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Coller BS, Varon D. Uri Seligsohn, MD (1937-2022). J Thromb Haemost 2022; 20:1275-1279. [PMID: 35247294 DOI: 10.1111/jth.15688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 02/19/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Barry S Coller
- Allen and Frances Adler Laboratory of Blood and Vascular Biology, The Rockefeller University, New York, New York, USA
| | - David Varon
- Coagulation Unit, Tel Aviv Medical Center, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
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2
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Cassel A, Rosenberg N, Muhammad E, Livnat T, Dardik R, Berl M, Preis M. Novel mutation in coagulation factor VII (Carmel mutation): Identification and characterization. Res Pract Thromb Haemost 2021; 5:e12407. [PMID: 34027285 PMCID: PMC8117812 DOI: 10.1002/rth2.12407] [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: 06/12/2019] [Revised: 05/28/2020] [Accepted: 05/30/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Measurement of factor VII (FVII) activity does not enable prediction of bleeding tendency in individuals with inherited FVII deficiency. OBJECTIVE To characterize the molecular and functional features of FVII in a family with FVII deficiency and correlate them with the bleeding tendency. PATIENTS/METHODS We studied 7 family members with very low FVII activity using prothrombin time (PT), activated factor VII (FVIIa), FVII activity level, and thrombin generation. The factor 7 gene was sequenced and the mutation was analyzed by prediction software. RESULTS The proband has very low FVII activity (0%-4%), with PT ranging between 5% to 18% depending on the tissue factor (TF) origin. Direct sequencing demonstrated a single homozygous nucleotide substitution G > A in exon 6, predicting a novel missense mutation Cys164Tyr. Three members of the family were found to be heterozygous carriers of this mutation. One of them was a compound heterozygote, carrying both the Cys164Tyr and Ala244Val mutation (linked to Arg353Gln polymorphism). Her FVII activity and antigen levels were 3%-7% and 8%, respectively. The other heterozygous carriers demonstrated FVII activity of 41%-54%, FVII antigen of 46%-66%, and FVIIa activity of 30%. FVIIa was undetectable in the homozygous and compound heterozygous subjects. Thrombin generation was normal in the presence of calcium, but no response to TF addition was observed in the homozygous proband, and a reduced response was observed in the compound heterozygous subject. CONCLUSION The patient homozygous for the "Carmel" mutation has mild clinical manifestations despite very low FVII activity, which correlates with thrombin generation results.
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Affiliation(s)
- Aliza Cassel
- Institute of HematologyCarmel Medical CenterHaifaIsrael
| | - Nurit Rosenberg
- The Israeli National HemophiliaSheba Medical CenterTel HashomerIsrael
- Sackler School of MedicineTel‐Aviv UniversityTel‐AvivIsrael
| | - Emad Muhammad
- Institute of HematologyCarmel Medical CenterHaifaIsrael
| | - Tami Livnat
- The Israeli National HemophiliaSheba Medical CenterTel HashomerIsrael
- Sackler School of MedicineTel‐Aviv UniversityTel‐AvivIsrael
| | - Rima Dardik
- The Israeli National HemophiliaSheba Medical CenterTel HashomerIsrael
- Sackler School of MedicineTel‐Aviv UniversityTel‐AvivIsrael
| | - Miriam Berl
- Institute of HematologyCarmel Medical CenterHaifaIsrael
| | - Meir Preis
- Institute of HematologyCarmel Medical CenterHaifaIsrael
- Ruth and Bruce Rappaport Faculty of MedicineIsrael Institute of TechnologyTechnion, HaifaIsrael
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He J, Zhou W, Lv H, Tao L, Chen X, Wang L. Novel IVS7+1G>T mutation of life-threatening congenital factor VII deficiency in neonates: A retrospective study in China. Medicine (Baltimore) 2019; 98:e17360. [PMID: 31577732 PMCID: PMC6783214 DOI: 10.1097/md.0000000000017360] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
