1
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Isik E, Aydinok Y, Albayrak C, Durmus B, Karakas Z, Orhan MF, Sarper N, Aydın S, Unal S, Oymak Y, Karadas N, Turedi A, Albayrak D, Tayfun F, Tugcu D, Karaman S, Tobu M, Unal E, Ozcan A, Unal S, Aksu T, Unuvar A, Bilici M, Azik F, Ay Y, Gelen SA, Zengin E, Albudak E, Eker I, Karakaya T, Cogulu O, Ozkinay F, Atik T. Identification of the molecular etiology in rare congenital hemolytic anemias using next-generation sequencing with exome-based copy number variant analysis. Eur J Haematol 2024; 113:82-89. [PMID: 38556258 DOI: 10.1111/ejh.14194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 02/29/2024] [Accepted: 03/09/2024] [Indexed: 04/02/2024]
Abstract
OBJECTIVES In congenital hemolytic anemias (CHA), it is not always possible to determine the specific diagnosis by evaluating clinical findings and conventional laboratory tests. The aim of this study is to evaluate the utility of next-generation sequencing (NGS) and clinical-exome-based copy number variant (CNV) analysis in patients with CHA. METHODS One hundred and forty-three CHA cases from 115 unrelated families referred for molecular analysis were enrolled in the study. Molecular analysis was performed using two different clinical exome panels in 130 patients, and whole-exome sequencing in nine patients. Exome-based CNV calling was incorporated into the traditional single-nucleotide variant and small insertion/deletion analysis pipeline for NGS data in 92 cases. In four patients from the same family, the PK Gypsy variant was investigated using long-range polymerase chain reaction. RESULTS Molecular diagnosis was established in 86% of the study group. The most frequently mutated genes were SPTB (31.7%) and PKLR (28.5%). CNV analysis of 92 cases revealed that three patients had different sizes of large deletions in the SPTB and six patients had a deletion in the PKLR. CONCLUSIONS In this study, NGS provided a high molecular diagnostic rate in cases with rare CHA. Analysis of the CNVs contributed to the diagnostic success.
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Affiliation(s)
- Esra Isik
- Division of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Yesim Aydinok
- Division of Pediatric Hematology, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Canan Albayrak
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Basak Durmus
- Division of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Zeynep Karakas
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mehmet Fatih Orhan
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Nazan Sarper
- Division of Pediatric Hematology, Department of Pediatrics, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Sultan Aydın
- Division of Pediatric Hematology and Oncology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Selma Unal
- Division of Pediatric Hematology, Department of Pediatrics, Faculty of Medicine, Mersin University, Mersin, Turkey
| | - Yesim Oymak
- Division of Pediatric Hematology, Dr. Behcet Uz Children's Hospital, Izmir, Turkey
| | - Nihal Karadas
- Division of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Aysen Turedi
- Division of Pediatric Hematology, Department of Pediatrics, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Davut Albayrak
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Medical Park Samsun Hospital, Samsun, Turkey
| | - Funda Tayfun
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Deniz Tugcu
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Serap Karaman
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mahmut Tobu
- Department of Hematology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Ekrem Unal
- Division of Pediatric Hematology, Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Alper Ozcan
- Division of Pediatric Hematology, Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Sule Unal
- Division of Pediatric Hematology, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Tekin Aksu
- Division of Pediatric Hematology, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Aysegul Unuvar
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mustafa Bilici
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Fatih Azik
- Department of Pediatrics, Division of Pediatric Hematology, Faculty of Medicine, Muğla Sıtkı Koçman University, Mugla, Turkey
| | - Yilmaz Ay
- Division of Pediatric Hematology and Oncology, Kartal Dr Lütfi Kırdar Training and Research Hospital, Istanbul, Turkey
| | - Sema Aylan Gelen
- Division of Pediatric Hematology, Department of Pediatrics, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Emine Zengin
- Division of Pediatric Hematology, Department of Pediatrics, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Esin Albudak
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Ibrahim Eker
- Department of Pediatric Hematology and Oncology and Pediatric Hematopoietic Stem Cell Transplantation Unit, Afyonkarahisar Health Science University Faculty of Medicine, Afyon, Turkey
| | - Taner Karakaya
