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Pastoret C, Wahl C, Castet S, Nedelec F, Pontis A, Bayart S, Fest T, Guillet B. Five new F10 variants in hereditary factor x deficiency detected by high-throughput sequencing. Haemophilia 2023; 29:1565-1572. [PMID: 37842794 DOI: 10.1111/hae.14888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 09/17/2023] [Accepted: 10/03/2023] [Indexed: 10/17/2023]
Abstract
INTRODUCTION Factor X deficiency is a rare inherited bleeding disorder. To date, 181 variants are reported in the recently updated F10-gene variant database. AIM This study aimed to describe new F10 variants. METHOD The F10 gene was analysed in 16 consecutive families with FX deficiency by a targeted high-throughput sequencing approach, including F10, F9, F8 genes, and 78 genes dedicated to haematological malignancies. RESULTS We identified 19 variants (17 missense, one nonsense and one frameshift) and two copy number variations. Two patients presenting a combined FVII-FX deficiency showed a loss of one F10 gene copy (del13q34) associated with a missense variant on the remaining allele, leading to a FX:C significantly lower than the FVII:C level and explaining their unusual bleeding history. We reported five novel variants. Three missense variants (p.Glu22Val affecting the signal peptide cleavage site, p.Cys342Tyr removing the disulphide bond between the FX heavy and light chains, and p.Val385Met located in FX peptidase S1 domain) were detected at compound heterozygosis status in three patients with severe bleeding symptoms and FX:C level below 10 IU/dL. Two truncating variants p.Tyr279* and p.Thr434Aspfs*13 leading to an altered FX protein were found at heterozygous state in two patients with mild bleeding history. CONCLUSION This study showed the feasibility and the interest of high-throughput sequencing approach for rare bleeding disorders, enabling the report of F10 gene screening in a 3-weeks delay, suitable for clinical use. The description of five new variants may contribute to a better understanding of the phenotype-genotype correlation in FX deficiency.
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Affiliation(s)
- Cédric Pastoret
- Laboratoire d'Hématologie, Pôle de Biologie, CHU de Rennes, Rennes, France
| | - Clémentine Wahl
- Laboratoire d'Hématologie, Pôle de Biologie, CHU de Rennes, Rennes, France
| | | | - Fabienne Nedelec
- Laboratoire d'Hématologie, Pôle de Biologie, CHU de Rennes, Rennes, France
- CRC-MHC, CHU de Rennes, Rennes, France
| | - Adeline Pontis
- Laboratoire d'Hématologie, Pôle de Biologie, CHU de Rennes, Rennes, France
| | - Sophie Bayart
- Laboratoire d'Hématologie, Pôle de Biologie, CHU de Rennes, Rennes, France
- CRC-MHC, CHU de Rennes, Rennes, France
| | - Thierry Fest
- Laboratoire d'Hématologie, Pôle de Biologie, CHU de Rennes, Rennes, France
| | - Benoît Guillet
- Laboratoire d'Hématologie, Pôle de Biologie, CHU de Rennes, Rennes, France
- CRC-MHC, CHU de Rennes, Rennes, France
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Rennes, France
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Fallah A, Shams M, Agi E, Jazebi M, Baghaipoor MR, Naderi T, Rezvany MR. Genotypes and phenotypes characterization of 17 Iranian patients with inherited factor X deficiency: identification of a novel mutation: Leu487Phe. Blood Coagul Fibrinolysis 2022; 33:75-82. [PMID: 35140190 DOI: 10.1097/mbc.0000000000001101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Factor X deficiency is a rare bleeding disorder that affects almost 1 : 1000 000 people worldwide. It derives from multiple mutational changes in the factor X gene (F10). The main objective of the present study was to determine a consistent correlation between the clinical presentations and causative genotype. The phenotype and genotype of 17 Iranian patients with reduced factor X activity (FX:C) from 14 unrelated families were analyzed to screen factor X gene expression for any possible mutations and function alteration. Analysis of the sequencing results led to the identification of eight different mutations besides a single nucleotide variation. One of the mutations was novel (Leu487Phe) as studied by means of online analysis programs and molecular modeling. Eight patients were homozygote; three were heterozygote, while six out of 17 patients were symptomatic cases without any mutations. The Arg40Thr missense mutation was detected in three patients including two siblings and was associated with severe bleeding symptoms. Also, two patients were identified with Gly262Asp missense mutation which commonly presented with bleeding disorder. Each of the other patients was associated with a unique missense mutation including one novel mutation in which the tentative relation of the mutation to bleeding symptoms is reported. Mutations leading to a FX:C of less than 1% are associated with severe bleeding symptoms confirming the strong correlation between clinical severity and FX:C. The novel Leu487Phe mutation with FX:C of 13% may have possible negative effects on factor X protein function resulting in minor clinical manifestation.
