1
|
Preisler B, Pezeshkpoor B, Banchev A, Fischer R, Zieger B, Scholz U, Rühl H, Kemkes-Matthes B, Schmitt U, Redlich A, Unal S, Laws HJ, Olivieri M, Oldenburg J, Pavlova A. Familial Multiple Coagulation Factor Deficiencies (FMCFDs) in a Large Cohort of Patients-A Single-Center Experience in Genetic Diagnosis. J Clin Med 2021; 10:jcm10020347. [PMID: 33477601 PMCID: PMC7831305 DOI: 10.3390/jcm10020347] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 01/05/2021] [Accepted: 01/14/2021] [Indexed: 12/15/2022] Open
Abstract
Background: Familial multiple coagulation factor deficiencies (FMCFDs) are a group of inherited hemostatic disorders with the simultaneous reduction of plasma activity of at least two coagulation factors. As consequence, the type and severity of symptoms and the management of bleeding/thrombotic episodes vary among patients. The aim of this study was to identify the underlying genetic defect in patients with FMCFDs. Methods: Activity levels were collected from the largest cohort of laboratory-diagnosed FMCFD patients described so far. Genetic analysis was performed using next-generation sequencing. Results: In total, 52 FMCFDs resulted from coincidental co-inheritance of single-factor deficiencies. All coagulation factors (except factor XII (FXII)) were involved in different combinations. Factor VII (FVII) deficiency showed the highest prevalence. The second group summarized 21 patients with FMCFDs due to a single-gene defect resulting in combined FV/FVIII deficiency or vitamin K–dependent coagulation factor deficiency. In the third group, nine patients with a combined deficiency of FVII and FX caused by the partial deletion of chromosome 13 were identified. The majority of patients exhibited bleeding symptoms while thrombotic events were uncommon. Conclusions: FMCFDs are heritable abnormalities of hemostasis with a very low population frequency rendering them orphan diseases. A combination of comprehensive screening of residual activities and molecular genetic analysis could avoid under- and misdiagnosis.
Collapse
Affiliation(s)
- Barbara Preisler
- Institute of Experimental Hematology and Transfusion Medicine, University Clinic Bonn, 53127 Bonn, Germany; (B.P.); (B.P.); (H.R.); (J.O.)
| | - Behnaz Pezeshkpoor
- Institute of Experimental Hematology and Transfusion Medicine, University Clinic Bonn, 53127 Bonn, Germany; (B.P.); (B.P.); (H.R.); (J.O.)
| | - Atanas Banchev
- Department of Paediatric Haematology and Oncology, University Hospital “Tzaritza Giovanna—ISUL”, 1527 Sofia, Bulgaria;
| | - Ronald Fischer
- Hemophilia Care Center, SRH Kurpfalzkrankenhaus Heidelberg, 69123 Heidelberg, Germany;
| | - Barbara Zieger
- Department of Pediatrics and Adolescent Medicine, University Medical Center–University of Freiburg, 79106 Freiburg, Germany;
| | - Ute Scholz
- Center of Hemostasis, MVZ Labor Leipzig, 04289 Leipzig, Germany;
| | - Heiko Rühl
- Institute of Experimental Hematology and Transfusion Medicine, University Clinic Bonn, 53127 Bonn, Germany; (B.P.); (B.P.); (H.R.); (J.O.)
| | | | - Ursula Schmitt
- Center of Hemostasis Berlin, 10789 Berlin-Schöneberg, Germany;
| | - Antje Redlich
- Pediatric Oncology Department, Otto von Guericke University Children’s Hospital Magdeburg, 39120 Magdeburg, Germany;
| | - Sule Unal
- Division of Pediatric Hematology Ankara, Hacettepe University, 06100 Ankara, Turkey;
| | - Hans-Jürgen Laws
- Department of Pediatric Oncology, Hematology and Clinical Immunology, University of Duesseldorf, 40225 Duesseldorf, Germany;
| | - Martin Olivieri
- Pediatric Hemostasis and Thrombosis Unit, Department of Pediatrics, Pediatric Hemophilia Centre, Dr. von Hauner Children’s Hospital, University Hospital, LMU Munich, 80337 Munich, Germany;
| | - Johannes Oldenburg
- Institute of Experimental Hematology and Transfusion Medicine, University Clinic Bonn, 53127 Bonn, Germany; (B.P.); (B.P.); (H.R.); (J.O.)
| | - Anna Pavlova
- Institute of Experimental Hematology and Transfusion Medicine, University Clinic Bonn, 53127 Bonn, Germany; (B.P.); (B.P.); (H.R.); (J.O.)