- Department of Medical Genetics, Samsun Education and Research Hospital, Samsun, Turkey
| | - Ozgur Cogulu
- Division of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Ferda Ozkinay
- Division of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Tahir Atik
- Division of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
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2
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He M, Lv YC, Wei YH, Liu LQ, Guo L, Li C. Complex heterozygous mutations in hereditary spherocytosis: A case report. World J Clin Cases 2024; 12:3582-3588. [PMID: 38983418 PMCID: PMC11229933 DOI: 10.12998/wjcc.v12.i18.3582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 04/13/2024] [Accepted: 04/22/2024] [Indexed: 06/13/2024] Open
Abstract
BACKGROUND The aim of this study was to investigate the complex heterozygous mutations of ANK1 and SPTA1 in the same individual and improve our understanding of hereditary spherocytosis (HS) in children. We also hope to promote the application of gene detection technology in children with HS, with the goals of identifying more related gene mutations, supporting the acquisition of improved molecular genetic information to further reveal the pathogenesis of HS in children, and providing important guidance for the diagnosis, treatment, and prevention of HS in children. CASE SUMMARY A 1-year and 5-month-old patient presented jaundice during the neonatal period, mild anemia 8 months later, splenic enlargement at 1 year and 5 months, and brittle red blood cell permeability. Genetic testing was performed on the patient, their parents, and sister. Swiss Model software was used to predict the protein structure of complex heterozygous mutations in ANK1 and SPTA1. Genetic testing revealed that the patient harbored a new mutation in the ANK1 gene from the father and a mutation in the SPTA1 gene from the mother. Combined with the clinical symptoms of the children, it is suggested that the newly discovered complex heterozygous mutations of ANK1 and SPTA1 may be the cause, providing important guidance for revealing the pathogenesis, diagnosis, treatment, and promotion of gene detection technology in children with HS. CONCLUSION This case involves an unreported complex heterozygous mutation of ANK1 and SPTA1, which provides a reference for exploring HS.
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Affiliation(s)
- Miao He
- Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
| | - Yan-Cheng Lv
- Department of Clinic Medicine, Southwest Medical University, Luzhou 646099, Sichuan Province, China
| | - Yu-Hong Wei
- Department of Clinic Medicine, Southwest Medical University, Luzhou 646099, Sichuan Province, China
| | - Lan-Qin Liu
- Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
- Sichuan Clinical Research Center for Birth Defects, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
| | - Ling Guo
- Sichuan Clinical Research Center for Birth Defects, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
| | - Cheng Li
- Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
- Sichuan Clinical Research Center for Birth Defects, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
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3
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Chueh HW, Shim YJ, Jung HL, Kim N, Hwang SM, Kim M, Choi HS. Current Status of Molecular Diagnosis of Hereditary Hemolytic Anemia in Korea. J Korean Med Sci 2024; 39:e162. [PMID: 38742293 PMCID: PMC11091231 DOI: 10.3346/jkms.2024.39.e162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 04/16/2024] [Indexed: 05/16/2024] Open
Abstract
Hereditary hemolytic anemia (HHA) is considered a group of rare hematological diseases in Korea, primarily because of its unique ethnic characteristics and diagnostic challenges. Recently, the prevalence of HHA has increased in Korea, reflecting the increasing number of international marriages and increased awareness of the disease. In particular, the diagnosis of red blood cell (RBC) enzymopathy experienced a resurgence, given the advances in diagnostic techniques. In 2007, the RBC Disorder Working Party of the Korean Society of Hematology developed the Korean Standard Operating Procedure for the Diagnosis of Hereditary Hemolytic Anemia, which has been continuously updated since then. The latest Korean clinical practice guidelines for diagnosing HHA recommends performing next-generation sequencing as a preliminary step before analyzing RBC membrane proteins and enzymes. Recent breakthroughs in molecular genetic testing methods, particularly next-generation sequencing, are proving critical in identifying and providing insight into cases of HHA with previously unknown diagnoses. These innovative molecular genetic testing methods have now become important tools for the management and care planning of patients with HHA. This review aims to provide a comprehensive overview of recent advances in molecular genetic testing for the diagnosis of HHA, with particular emphasis on the Korean context.