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Affiliation(s)
- Aysan Fallah
- Department of Hematology, Faculty of Allied Medicine, Iran University of Medical Sciences, Tehran
| | - Mahmood Shams
- Department of Laboratory Sciences, Paramedical Faculty, Babol University of Medical Sciences, Babol
| | - Elnaz Agi
- Iranian Comprehensive Hemophilia Care Center, Blood and Viral Disease Research Center
| | - Mohammad Jazebi
- Iranian Comprehensive Hemophilia Care Center, Blood and Viral Disease Research Center
| | - Mohammad R Baghaipoor
- Iranian Comprehensive Hemophilia Care Center, Blood and Viral Disease Research Center
| | - Tohid Naderi
- Department of Laboratory Sciences, Paramedical Faculty, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad R Rezvany
- Department of Hematology, Faculty of Allied Medicine, Iran University of Medical Sciences, Tehran
- Department of Oncology-Pathology, Immune and Gene Therapy Lab, Cancer Center Karolinska (CCK), Karolinska University Hospital Solna and Karolinska Institute, Stockholm, Sweden
- Pediatrics Growth and Development Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
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Characterization of a Missense Mutation in the Catalytic Domain and a Splicing Mutation of Coagulation Factor X Compound Heterozygous in a Chinese Pedigree. Genes (Basel) 2021; 12:genes12101521. [PMID: 34680916 PMCID: PMC8535979 DOI: 10.3390/genes12101521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 09/14/2021] [Accepted: 09/24/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Congenital coagulation factor X (FX) deficiency is a rare bleeding disorder with an incidence of one in one million caused by mutations in the FX-coding gene(F10), leading to abnormal coagulation activity and a tendency for severe hemorrhage. Therefore, identifying mutations in FX is important for diagnosing congenital FX deficiency. Results: Genetic analysis of the proband identified two single-base substitutions: c.794T > C: p.Ile265Thr and c.865 + 5G > A: IVS7 + 5G > A. His FX activity and antigen levels were < 1% and 49.7%, respectively; aPTT and PT were prolonged to 65.3 and 80.5 s, respectively. Bioinformatics analysis predicted the two novel variants to be pathogenic. In-vitro expression study of the missense mutation c.794T > C: p.Ile265Thr showed normal synthesis and secretion. Activation of FXs by RVV, FVII/TF, and FVIII/FIX all showed no obvious difference between the variant and the reference. However, clotting activity by PT and aPTT assays and activity of thrombin generation in a TGA assay all indicated reduced activity of the mutant FX-Ile265Thr compared to FX-WT. Minigene assay showed a normal splicing mode c.865 + 5G > A: IVS7 + 5G > A, which is inconsistent with clinical phenotype. Conclusions: The heterozygous variants c.794T > C: p.Ile265Thr or c.865 + 5G > A: IVS7 + 5G > A indicate mild FX deficiency, but the compound heterozygous mutation of the two causes severe congenital FX deficiency. Genetic analysis of these two mutations may help characterize the bleeding tendency and confirm congenital FX deficiency. In-vitro expression and functional study showed that the low activity of the mutant FX-Ile265Thr is caused by decrease in its enzyme activity rather than self-activation. The minigene assay help us explore possible mechanisms of the splicing mutation. However, more in-depth mechanism research is needed in the future.
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Sharma Pandey A. Case reports of metabolic disorders from Nepal. Mol Genet Metab Rep 2019; 21:100542. [PMID: 31788425 PMCID: PMC6880005 DOI: 10.1016/j.ymgmr.2019.100542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 11/08/2019] [Accepted: 11/11/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The prevalence of metabolic disease in Nepal is largely unknown. Some consideration has been given by the nepalese government for high prevalence of congenital disorders in some populations, but disorders due to enzymatic deficiencies have not been considered as a class of diseases where timely diagnosis and intervention might be possible. No case for these disorders has been made so far, however, findings of many rare metabolic diseases have been reported in literature by the nepalese medical fraternity. METHODS A search for case reports on metabolic disorders listed according to International Classification of Diseases -11 was performed using the google search engine. RESULTS A total of 443 cases have been discovered presented in the literature. This does not include disorders that might be due to lifestyle and behaviour. Most of the reported cases have been identified based on clinical acumen, radiological and histopathological findings. CONCLUSIONS Glucose 6 phosphate dehydrogenase deficiency, Wilson's disease and lysosomal disorders should be considered for early diagnosis through newborn screening along with the acknowledged disorders hypothyroidism and hemoglobinopathies in Nepal. Early intervention in these disorders can significantly reduce morbidity and mortality in infancy.