- Correspondence: ; Tel.: +49-228-287-19711
| |
Collapse
|
2
|
Prabhudesai A, Shanbhag S, Mirgal D, Kawankar N, Shetty S. A de novo factor VIII mutation in a haemophilia B family leading to combined deficiency of factor VIII and IX. Haemophilia 2017; 23:e477-e479. [PMID: 28750473 DOI: 10.1111/hae.13307] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2017] [Indexed: 11/28/2022]
Affiliation(s)
- A Prabhudesai
- Department of Haemostasis and Thrombosis, National Institute of Immunohaematology (ICMR), Parel, Mumbai, India
| | - S Shanbhag
- Department of Haemostasis and Thrombosis, National Institute of Immunohaematology (ICMR), Parel, Mumbai, India
| | - D Mirgal
- Department of Haemostasis and Thrombosis, National Institute of Immunohaematology (ICMR), Parel, Mumbai, India
| | - N Kawankar
- Department of Haemostasis and Thrombosis, National Institute of Immunohaematology (ICMR), Parel, Mumbai, India
| | - S Shetty
- Department of Haemostasis and Thrombosis, National Institute of Immunohaematology (ICMR), Parel, Mumbai, India
| |
Collapse
|
3
|
SIDDIQ S, MORSE C, GOODEVE A, PANAYI M, TAIT RC, MUMFORD A. F8 and F9 mutations fail to co-segregate in a family with co-incident haemophilia A and B. Haemophilia 2010; 17:e230-4. [DOI: 10.1111/j.1365-2516.2010.02396.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
4
|
Robson PJ, Mumford AD. Familial multiple coagulation factor deficiencies - chance associations and distinct clinical disorders. Haemophilia 2009; 15:11-9. [PMID: 19149846 DOI: 10.1111/j.1365-2516.2008.01897.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: 11/29/2022]
Abstract
The familial multiple coagulation factor deficiencies (FMCFDs) are a group of rare haemostatic disorders of genetic origin in which there is reduced plasma activity of more than one coagulation factor. FMCFDs may arise from co-incidental inheritance of separate coagulation factor deficiencies or from a single genetic or cytogenetic defect. All the FMCFDs present significant challenges in diagnosis and management yet there is little systematic evidence with which to guide clinical practice. This review summarizes the historical literature that describes the FMCFDs and introduces a refined classification of these disorders. The clinical and laboratory characteristics of the most common FMCFDs are considered in detail.
Collapse
Affiliation(s)
- P J Robson
- Department of Haematology, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | | |
Collapse
|
5
|
Abstract
Inherited bleeding disorders (IBDs) are caused by quantitative and qualitative alterations of either platelets or plasma proteins involved in coagulation and fibrinolysis. Hemophilias are the most frequent IBDs; however, accumulated data from various studies reported that von Willebrand disease (VWD) is the most common cause of IBD, with an increased incidence of platelet function defects, mostly due to the increased rate of consanguinity in some communities. VWD is an inherited disorder of homeostasis due to quantitative or qualitative defect of von Willebrand factor. Data on its epidemiology and impact in developing countries are limited. The objective of this study was to assess the local prevalence of some IBD and establish the clinical and historical variables that are predictive for those bleeding disorders in pediatrics. The study involved 43 children with various bleeding manifestations and 15 age- and sex-matched controls, recruited from the Pediatrics Hematology Clinic at the National Research Centre, Sausan Mubarek children's hospital in Cairo, Egypt and the King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia. Hematological profile included platelet counts and function, prothrombin time, partial thromboplastin time, factor VIII antigen and its activity, factor IX antigen and its activity, von Willebrand factor and its activity assayed with multimeric analysis. A total of 12 (27.9%) children had VWD, 11 (25.5%) had hemophilia A, three (7%) had hemophilia B, seven (16.3%) had platelet dysfunction and 10 (23.3%) had bleeding with undiagnosed cause. Two of the VWD cases had type I, three had type II, four had type III and one case appeared to have type IIM and another to have IIB VWD. Bruising and epistaxis were the main symptoms in all children with VWD The majority of platelet dysfunction disorders were diagnosed as Glanzmann's thrombasthenia. VWD and Glanzmann's thrombasthenia should be considered not uncommon causes of IBDs in children in Egypt and Kingdom of Saudi Arabia. Routine hematological screening should be mandatory in children with positive family history of bruising and bleeding as a predictor for IBD.
Collapse
|
6
|
Current World Literature. Curr Opin Obstet Gynecol 2007; 19:596-605. [DOI: 10.1097/gco.0b013e3282f37e31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|