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Affiliation(s)
- Hee Won Chueh
- Department of Pediatrics, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Ye Jee Shim
- Department of Pediatrics, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Korea
| | - Hye Lim Jung
- Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Namhee Kim
- Department of Laboratory Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Sang Mee Hwang
- Department of Laboratory Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Myungshin Kim
- Department of Laboratory Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
| | - Hyoung Soo Choi
- Department of Pediatrics, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
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4
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Pang L, Zeng Z, Ding Y, Huang H, Li H. Case report: Whole-exome sequencing for a hereditary elliptocytosis case with an unexpectedly low HbA 1c. Front Med (Lausanne) 2023; 10:1301760. [PMID: 38148910 PMCID: PMC10749931 DOI: 10.3389/fmed.2023.1301760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 11/23/2023] [Indexed: 12/28/2023] Open
Abstract
Objectives Hereditary elliptocytosis is a group of erythroid hereditary diseases characterized by elliptically shaped erythrocytes in peripheral blood. It is mainly inherited through autosomal dominant inheritance. This study aimed to conduct a genetic etiology analysis in a case with a clinical diagnosis of hereditary elliptocytosis and an unexpectedly low HbA1c. Methods Whole-exome sequencing was performed to find the possible pathogenic mutations. At the same time, bioinformatics software was used to predict the mutation function. Sanger sequencing was performed to verify the suspected pathogenic mutations. Results Whole-exome sequencing results showed that the proband with mild anemia had a heterozygous c.2303G>A (p.G768D) missense mutation in the 13th exon of the SPTB gene. The Sanger sequencing confirmed this heterozygous mutation. This mutation was extremely rare in the population, and multiple software's predictions were harmful. Conservative analysis revealed that this site was highly conserved in various species. Conclusion The c.2303G>A mutation of the SPTB gene is the suspected cause of hereditary elliptocytosis in the patient. Our data show that microscopic examination of red blood cells on blood smears is an important means of diagnosing hereditary elliptocytosis. Whole-exome sequencing is an effective tool to determine the genetic etiology of erythrocyte membrane diseases, which can promote accurate diagnosis and genetic counseling.
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Affiliation(s)
| | | | | | | | - Haixia Li
- Department of Clinical Laboratory, Peking University First Hospital, Beijing, China
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5
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Silva R, Amarasinghe D, Perera S, Premawardhena A. A Systematic review on diagnostic methods of red cell membrane disorders in Asia. Int J Lab Hematol 2022; 44:248-262. [DOI: 10.1111/ijlh.13800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 01/05/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Ruwindi Silva
- Department of Biochemistry and Clinical Chemistry Faculty of Medicine University of Kelaniya Kelaniya Sri Lanka
| | - Dinusha Amarasinghe
- Department of Medical Laboratory Sciences Faculty of Allied Health Sciences University of Ruhuna Galle Sri Lanka
| | - Shiromi Perera
- Department of Biochemistry and Clinical Chemistry Faculty of Medicine University of Kelaniya Kelaniya Sri Lanka
| | - Anuja Premawardhena
- Department of Medicine Faculty of Medicine University of Kelaniya Kelaniya Sri Lanka
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6
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Clinical and genetic diagnosis of thirteen Japanese patients with hereditary spherocytosis. Hum Genome Var 2022; 9:1. [PMID: 35022413 PMCID: PMC8755803 DOI: 10.1038/s41439-021-00179-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 09/08/2021] [Accepted: 09/18/2021] [Indexed: 01/15/2023] Open
Abstract
Hereditary spherocytosis is the most frequent cause of hereditary hemolytic anemia and is classified into five subtypes (SPH1-5) according to OMIM. Because the clinical and laboratory features of patients with SPH1-5 are variable, it is difficult to classify these patients into the five subtypes based only on these features. We performed target capture sequencing in 51 patients with hemolytic anemia associated with/without morphological abnormalities in red blood cells. Thirteen variants were identified in five hereditary spherocytosis-related genes (six in ANK1 [SPH1]; four in SPTB [SPH2]; and one in each of SPTA1 [SPH3], SLC4A1 [SPH4], and EPB42 [SPH5]). Among these variants, seven were novel. The distribution pattern of the variants was different from that reported previously in Japan but similar to those reported in other Asian countries. Comprehensive genomic analysis would be useful and recommended, especially for patients without a detailed family history and those receiving frequent blood transfusions due to chronic hemolytic anemia.