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Affiliation(s)
- Arti Sharma Pandey
- Department of Biochemistry, Kathmandu Medical College (Basic Sciences), Duwakot, Bhaktapur, Nepal
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Togashi T, Nagaya S, Nagasawa M, Meguro-Horike M, Nogami K, Imai Y, Kuzasa K, Sekiya A, Horike SI, Asakura H, Morishita E. Genetic analysis of a compound heterozygous patient with congenital factor X deficiency and regular replacement therapy with a prothrombin complex concentrate. Int J Hematol 2019; 111:51-56. [PMID: 31667683 DOI: 10.1007/s12185-019-02767-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 10/16/2019] [Accepted: 10/17/2019] [Indexed: 12/19/2022]
Abstract
Congenital factor X (FX) deficiency is a rare bleeding disorder with an incidence of one in one million. The proband, a 2-year-old girl, exhibited easy bruising and a history of umbilical cord bleeding at birth. Prothrombin time (> 40 s) and activated partial thromboplastin time (65.0 s) were prolonged. Marked declines in FX activity (< 1%) and FX antigen levels (5%) were also observed. Genetic analysis of the proband identified two types of single-base substitutions, c.353G>A (p.Gly118Asp) and c.1303G>A (p.Gly435Ser), indicating compound heterozygous congenital FX deficiency. Genetic analysis of family members revealed that her father and older sister (5-year-old) were also heterozygous for p.Gly118Asp, and that her mother was heterozygous for p.Gly435Ser. To improve the bleeding tendency, the proband received regular replacement of 500 units of PPSB-HT, a prothrombin complex concentrate (PCC). Following continued regular replacement of 500 units of PPSB-HT once per week, the proband has exhibited no bleeding tendencies and no new bruises have been observed. There are no previous report of the use of PPSB-HT for regular FX replacement. Regular replacement therapy with PPSB-HT may be an effective method for preventative control of bleeding tendencies in FX deficiency.
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Affiliation(s)
- Tomoki Togashi
- Department of Laboratory Sciences, School of Health Sciences, College of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Satomi Nagaya
- Department of Clinical Laboratory Science, Kanazawa University Graduate School of Medical Science, 5-11-80 Kodatsuno, Kanazawa, 920-0942, Ishikawa, Japan
| | | | | | - Keiji Nogami
- Department of Pediatrics, Nara Medical University Hospital, Kashihara, Nara, Japan
| | - Yuta Imai
- Department of Laboratory Sciences, School of Health Sciences, College of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Kana Kuzasa
- Department of Laboratory Sciences, School of Health Sciences, College of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Akiko Sekiya
- Department of Clinical Laboratory Science, Kanazawa University Graduate School of Medical Science, 5-11-80 Kodatsuno, Kanazawa, 920-0942, Ishikawa, Japan
| | - Shin-Ichi Horike
- Advanced Science Research Center, Kanazawa University, Kanazawa, Japan
| | - Hidesaku Asakura
- Department of Hematology, Kanazawa University Hospital, Kanazawa, Japan
| | - Eriko Morishita
- Department of Clinical Laboratory Science, Kanazawa University Graduate School of Medical Science, 5-11-80 Kodatsuno, Kanazawa, 920-0942, Ishikawa, Japan. .,Department of Hematology, Kanazawa University Hospital, Kanazawa, Japan.
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Genotyping of five Pakistani patients with severe inherited factor X deficiency: identification of two novel mutations. Blood Coagul Fibrinolysis 2018; 29:622-625. [PMID: 30036279 DOI: 10.1097/mbc.0000000000000764] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
: Congenital factor X deficiency is a rare coagulation defect characterized by variable bleeding tendency. The aim of the study was to give a first insight of F10 gene mutations in Pakistani probands. Direct sequencing and/or next-generation sequencing was performed on the coding regions, boundaries and 5' and 3' untranslated regions of the F10 gene in five severe factor X-deficient patients from Pakistan. All patients were born from consanguineous marriages and displayed FX:C levels below 2%. Sequencing revealed five different substitutions, including three previously reported p.Ala15Asp, p.Gly406Ser, and p.Gly420Arg missense variants, and also two novel variants: p.Cys57Arg and p.Gln175*. Though one genotype could not be characterized, we were able to confirm the inherited nature of the defect using familial studies. As the copy number variations were ruled out, we hypothesized the presence of deep intronic mutants that might have escaped detection from sequencing or abnormalities in epigenetic regulation. Three patients presented with severe clinical symptoms, in the early days of life, whereas two presented only with trauma-provoked bleeds and bruises later in life. Those patients with milder forms bore the p.Gly406Ser at the homozygous state and F10 unknown alleles, respectively. F10 mutation spectrum in Pakistan is heterogeneous as seen in other populations. Identification of the F10 mutations is important for genetic counseling and prenatal diagnosis in subsequent pregnancies.