In neonates, congenital factor VII deficiency (FVIID) is characterized by central nervous system bleeding and gastrointestinal hemorrhage, often resulting in poor prognosis and high mortality.To improve understanding of FVIID in neonates in Asia, we retrospectively analyzed the clinical manifestations, diagnosis, treatment, clinical course, and genetic diagnosis of 2 cases of neonatal FVIID in the Department of Neonatology, Guangzhou Women and Children's Medical Center, Guangzhou, China, from January 2007 to December 2017 and performed a review of the relevant literature.Both neonates were female and presented with severe gastrointestinal tract and intracranial hemorrhage. The laboratory findings were characterized by repeated and non-vitamin K1-dependent prolonged of the prothrombin time (PT), Factor VII (FVII) activity was 1.5% and 3%, respectively. Both neonates died of severe intracranial hemorrhage, at 31 days and 6 months after birth, respectively. Gene sequencing results revealed a homozygous mutation in the FVII gene splice site (IVS7+1G>T) in both cases. Upon review of relevant literature published since 1996, we identified 19 cases of neonatal FVIID. The patients were full-term neonates with onset of symptoms mostly within 7 days after birth (73.7%), which included gastrointestinal bleeding (blood stool, vomiting blood; 31.6%), nervous system signs (drowsiness, convulsions, poor response; 26.3%), severe intracranial hemorrhage (84.2%), significantly prolonged PT with significantly decreased FVII activity (89.5%), high mortality, and disability (68.4%). Gene sequencing was performed in 9 of the 19 children evaluated and revealed a mutation in the FVII gene in all cases.FVIID can be clinically diagnosed based on the presence of prolonged PT that is difficult to correct and significantly decreased FVII activity (≤5%). As mutations in some sites are associated with severe bleeding, genetic diagnosis represents a useful tool for prenatal diagnosis of FVIID. In brief, we should pay great attention to the FVIID onset of the neonatal period, although it is rare but result in life-threatening bleeding with poor prognosis.
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Affiliation(s)
- Juan He
- The First Affiliated Hospital of Jinan University
- Department of Neonatology, Guangzhou Women and Children's Medical Center, Guangdong, China
| | - Wei Zhou
- Department of Neonatology, Guangzhou Women and Children's Medical Center, Guangdong, China
| | - Hui Lv
- Department of Neonatology, Guangzhou Women and Children's Medical Center, Guangdong, China
| | - Li Tao
- Department of Neonatology, Guangzhou Women and Children's Medical Center, Guangdong, China
| | - XiaoWen Chen
- Department of Neonatology, Guangzhou Women and Children's Medical Center, Guangdong, China
| | - Ling Wang
- Department of Neonatology, Guangzhou Women and Children's Medical Center, Guangdong, China
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4
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Cattivelli K, Distefano C, Bonetti L, Testa S, Siboni SM, Plebani A, Poggiani C. Recurrent Bleedings in Newborn: A Factor VII Deficiency Case Report. Transfus Med Hemother 2018; 45:104-106. [PMID: 29765293 DOI: 10.1159/000481993] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Accepted: 09/29/2017] [Indexed: 11/19/2022] Open
Abstract
Background: Major hemorrhages in newborns can be caused by several conditions, and knowledge of the differential diagnosis is essential in order to ensure prompt recognition and appropriate treatment. Case Report: We describe the case of a male newborn experiencing recurrent hemorrhages from the first days of life. Laboratory findings showed normal platelet count, hepatic function, and C-reactive protein. Coagulation tests detected an isolated prothrombin time (PT) prolongation and severe factor VII (FVII) deficiency. Conclusion: Inherited FVII deficiency is a rare autosomal recessive bleeding disorder. Clinical presentation is heterogeneous, and bleeding severity is not directly related to FVII levels. Acute bleeding episodes can be treated with human plasma-derived FVII (pdFVII) or recombinant activated FVII (rFVIIa). In case of severe deficiency, prophylaxis must be evaluated. Awareness of this condition is crucial in order to establish prompt diagnosis and treatment.