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7
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Shin S, Hwang KA, Paik K, Park J. A novel EPB41 p.Trp704* mutation in a Korean patient with hereditary elliptocytosis: a case report. ACTA ACUST UNITED AC 2021; 25:321-326. [PMID: 32807033 DOI: 10.1080/16078454.2020.1807227] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Objectives: Hereditary elliptocytosis (HE) is inherited in an autosomal dominant fashion, and the majority of HE-associated defects occur due to qualitative and quantitative defects in the RBC membrane skeleton proteins α-spectrin, β-spectrin, or protein 4.1R. The complex EPB41 gene encodes a diverse family of protein 4.1R isoforms which are key components of the erythroid membrane skeleton that regulates red cell morphology and mechanical stability. The purpose of this study was to investigate the genome of a Korean patient with HE to discover the causative gene mutation using gene panel sequencing. Methods: An 89-year-old female presented to the Emergency Department and was diagnosed with pancreatitis and gallstones. A peripheral blood smear revealed that approximately 60% of the RBCs were abnormally shaped and appeared oval or elongated, from slightly egg-shaped to rod or pencil forms (elliptocytes). Targeted gene panel sequencing consisting of 33 genes related to inherited RBC disorders and Sanger sequencing were performed. Results: A heterozygous c.2112G > A of the EPB41 gene leading to premature termination codon (NM_001166005.1:c.2112G > A, p.Trp704*) was identified. This variant, which had not been previously reported to be related to HE, was confirmed by Sanger sequencing. Thus, the patient's diagnosis of HE-1 was genetically confirmed. Conclusion: The present study confirmed a novel mutation of the EPB41 gene that plays an important role in expanding the mutational distribution in HE-1. It could also be helpful for understanding the correlation between the genotype and phenotype in HE.
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Affiliation(s)
- Soyoung Shin
- Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyung-Ah Hwang
- Department of Research and Development, SML Genetree, Seoul, Korea
| | - Kyuhyun Paik
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Joonhong Park
- Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.,Department of Laboratory Medicine, Jeonbuk National University Medical School and Hospital, Jeonju, Korea
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8
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Mansour-Hendili L, Aissat A, Badaoui B, Sakka M, Gameiro C, Ortonne V, Wagner-Ballon O, Pissard S, Picard V, Ghazal K, Bahuau M, Guitton C, Mansour Z, Duplan M, Petit A, Costedoat-Chalumeau N, Michel M, Bartolucci P, Moutereau S, Funalot B, Galactéros F. Exome sequencing for diagnosis of congenital hemolytic anemia. Orphanet J Rare Dis 2020; 15:180. [PMID: 32641076 PMCID: PMC7341591 DOI: 10.1186/s13023-020-01425-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 05/27/2020] [Indexed: 02/07/2023] Open
Abstract
Background Congenital hemolytic anemia constitutes a heterogeneous group of rare genetic disorders of red blood cells. Diagnosis is based on clinical data, family history and phenotypic testing, genetic analyses being usually performed as a late step. In this study, we explored 40 patients with congenital hemolytic anemia by whole exome sequencing: 20 patients with hereditary spherocytosis and 20 patients with unexplained hemolysis. Results A probable genetic cause of disease was identified in 82.5% of the patients (33/40): 100% of those with suspected hereditary spherocytosis (20/20) and 65% of those with unexplained hemolysis (13/20). We found that several patients carried genetic variations in more than one gene (3/20 in the hereditary spherocytosis group, 6/13 fully elucidated patients in the unexplained hemolysis group), giving a more accurate picture of the genetic complexity of congenital hemolytic anemia. In addition, whole exome sequencing allowed us to identify genetic variants in non-congenital hemolytic anemia genes that explained part of the phenotype in 3 patients. Conclusion The rapid development of next generation sequencing has rendered the genetic study of these diseases much easier and cheaper. Whole exome sequencing in congenital hemolytic anemia could provide a more precise and quicker diagnosis, improve patients’ healthcare and probably has to be democratized notably for complex cases.
