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Nagaya S, Akiyama M, Murakami M, Sekiya A, Asakura H, Morishita E. Congenital coagulation factor X deficiency: Genetic analysis of five patients and functional characterization of mutant factor X proteins. Haemophilia 2018; 24:774-785. [DOI: 10.1111/hae.13606] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 07/27/2018] [Accepted: 07/30/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Satomi Nagaya
- Asanogawa General Hospital; Kanazawa Ishikawa Japan
- Department of Clinical Laboratory Science; Kanazawa University Graduate School of Medical Science; Kanazawa Ishikawa Japan
| | - Masashi Akiyama
- Department of Molecular Pathogenesis; National Cerebral and Cardiovascular Center Research Institute; Osaka Japan
| | - Morika Murakami
- Department of Clinical Laboratory Science; Kanazawa University Graduate School of Medical Science; Kanazawa Ishikawa Japan
| | - Akiko Sekiya
- Department of Clinical Laboratory Science; Kanazawa University Graduate School of Medical Science; Kanazawa Ishikawa Japan
| | - Hidesaku Asakura
- Department of Hematology; Kanazawa University Hospital; Kanazawa Ishikawa Japan
| | - Eriko Morishita
- Department of Clinical Laboratory Science; Kanazawa University Graduate School of Medical Science; Kanazawa Ishikawa Japan
- Department of Hematology; Kanazawa University Hospital; Kanazawa Ishikawa Japan
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Girolami A, Cosi E, Santarossa C, Ferrari S, Girolami B, Lombardi AM. Prevalence of bleeding manifestations in 128 heterozygotes for Factor X deficiency, mainly for FX Friuli, matched versus 128 unaffected family members, during a long sequential observation period (23.5 years). Eur J Haematol 2016; 97:547-553. [DOI: 10.1111/ejh.12767] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Antonio Girolami
- Department of Medicine; University of Padua Medical School; Padua Italy
| | - Elisabetta Cosi
- Department of Medicine; University of Padua Medical School; Padua Italy
| | | | - Silvia Ferrari
- Department of Medicine; University of Padua Medical School; Padua Italy
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A family with factor X deficiency from Argentina: a compound heterozygosis because of the combination of a new mutation (Gln138Arg) with an already known one (Glu350Lys). Blood Coagul Fibrinolysis 2016; 27:732-6. [PMID: 27031279 DOI: 10.1097/mbc.0000000000000563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The objective was to investigate a family from Argentina. The proposita was a 51-year-old woman who had a moderate bleeding tendency. Some of her children showed a mild bleeding tendency. Her mother and the husband were asymptomatic. Clotting, immunological and molecular biology techniques were used. Partial thromboplastin, prothrombin, Russell Viper venom-clotting times were moderately prolonged in the proposita, whereas they were slightly prolonged in the children and in her mother. Factor X (FX) activity was about 2-3% of normal in all assay systems. FX antigen was less than 5%. Other clotting factors and platelet were normal. Genetic analysis showed a compound heterozygosis: combination of a 'new' mutation (Gln138Arg) with an already known mutation (Glu350Lys). The children had intermediate FX levels (35-63% of normal) and were carriers of one of the two mutations present in the proposita. This is the first observation of a FX deficiency in Argentina.
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Tan CW, Najm J, Morel-Kopp MC, Teo J, Chen Q, Felbor U, Ward CM. Severe FX deficiency caused by a previously unidentified 4-bp deletion compound heterozygous with a large deletion involving FVII and FX genes. Haemophilia 2011; 18:e55-8. [PMID: 22126652 DOI: 10.1111/j.1365-2516.2011.02707.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Rauch R, Girisch M, Wiegand G, Schroeder W, Hofbeck M, Welisch E, Wulff K. Factor X deficiency and intracranial bleeding: who is at risk? Haemophilia 2011; 17:759-63. [PMID: 21682820 DOI: 10.1111/j.1365-2516.2011.02591.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Very few mutations of the gene encoding for coagulation factor X (FX) have been found associated with intracranial haemorrhage (ICH) due to FX deficiency (FXD). No guidelines exist as to when prophylaxis in FXD should be started and how patients at risk for ICH can be identified. We report on a novel mutation causative for ICH in a family of Iranian origin and provide a summary of all published mutations in the FX gene related to ICH. The index patient is an infant with umbilical bleeding requiring blood transfusion in the postnatal period. The international normalized ratio (6.01) and activated partial thromboplastin time (117 s) were prolonged. Coagulation factor analysis was normal except for FX activity (<1%). At 4 months, the child suffered a spontaneous severe intracranial haemorrhage. The child was the product of a consanguineous union. Four of five available family members from three generations displayed minor bleeding symptoms and mildly reduced FX. Sequencing of FX gene demonstrated homozygosity for a novel duplication A (c.1402_1403dupA)* in exon 8 and heterozygosity in four family members. We compare this case to all 15 patients with FXD and ICH and their 11 known mutations described so far. This case illustrates a pattern of FXD (a male neonate with umbilical or gastrointestinal bleeding, very low FX:C (<1%) and an underlying homozygous genotype) who may be at high risk for ICH. In these cases, we recommend to start early prophylactic substitution of FX to prevent a possible life-threatening haemorrhage.
