Hemophilia Center, Esfahan University of Medical Science, Esfahan, Islamic Republic of Iran
| | - Mehran Karimi
- Hematology Research Center, Shiraz University of Medical Science, Shiraz, Iran
| | - Bijan Keikhaei
- Thalassemia and Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Riitta Lassila
- Research Program Unit in Oncology, University of Helsinki, Helsinki University Central Hospital, Coagulation Disorders, Helsinki, Finland
| | - Frank W G Leebeek
- Department of Hematology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | - Pier Mannuccio Mannucci
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center and Fondazione Luigi Villa, Milan, Italy
| | - Renato Marino
- Hemophilia and Thrombosis Centre, University Hospital Policlinico, Bari, Italy
| | - Nikolas Nikšić
- Faculty of Medicine, Dentistry and Health, University of Sheffield, Sheffield, United Kingdom
| | - Florian Oyen
- Department of Pediatric Hematology and Oncology, University Medical Centre, Hamburg-Eppendorf, Hamburg, Germany
| | - Cristina Santoro
- Hematology, Hemophilia and Thrombosis Center, University Hospital Policlinico Umberto I, Rome, Italy
| | - Andreas Tiede
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Gholamreza Toogeh
- Thrombosis Hemostasis Research Center-Vali-Asr Hospital-Emam Khameini Complex Hospital, Tehran University of Medical Science, Tehran, Islamic Republic of Iran
| | - Alberto Tosetto
- Hemophilia and Thrombosis Center, Hematology Department, San Bortolo Hospital, Vicenza, Italy
| | - Marc Trossaert
- Centre Régional de Traitement de l'Hémophilie-Laboratoire d'Hématologie, Nantes, France
| | | | - Jeroen Eikenboom
- Department of Internal Medicine, Division of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands
| | - Augusto B Federici
- Hematology and Transfusion Medicine, L. Sacco University Hospital, Department of Oncology and Oncohematology, University of Milan, Milan, Italy; and
| | - Flora Peyvandi
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center and Fondazione Luigi Villa, Milan, Italy
- Department of Pathophysiology and Transplantation and Università degli Studi di Milano and Milan and Italy
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Wang X, Tang N, Lu Y, Hu Q, Li D. Two cases of von Willebrand disease type 3 in consanguineous Chinese families. Mol Genet Genomic Med 2019; 8:e1075. [PMID: 31793247 PMCID: PMC7005608 DOI: 10.1002/mgg3.1075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 10/30/2019] [Accepted: 11/14/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND von Willebrand disease (VWD) is the most common inherited bleeding disorder caused by defective or deficient von Willebrand factor (VWF). VWD type 3 is inherited in autosomal recessive manner. We described clinical and molecular features of VWD type 3 in two consanguineous marriage families. METHODS Peripheral blood was collected, PT, APTT, FVIII:C, VWF:RCo, VWF:Ag were measured. A targeted next-generation sequencing panel covering F8, F9, and VWF genes was applied followed by Sanger sequencing. RESULTS Both families had a baby die in their first year due to bleeding disorders. A 23-year-old female patient from family A suffered menorrhagia, and another 30-year-old male patient from family B was characterized with hematoma in the lower extremity. Both patients showed severely decreased FVIII:C, VWF:Ag. Recurrent homozygous VWF c.4696C>T (p.Arg1566Ter) nonsense mutation was identified in the female patient, and novel homozygous VWF c.6450C>A (p.Cys2150Ter) nonsense mutation was identified the male patient. Heterozygotes in family members showed mild/moderate decrease in VWF:Ag or VWF:RCo. CONCLUSIONS We identified VWD type 3 in two consanguineous marriage families, and our work further strengthen the risk of delivering disorders inherited in AR manner in populations with frequent consanguineous partnerships.
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Affiliation(s)
- Xiong Wang
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ning Tang
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yanjun Lu
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qun Hu
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Dengju Li
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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