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Affiliation(s)
- Lamisse Mansour-Hendili
- Département de Biochimie-Biologie Moléculaire, Pharmacologie, Génétique Médicale, AP-HP, Hôpitaux Universitaires Henri Mondor, F-94010, Creteil, France. .,Univ Paris Est Creteil, INSERM, IMRB, F-94010, Creteil, France.
| | - Abdelrazak Aissat
- Département de Biochimie-Biologie Moléculaire, Pharmacologie, Génétique Médicale, AP-HP, Hôpitaux Universitaires Henri Mondor, F-94010, Creteil, France.,Univ Paris Est Creteil, INSERM, IMRB, F-94010, Creteil, France
| | - Bouchra Badaoui
- Département d'hématologie et d'immunologie, AP-HP, Hôpitaux Universitaires Henri Mondor, F-94010, Creteil, France
| | - Mehdi Sakka
- Département de Biochimie-Biologie Moléculaire, Pharmacologie, Génétique Médicale, AP-HP, Hôpitaux Universitaires Henri Mondor, F-94010, Creteil, France.,Univ Paris Est Creteil, INSERM, IMRB, F-94010, Creteil, France
| | - Christine Gameiro
- Département de Biochimie-Biologie Moléculaire, Pharmacologie, Génétique Médicale, AP-HP, Hôpitaux Universitaires Henri Mondor, F-94010, Creteil, France
| | - Valérie Ortonne
- Département de Biochimie-Biologie Moléculaire, Pharmacologie, Génétique Médicale, AP-HP, Hôpitaux Universitaires Henri Mondor, F-94010, Creteil, France
| | - Orianne Wagner-Ballon
- Univ Paris Est Creteil, INSERM, IMRB, F-94010, Creteil, France.,Département d'hématologie et d'immunologie, AP-HP, Hôpitaux Universitaires Henri Mondor, F-94010, Creteil, France
| | - Serge Pissard
- Département de Biochimie-Biologie Moléculaire, Pharmacologie, Génétique Médicale, AP-HP, Hôpitaux Universitaires Henri Mondor, F-94010, Creteil, France.,Univ Paris Est Creteil, INSERM, IMRB, F-94010, Creteil, France
| | - Véronique Picard
- Département d'hématologie, AP-HP, Hôpital Bicêtre, F-94270, Le Kremlin-Bicêtre, France
| | - Khaldoun Ghazal
- Département de Biochimie, AP-HP, Hôpital Bicêtre, F-94270, Le Kremlin-Bicêtre, France
| | - Michel Bahuau
- Département de Biochimie-Biologie Moléculaire, Pharmacologie, Génétique Médicale, AP-HP, Hôpitaux Universitaires Henri Mondor, F-94010, Creteil, France
| | - Corinne Guitton
- Département d'hématologie pédiatrique, AP-HP, Hôpital Bicêtre, F-94270, Le Kremlin-Bicêtre, France
| | - Ziad Mansour
- Clinique ADASSA, Maternité, F-67000, Strasbourg, France
| | - Mylène Duplan
- Département d'onco-hématologie pédiatrique, CHU d'Angers, 4 Rue Larrey, 49100, Angers, France
| | - Arnaud Petit
- Département d'onco-hématologie pédiatrique, AP-HP, Hôpital Armand Trousseau, F-75012, Paris, France
| | | | - Marc Michel
- Univ Paris Est Creteil, INSERM, IMRB, F-94010, Creteil, France.,Département de médecine interne, AP-HP, Hôpitaux Universitaires Henri Mondor, F-94010, Creteil, France
| | - Pablo Bartolucci