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Affiliation(s)
- Kim Cattivelli
- Pediatrics Clinic, University of Brescia, Spedali Civili di Brescia, Brescia, Italy
| | - Cristina Distefano
- Pediatrics Clinic, University of Brescia, Spedali Civili di Brescia, Brescia, Italy
| | - Lorenza Bonetti
- Pediatrics Department, Istituti Ospedalieri di Cremona, Cremona, Italy
| | - Sophie Testa
- Hemostasis and Thrombosis Center, Istituti Ospitalieri di Cremona, Cremona, Italy
| | - Simona Maria Siboni
- Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Alessandro Plebani
- Pediatrics Clinic, University of Brescia, Spedali Civili di Brescia, Brescia, Italy
| | - Carlo Poggiani
- Neonatal Intensive Care Unit, Istituti Ospedalieri di Cremona, Cremona, Italy
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5
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Severe coagulation factor VII deficiency caused by a novel homozygous mutation (p. Trp284Gly) in loop 140s. Blood Coagul Fibrinolysis 2016; 27:461-3. [DOI: 10.1097/mbc.0000000000000499] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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A novel gene insertion combined with a missense mutation causing factor VII deficiency in two unrelated Chinese families. Blood Coagul Fibrinolysis 2015; 26:687-90. [PMID: 26083983 DOI: 10.1097/mbc.0000000000000319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Hereditary coagulation factor VII (FVII) deficiency is a rare bleeding disorder characterized by reduced FVII activity (FVII:C) and inconsistent FVII antigen (FVII:Ag). In our study, two pregnant probands were diagnosed with FVII deficiency, based on the tests that FVII:C were both 3% and FVII:Ag were less than 7.5%. Gene sequencing revealed the same compound mutations, a recurrent missense mutation p.Arg277Cys and a novel insertion mutation g.11520-11521insT. What is more, haplotype analysis of SNPs excluded the possibility of consanguinity between the two families. According to the model, we speculated that although the insertion mutation was close to the carboxy-terminal, it induced the protein extension and affected the 3' untranslated region of F7 gene, which is significant to posttranscriptional regulation. Hypothetically, the stability or translational efficiency of mRNA may be influenced, resulting in reducing FVII:C.
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Mourey G, Tachon G, Pellequer JL, Zawadzki C, Trossaërt M, Bertrand MA, Schved JF, Giansily-Blaizot M. A Haut-Doubs FVII variant depending on species-derived-thromboplastin reagent (F7:p.Arg337His). Haemophilia 2014; 20:e347-9. [DOI: 10.1111/hae.12455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2014] [Indexed: 11/27/2022]
Affiliation(s)
- G. Mourey
- Laboratoire d'hémostase; Etablissement Français du Sang; Besançon France
| | - G. Tachon
- Département d'hématologie biologique; CHU de Montpellier; Hôpital Saint Eloi; Montpellier France
| | - J.-L. Pellequer
- CEA, iBEB; Service de Biochimie et Toxicologie Nucléaire; Bagnols sur Cèze France
| | - C. Zawadzki
- Laboratoire d'Hématologie; Centre de Biologie et Pathologie EA-2693; Centre Hospitalier Régional et Universitaire; Lille France
| | - M. Trossaërt
- Centre Régional de Traitement de l'Hémophilie; Laboratoire hématologie; CHU Hôtel-Dieu; Nantes France
| | - M.-A. Bertrand
- Centre Régional de Traitement de l'Hémophilie; Service d'hématologie CHU Besançon; Besançon France
| | - J.-F. Schved
- Département d'hématologie biologique; CHU de Montpellier; Hôpital Saint Eloi; Montpellier France
| | - M. Giansily-Blaizot
- Département d'hématologie biologique; CHU de Montpellier; Hôpital Saint Eloi; Montpellier France
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Girolami A, Treleani M, Scarparo P, Bonamigo E, Lombardi AM. Considerations on a tentative classification of FVII deficiency suited for practical clinical purposes. Clin Appl Thromb Hemost 2012; 18:654-7. [PMID: 22411998 DOI: 10.1177/1076029611434529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Adequate classifications of disorders are of paramount importance in the management of congenital bleeding disorders. Classification of congenital FVII deficiency should be simple, based on few tests using thromboplastins of different origin. The first thromboplastin to be used is a rabbit brain preparation since it has been proven that this is the one that, overall, yields the lowest activity level. This is particularly so since molecular biology techniques have supplied important information with regard to the structure-function relation but have failed to supply a satisfactory classification of the defect. Mutations in the same domain have yielded different forms of FVII deficiency. Furthermore, molecular biology techniques are time consuming and are not feasible in every laboratory. A classification of FVII deficiency based on clinical, clotting, and immunological assays is proposed. This classification is suited for practical clinical purposes and may represent a useful preparatory basis for molecular biology studies.