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Affiliation(s)
- R Rauch
- Department of Paediatrics, University of Western ON, London, Ontario, Canada.
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Girolami A, Scarparo P, Vettore S, Candeo N, Scandellari R, Lombardi A. Unexplained Discrepancies in the Activity—Antigen Ratio in Congenital FX Deficiencies With Defects in the Catalytic Domain. Clin Appl Thromb Hemost 2009; 15:621-7. [DOI: 10.1177/1076029609343447] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Studies on molecular biology have considerably enhanced our understanding of congenital coagulation disorders but have failed so far to supply tools for an adequate classification of defects. In fact, mutations in the same domain may give rise to different phenotypes. Conversely, mutations in different domains, controlled by different exons, may cause similar patterns. The 37 kindreds with congenital factor X (FX) deficiency, known to have a defect in the catalytic domain, have been evaluated in an attempt to investigate the genotype—phenotype relation. Discrepant results were obtained because about half kindreds showed a type I pattern, namely a concomitant decrease in FX activity and antigen. The other half showed a type II pattern, namely a decrease in FX activity with a normal or near normal FX antigen. In a few instances, the allocation of the kindred either to type I or to type II defect could not be reached, due to the lack of information about the antigen. The comparison of the kindreds in which the same mutation has been discovered by different investigations is not always possible also for lack of information. The study analyzes the need to have a multipronged approach to the study of congenital FX deficiency. The indication of a mutation in a given domain does not provide clear information about the phenotype.
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Affiliation(s)
- A. Girolami
- Department of Medical and Surgical Sciences, University of Padua Medical School, Padua, Italy
| | - P. Scarparo
- Department of Medical and Surgical Sciences, University of Padua Medical School, Padua, Italy
| | - S. Vettore
- Department of Medical and Surgical Sciences, University of Padua Medical School, Padua, Italy
| | - N. Candeo
- Department of Medical and Surgical Sciences, University of Padua Medical School, Padua, Italy
| | - R. Scandellari
- Department of Medical and Surgical Sciences, University of Padua Medical School, Padua, Italy
| | - A.M. Lombardi
- Department of Medical and Surgical Sciences, University of Padua Medical School, Padua, Italy
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Girolami A, Scandellari R, Scapin M, Vettore S. Congenital Bleeding Disorders of the Vitamin K‐Dependent Clotting Factors. VITAMINS & HORMONES 2008; 78:281-374. [DOI: 10.1016/s0083-6729(07)00014-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Herrmann FH, Auerswald G, Ruiz-Saez A, Navarrete M, Pollmann H, Lopaciuk S, Batorova A, Wulff K. Factor X deficiency: clinical manifestation of 102 subjects from Europe and Latin America with mutations in the factor 10 gene. Haemophilia 2006; 12:479-89. [PMID: 16919077 DOI: 10.1111/j.1365-2516.2006.01303.x] [Citation(s) in RCA: 86] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Inherited factor X deficiency (FXD) is a rare (1:1,000,000) recessive bleeding disorder. The clinical and laboratory phenotypes of FXD are poorly correlated and few regional studies on the genotype and the clinical manifestations of FXD are known. To understand the association between clinical manifestations and causative genotype, detailed evaluation of bleeding pattern in a high number of patients is needed. This international study analysed the phenotype and genotype of 102 subjects from Central Europe (Germany, Poland and Slovakia) and Latin America (Costa Rica and Venezuela) with causative mutations in the F10 gene, via sequencing. Twenty-eight homozygous, seven compound-heterozygous and 67 heterozygous FXD subjects were characterized. Twenty-nine different causative mutations, including 15 novel mutations, were analysed. Spontaneous bleeding symptoms in 42 symptomatic individuals (26 homozygous, seven compound heterozygous and nine heterozygous) comprised easy bruising (55%), haematoma (43%), epistaxis (36%), haemarthrosis (33%), intracranial haemorrhage (ICH; 21%), and gastrointestinal (GI) haemorrhage (12%). The manifestation of bleeding symptoms in 9 of 67 (13%) symptomatic heterozygous subjects is described. The bleeding patterns of the enrolled patients showed differences that are associated with the types of F10 mutation, and the corresponding genotypes. The homozygous patients were evaluated for genotype-phenotype correlation. The results suggested that ICH seems to be associated with the F10 mutation Gly380Arg, and possibly with the mutations IVS7-1G>A and Tyr163delAT. A tentative association of other mutations to severe symptoms such as haemarthrosis and GI haemorrhage is reported. The severity of FXD, the genotype-phenotype association, and the results of regional studies are discussed.