- Univ Paris Est Creteil, INSERM, IMRB, F-94010, Creteil, France.,Département de médecine interne, AP-HP, Hôpitaux Universitaires Henri Mondor, F-94010, Creteil, France.,Unité des maladies génétiques du globule rouge (UMGGR), AP-HP, Hôpitaux Universitaires Henri Mondor, F-94010, Creteil, France
| | - Stéphane Moutereau
- Département de Biochimie-Biologie Moléculaire, Pharmacologie, Génétique Médicale, AP-HP, Hôpitaux Universitaires Henri Mondor, F-94010, Creteil, France.,Univ Paris Est Creteil, INSERM, IMRB, F-94010, Creteil, France
| | - Benoît Funalot
- Département de Biochimie-Biologie Moléculaire, Pharmacologie, Génétique Médicale, AP-HP, Hôpitaux Universitaires Henri Mondor, F-94010, Creteil, France.,Univ Paris Est Creteil, INSERM, IMRB, F-94010, Creteil, France
| | - Frédéric Galactéros
- Univ Paris Est Creteil, INSERM, IMRB, F-94010, Creteil, France.,Département de médecine interne, AP-HP, Hôpitaux Universitaires Henri Mondor, F-94010, Creteil, France.,Unité des maladies génétiques du globule rouge (UMGGR), AP-HP, Hôpitaux Universitaires Henri Mondor, F-94010, Creteil, France
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9
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Bahr TM, Lozano-Chinga M, Agarwal AM, Meznarich JA, Gerday E, Smoot JL, Taylor A, Christensen RD. Dizygotic twins with prolonged jaundice and microcytic, hypochromic, hemolytic anemia with pyropoikilocytosis. Blood Cells Mol Dis 2020; 85:102462. [PMID: 32623341 DOI: 10.1016/j.bcmd.2020.102462] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/23/2020] [Accepted: 06/23/2020] [Indexed: 12/27/2022]
Abstract
Dizygotic twin males, born at 34 weeks gestation, had prolonged jaundice, microcytic, hypochromic anemia, FABarts hemoglobin, elevated end-tidal CO, and blood films consistent with hereditary pyropoikilocytosis. DNA sequencing revealed both had a heterozygous alpha spectrin (SPTA1) mutation (c.460_462dup) inherited from their asymptomatic mother, plus a 3-base pair duplication in alpha globin (HBA2) (c.364_366dupGTG) inherited from their asymptomatic father.
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MESH Headings
- Anemia, Hemolytic/blood
- Anemia, Hemolytic/complications
- Anemia, Hemolytic/genetics
- Anemia, Hypochromic/blood
- Anemia, Hypochromic/complications
- Anemia, Hypochromic/genetics
- Elliptocytosis, Hereditary/blood
- Elliptocytosis, Hereditary/complications
- Elliptocytosis, Hereditary/genetics
- Humans
- Infant, Newborn
- Jaundice/blood
- Jaundice/complications
- Jaundice/genetics
- Male
- Point Mutation
- Spectrin/genetics
- Twins, Dizygotic/genetics
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Affiliation(s)
- Timothy M Bahr
- Division of Neonatology, Department of Pediatrics, University of Utah Health, Salt Lake City, UT, United States of America.