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Affiliation(s)
- Antonio Girolami
- Department of Medical and Surgical Sciences, University of Padua Medical School, Padua, Italy
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Girolami A, de Marinis GB, Bonamigo E, Vettore S. Similarities and Discrepancies in Homozygous Factor VII Defects due to Mutations in the Region of Residues Met298 to Cys310 (Exon 8) in the Catalytic Domain of Factor VII. ACTA ACUST UNITED AC 2011; 17:17-21. [DOI: 10.1532/lh96.11-001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Landau D, Rosenberg N, Zivelin A, Staretz-Chacham O, Kapelushnik J. Familial factor VII deficiency with foetal and neonatal fatal cerebral haemorrhage associated with homozygosis to Gly180Arg mutation. Haemophilia 2010; 15:774-8. [PMID: 19432927 DOI: 10.1111/j.1365-2516.2009.02004.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Inherited factor VII (FVII) deficiency is a rare autosomal recessive disorder with a wide heterogeneous clinical pattern. Intracranial haemorrhage in infants has been previously reported in the severe form of the FVII deficiency and it has a high fatality rate. We report a family with high consanguineous relations, who experienced death of two baby girls, the first with prenatal manifestation of foetal hydrocephalus secondary to intracranial bleeding and the second with postnatal intracranial bleeding, both with less than 1% activity of FVII. Genetic analysis revealed that both parents are heterozygous and both daughters homozygous for a point mutation gG9639A in exon 7, predicting Gly180Arg substitution. This mutation was described previously in a compound heterozygous patient with mild bleeding manifestation. It seems that in this family, the mutation in its homozygous state is fatal and the lethal clinical expression can appear in utero at an early stage of gestation.
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Affiliation(s)
- D Landau
- Neonatal Department, Sheba Medical Center, Tel-Hashomer, Israel.
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11
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Chafa O, Fischer AM, Reghis A, Tapon-Bretaudiere J. Homozygous nonsense mutation (Cys72-->stop) in the human F7 gene: a not life-threatening mutation despite the absence of circulating factor VII. J Thromb Haemost 2005; 3:175-7. [PMID: 15634284 DOI: 10.1111/j.1538-7836.2004.01089.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Fromovich-Amit Y, Zivelin A, Rosenberg N, Tamary H, Landau M, Seligsohn U. Characterization of mutations causing factor VII deficiency in 61 unrelated Israeli patients. J Thromb Haemost 2004; 2:1774-81. [PMID: 15456489 DOI: 10.1111/j.1538-7836.2004.00921.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Inherited factor (F)VII deficiency is rare in most populations but relatively common in Israel. The aim of this study was to characterize the molecular and functional defect in unrelated Israeli patients with FVII deficiency. Mutations were identified by direct sequencing of PCR-amplified genomic DNA fragments. Selected mutations were expressed in baby hamster kidney (BHK) cells and tested for binding to tissue factor (TF), activation by FXa and activation of FX. In 61 patients with FVII deficiency, the causative mutation in the FVII gene was discerned. The predominant mutation found in this and a previously reported cohort of 27 unrelated patients in Israel was Ala244Val substitution; of 121 independent mutant alleles defined in all 88 patients ascertained in Israel, 102 (84%) bore this alteration. Eleven additional mutations were identified of which one, Cys22Arg, is novel. Expression of the mutations in BHK cells revealed that four (Ala244Val, 11128delC, Leu300Pro and Cys22Arg) were cross-reacting material (CRM)- negative, and three (Ala294Val, Cys310Phe and Phe24del) were CRM-positive. As predicted by modeling, we observed no binding to TF of FVII Phe24del, diminished binding of FVII Cys310Phe and normal binding of FVII Ala294Val. The main defect of FVII Ala294Val was its inability to activate FX in the presence of TF. Coexpression of Ala294Val and Arg353Gln, a polymorphism known to affect FVII secretion, did not reveal an additive effect on FVII secretion, while coexpression of Ala244Val and Arg353Gln did yield an additive effect.