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Affiliation(s)
- F H Herrmann
- Institute of Human Genetics, University of Greifswald, Greifswald, and Hess Children's Hospital, Klinikum Bremen-Mitte, Bremen, Germany.
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Jayandharan G, Viswabandya A, Baidya S, Nair SC, Shaji RV, George B, Chandy M, Srivastava A. Six novel mutations including triple heterozygosity for Phe31Ser, 514delT and 516T-->G factor X gene mutations are responsible for congenital factor X deficiency in patients of Nepali and Indian origin. J Thromb Haemost 2005; 3:1482-7. [PMID: 15892863 DOI: 10.1111/j.1538-7836.2005.01339.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Factor X (FX) deficiency is a rare (1 : 100000) autosomal recessive disorder caused by heterogeneous mutations in FX gene. We have studied the molecular basis this disease in six Indian and one Nepali patients. Diagnosis was confirmed by measuring the FX coagulant activity (FX: C) using a PT based assay. Six of them had a FX: C of < 1% and one patient had 24% coagulant activity. Mutations were identified in all the seven patients. These included eight (88.8%) missense and one frame-shift (11.2%) mutations of which six were novel. Three of the novel mutations, a Phe31Ser affecting 'Gla' domain and 514delT and 516T-->G mutations affecting Cys132 in 'connecting region' were identified in a triple compound heterozygous state in a Nepali patient presenting with a severe phenotype. Two other novel mutations, Gly133Arg, may affect the disulphide bridge between Cys132-Cys302 in the connecting region while Gly223Arg may perturb the catalytic triad (His236, Asp282 and Ser379). The other novel mutation, Ser354Arg, involves the replacement of a small-buried residue by a large basic aminoacid and is likely to have steric or electrostatic effects in the pocket involving Lys351-Arg347-Lys414 that contributes to the core epitope of FXa for binding to FVa. Three previously reported mutations, Thr318Met; Gly323Ser; Gly366Ser were also identified. This is the first report of the molecular basis of FX deficiency in patients from the Indian subcontinent.
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Affiliation(s)
- G Jayandharan
- Department of Hematology, Christian Medical College, Vellore, India
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Herrmann FH, Navarette M, Salazar-Sanchez L, Carillo JM, Auerswald G, Wulff K. Homozygous Factor X gene mutations Gly380Arg and Tyr163delAT are associated with perinatal intracranial hemorrhage. J Pediatr 2005; 146:128-30. [PMID: 15644837 DOI: 10.1016/j.jpeds.2004.08.049] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Intracranial hemorrhage (ICH) is a severe complication of Factor X (FX) deficiency. We report 6 homozygous patients with central nervous system (ICH) bleeds. Five patients are homozygous for the mutation Gly380Arg and one for the novel deletion Tyr163delAT. We describe the association of these mutations with ICH bleeding.
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Vianello F, Lombardi AM, Dal Bello F, Zanon E, Cabrio L, Girolami A. Conformation sensitive gel electrophoresis for detection of factor X gene mutations. Thromb Res 2002; 107:51-4. [PMID: 12413589 DOI: 10.1016/s0049-3848(02)00178-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Fifteen patients from five families with laboratory data suggesting factor X (FX) deficiency were screened for causative mutations by conformation sensitive gel electrophoresis (CSGE) followed by sequencing. All exonic and flanking intronic regions of factor X gene were amplified using PCR. After heteroduplex formation, samples were analyzed onto a polyacrylamide gel for possible mismatch. An abnormal CSGE profile indicating an heteroduplex was identified in 10/15 cases. All the 10 patients with a patter of migration suggesting a mismatch had a laboratoristic pattern of FX deficiency whereas the five cases with a normal CSGE aspect referred to the normal components of the families who did not carry any FX defect. Sequencing demonstrated that the 10 exons, which showed a suspect CSGE pattern, harbored a mutation responsible for the factor X defect. Of the five mutation identified, two were recognized to be novel mutations (a 871C>T substitution and a 1169G>T transversion in exon 8), both located in the catalytic portion of FX. CSGE may be an effective and simple procedure for screening factor X gene mutations.
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Affiliation(s)
- Fabrizio Vianello
- Department of Medical and Surgical Sciences, Second Chair of Medicine, University of Padua Medical School, via Ospedale, 105, 35100, Padua, Italy.
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