| | - Michell Lozano-Chinga
- Division of Hematology/Oncology, Department of Pediatrics, University of Utah Health, Salt Lake City, UT, United States of America
| | - Archana M Agarwal
- Division of Hematopathology, Department of Pathology, University of Utah Health, Salt Lake City, UT, United States of America; ARUP Laboratories, Salt Lake City, UT, United States of America
| | - Jessica A Meznarich
- Division of Hematology/Oncology, Department of Pediatrics, University of Utah Health, Salt Lake City, UT, United States of America
| | - Erick Gerday
- Department of Pediatrics, Division of Neonatology, Utah Valley Hospital, Provo, UT, United States of America
| | - Jennifer L Smoot
- Department of Pediatrics, Division of Neonatology, Utah Valley Hospital, Provo, UT, United States of America
| | - Ann Taylor
- Department of Pathology, Utah Valley Hospital, Provo, UT, United States of America
| | - Robert D Christensen
- Division of Neonatology, Department of Pediatrics, University of Utah Health, Salt Lake City, UT, United States of America; Division of Hematology/Oncology, Department of Pediatrics, University of Utah Health, Salt Lake City, UT, United States of America
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10
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Lin PC, Cheng CN, Huang HY, Tseng YH, Chang YS, Lin CY, Chang JG. Congenital dyserythropoiesis anemia type Ia with a novel CDAN1 mutation diagnosed by whole exome sequencing. Mol Genet Genomic Med 2020; 8:e1220. [PMID: 32160409 PMCID: PMC7216794 DOI: 10.1002/mgg3.1220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 02/15/2020] [Accepted: 02/24/2020] [Indexed: 11/17/2022] Open
Abstract
Background Congenital dyserythropoiesis anemia type Ia (OMIM:224120), is a rare hereditary anemia. The diagnosis is difficult to make and usually delayed in part due to its rarity and nonspecific clinical manifestations. Methods Whole exome sequencing was applied for the genetic diagnosis of a 12‐year‐old boy who has suffered from hemolytic anemia since birth and who requires regular transfusions. Sanger sequencing of the variants detected in whole exome sequencing was performed in the patient and his parents. Results Compound heterozygous mutations of CDAN1 gene, including one previously reported and one novel mutation, which is a splicing change, were detected in the whole exome sequencing and confirmed by Sanger sequencing. The autosomal recessive inheritance was confirmed by pedigree analysis. Conclusion To our knowledge, this is the first case report of congenital dyserythropoiesis anemia type Ia with genetic diagnosis to be located in Taiwan. Because of the rarity of CDA Ia and the overlapping of the clinical manifestations with other hereditary anemias, the next‐generation sequencing approach is effective for conclusive diagnosis of CDA Ia.
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Affiliation(s)
- Pei-Chin Lin
- Division of Hematology and Oncology, Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Pediatrics, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chao-Neng Cheng
- Division of Hematology and Oncology, Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Hsi-Yuan Huang
- Center for Precision Medicine, China Medical University Hospital, Taichung, Taiwan.,Department of Laboratory Medicine, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Yu-Hsin Tseng
- Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ya-Sian Chang
- Center for Precision Medicine, China Medical University Hospital, Taichung, Taiwan.,Department of Laboratory Medicine, China Medical University Hospital, China Medical University, Taichung, Taiwan.,Epigenome Research Center, China Medical University Hospital, Taichung, Taiwan.,School of Medicine, China Medical University, Taichung, Taiwan
| | - Chien-Yu Lin
- Graduate Institute of Clinical Medical Science, School of Medicine, China Medical University, Taichung, Taiwan
| | - Jan-Gowth Chang
- Center for Precision Medicine, China Medical University Hospital, Taichung, Taiwan.,Department of Laboratory Medicine, China Medical University Hospital, China Medical University, Taichung, Taiwan.,Epigenome Research Center, China Medical University Hospital, Taichung, Taiwan.,School of Medicine, China Medical University, Taichung, Taiwan.,Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
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11
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Study of pathophysiology and molecular characterization of congenital anemia in India using targeted next-generation sequencing approach. Int J Hematol 2019; 110:618-626. [PMID: 31401766 DOI: 10.1007/s12185-019-02716-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 08/02/2019] [Accepted: 08/02/2019] [Indexed: 12/12/2022]
Abstract
Most patients with anemia are diagnosed through clinical phenotype and basic laboratory testing. Nonetheless, in cases of rare congenital anemias, some patients remain undiagnosed despite undergoing an exhaustive workup. Genetic testing is complicated by the large number of genes that are involved in rare anemias, due to similarities in the clinical presentation. We sought to enhance the diagnosis of patients with congenital anemias by using targeted next-generation sequencing. The genetic diagnosis was performed by gene capture followed by next-generation sequencing of 76 genes known to cause anemia syndromes. Genetic diagnosis was achieved in 17 of 21 transfusion-dependent patients and undiagnosed by conventional workup. Four cases were diagnosed with red cell membrane protein defects, four patients were diagnosed with pyruvate kinase deficiency, one case of adenylate kinase deficiency, one case of glucose phosphate isomerase deficiency, one case of hereditary xerocytosis, three cases having combined membrane and enzyme defect, two cases with Diamond-Blackfan anemia (DBA) and 1 with CDA type II with 26 different mutations, of which 21 are novel. Earlier incorporation of this NGS method into the workup of patients with congenital anemia may improve patient care and enable genetic counselling.