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Affiliation(s)
- Y Fromovich-Amit
- Amalia Biron Research Institute of Thrombosis and Haemostasis, Chaim Sheba Medical Center, Tel Hashomer, Israel
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Gomez K, Laffan MA, Kemball-Cook G, Pasi J, Layton M, Singer JD, Tuddenham EGD, McVey JH. Two novel mutations in severe factor VII deficiency. Br J Haematol 2004; 126:105-10. [PMID: 15198740 DOI: 10.1111/j.1365-2141.2004.04997.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We have characterized the molecular defect in two families with severe factor VII (FVII) deficiency. In family I, the proband was found to be homozygous for a novel 18 bp deletion in exon 8 (g.10896-10913del) resulting in the in-frame deletion of six amino acids in the serine protease domain. Molecular modelling suggests the deletion is likely to disrupt folding of the FVII molecule. The reduced FVII antigen (21 U/dl) and negligible activity (0.4 U/dl) in the patient's plasma indicated that the deletion affected both the secretion/stability and function of the mutant protein. In family II, the proband was found to be a compound heterozygote for a novel missense mutation (g.7884G>A; FVII G117R) in exon 5 encoding the EGF2 domain of FVII and a nonsense mutation (g.8960C>T; FVII R152X) in exon 6. Extensive sequence comparison in a wide evolutionary context suggested that the Gly117 residue is critical for structure of FVII. The grossly reduced FVII antigen (1.1 U/dl) and activity (0.4 U/dl) plasma values indicate the mutation primarily affected the folding/secretion or stability of the protein.
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Affiliation(s)
- Keith Gomez
- Haemostasis and Thrombosis, MRC Clinical Sciences Centre, The Faculty of Medicine, Imperial College, Du Cane Road, London, UK
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Giansily-Blaizot M, Aguilar-Martinez P, Briquel ME, d'Oiron R, De Maistre E, Epelbaum S, Schved JF. Two novel cases of cerebral haemorrhages at the neonatal period associated with inherited factor VII deficiency, one of them revealing a new nonsense mutation (Ser52Stop). Blood Coagul Fibrinolysis 2003; 14:217-20. [PMID: 12632035 DOI: 10.1097/00001721-200302000-00016] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Factor VII (FVII) is a plasma glycoprotein that plays a key role in the initiation of blood coagulation cascade. Inherited FVII deficiency is a rare autosomal recessive disorder with a wide heterogeneous clinical pattern. The severe form may be associated with intracranial haemorrhages occurring closely to birth with a high mortality rate. In the present article, we report two novel cases of neonatal intracerebral bleeding associated with FVII activity levels below 1% of normal. FVII genotyping investigations revealed particular genotypes including the deleterious Cys135Arg mutation and a novel Ser52Stop nonsense mutation at the homozygous state. Both mutations, through different mechanisms, are expected to be inconsistent with the production of functional FVII. These putative mechanisms are discussed through a review of the literature on phenotypic and genotypic characteristics of cerebral haemorrhages in severe inherited FVII deficiency.
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