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12
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Shen H, Huang H, Luo K, Yi Y, Shi X. Two different pathogenic gene mutations coexisted in the same hereditary spherocytosis family manifested with heterogeneous phenotypes. BMC MEDICAL GENETICS 2019; 20:90. [PMID: 31126250 PMCID: PMC6534931 DOI: 10.1186/s12881-019-0826-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Accepted: 05/16/2019] [Indexed: 01/14/2023]
Abstract
Background Hereditary spherocytosis (HS) is a common type of hereditary hemolytic anemia. According to the current diagnostic criteria of HS, patients with a family history of HS, typical clinical features and laboratory investigations could be diagnosed without the requirement of any additional tests, including genetic analysis. However, the clinical heterogeneities incur difficulties in HS diagnosis. We therefore aimed to investigate the application of genetic diagnosis in a family-based cohort. Case presentation In the present Chinese family, two probands sharing similar clinical manifestations, including jaundice, cholelithiasis, splenomegaly and spherocytes, while the clinical features of other family members were inconclusive. Whole-exome sequencing (WES) unexpectedly unveiled two separate disease-causing mutations in the two probands. SPTB R1625X mutation detected in proband D was a de novo mutation; while proband W inherited the SLC4A1 c.G1469A mutation from her mother, which was also inherited by her brother. However, the clinical features of proband W and her mother and brother were discrepant: proband W suffered from significant splenomegaly, jaundice and cholelithiasis, which resulted in cholecystectomy and splenectomy; while her mother and brother’s HS were not complicated by cholelithiasis, and their splenomegaly and elevated serum bilirubin were moderate. In addition, additional genomic defects involved with HS-related symptoms have not been detected in this family. Conclusions Both genotypes and phenotypes could be heterogeneous in the same HS family. The analysis of pathogenic gene mutations may endeavor to play an indispensable role in the accurate diagnosis and genetic consultation of HS individuals and their family members.
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Affiliation(s)
- Hongwei Shen
- Central Lab, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, People's Republic of China
| | - Hui Huang
- Department of Medical Genetics, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, People's Republic of China
| | - Kaizhong Luo
- Department of Infectious Diseases, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, People's Republic of China
| | - Yan Yi
- Department of Hematology, The Second Xiangya Hospital, Central South University, 139 Middle Renmin Road, Changsha, Hunan Province, 410011, People's Republic of China.
| | - Xiaoliu Shi
- Department of Medical Genetics, The Second Xiangya Hospital, Central South University, 139 Middle Renmin Road, Changsha, Hunan Province, 410011, People's Republic of China.
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Rets A, Clayton AL, Christensen RD, Agarwal AM. Molecular diagnostic update in hereditary hemolytic anemia and neonatal hyperbilirubinemia. Int J Lab Hematol 2019; 41 Suppl 1:95-101. [DOI: 10.1111/ijlh.13014] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 02/27/2019] [Accepted: 03/01/2019] [Indexed: 01/19/2023]
Affiliation(s)
- Anton Rets
- Department of Pathology University of Utah Health Salt Lake City Utah
- ARUP Laboratories Salt Lake City Utah
| | | | - Robert D. Christensen
- Division of Neonatology and Hematology/Oncology University of Utah Health Salt Lake City Utah
| | - Archana M. Agarwal
- Department of Pathology University of Utah Health Salt Lake City Utah
- ARUP Laboratories Salt Lake City Utah
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