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Synergistic effect of factor VII gene polymorphisms causing mild factor VII deficiency in a case of severe factor X deficiency. Blood Coagul Fibrinolysis 2017; 28:105-106. [PMID: 26919454 DOI: 10.1097/mbc.0000000000000544] [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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Edison E, Konkle BA, Goodeve AC. Genetic analysis of bleeding disorders. Haemophilia 2016; 22 Suppl 5:79-83. [PMID: 27405681 DOI: 10.1111/hae.13024] [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] [Accepted: 06/08/2016] [Indexed: 11/29/2022]
Abstract
Molecular genetic analysis of inherited bleeding disorders has been practised for over 30 years. Technological changes have enabled advances, from analyses using extragenic linked markers to next-generation DNA sequencing and microarray analysis. Two approaches for genetic analysis are described, each suiting their environment. The Christian Medical Centre in Vellore, India, uses conformation-sensitive gel electrophoresis mutation screening of multiplexed PCR products to identify candidate mutations, followed by Sanger sequencing confirmation of variants identified. Specific analyses for F8 intron 1 and 22 inversions are also undertaken. The MyLifeOurFuture US project between the American Thrombosis and Hemostasis Network, the National Hemophilia Foundation, Bloodworks Northwest and Biogen uses molecular inversion probes (MIP) to capture target exons, splice sites plus 5' and 3' sequences and to detect F8 intron 1 and 22 inversions. This allows screening for all F8 and F9 variants in one sequencing run of multiple samples (196 or 392). Sequence variants identified are subsequently confirmed by a diagnostic laboratory. After having identified variants in genes of interest through these processes, a systematic procedure determining their likely pathogenicity should be applied. Several scientific societies have prepared guidelines. Systematic analysis of the available evidence facilitates reproducible scoring of likely pathogenicity. Documentation of frequency in population databases of variant prevalence and in locus-specific mutation databases can provide initial information on likely pathogenicity. Whereas null mutations are often pathogenic, missense and splice site variants often require in silico analyses to predict likely pathogenicity and using an accepted suite of tools can help standardize their documentation.
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Affiliation(s)
- E Edison
- Department of Haematology, Christian Medical College, Vellore, India
| | - B A Konkle
- Bloodworks Northwest and University of Washington, Seattle, WA, USA
| | - A C Goodeve
- Sheffield Diagnostic Genetics Service, Sheffield Children's NHS Foundation Trust, Sheffield, UK.,Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
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Neonatal onset of congenital factor X deficiency: a description of two novel mutations with 6-year follow-up. Blood Coagul Fibrinolysis 2016; 26:679-81. [PMID: 26083982 DOI: 10.1097/mbc.0000000000000305] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Factor X congenital deficiency is a rare coagulation disorder involving autosomal recessive transmission. The clinical situation depends on the extent of the defect and may appear at any age. We report a case of a term newborn who developed a life-threatening bleeding event on the first day of life because of a Factor X (FX) deficiency. Fresh frozen plasma and FX intravenous replacement therapy were administered with normalization of the coagulation test. Genetic analysis identified two novel mutations (c.517G>T; c.139delG) in heterozygous state in the proband that were confirmed in the parents. We also describe a 6-year follow-up during which the patient has been administered prophylactic replacement therapy. The description of these two novel mutations and the long clinical follow-up help to increase our knowledge of the genotype-phenotype correlation of congenital FX deficiency, and provide information on better ways of managing the replacement therapy in patients with similar mutations.
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10
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Kulkarni BP, Nair SB, Vijapurkar M, Mota L, Shanbhag S, Ali S, Shetty SD, Ghosh K. Molecular pathology of rare bleeding disorders (RBDs) in India: a systematic review. PLoS One 2014; 9:e108683. [PMID: 25275492 PMCID: PMC4183524 DOI: 10.1371/journal.pone.0108683] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Accepted: 09/02/2014] [Indexed: 11/20/2022] Open
Abstract
Background Though rare in occurrence, patients with rare bleeding disorders (RBDs) are highly heterogeneous and may manifest with severe bleeding diathesis. Due to the high rate of consanguinity in many caste groups, these autosomal recessive bleeding disorders which are of rare occurrence in populations across the world, may not be as rare in India. Objectives To comprehensively analyze the frequency and nature of mutations in Indian patients with RBDs. Methods Pubmed search was used (www.pubmed.com) to explore the published literature from India on RBDs using the key words “rare bleeding disorders”, “mutations”, “India”, “fibrinogen”, “afibrinogenemia”, “factor II deficiency”, “prothrombin” “factor VII deficiency”, “factor V deficiency”, “factor X deficiency”, “factor XI deficiency”, “combined factor V and VIII deficiency”, “factor XIII deficiency”, “Bernard Soulier syndrome” and “Glanzmanns thrombasthenia” in different combinations. A total of 60 relevant articles could be retrieved. The distribution of mutations from India was compared with that of the world literature by referring to the Human Gene Mutation Database (HGMD) (www.hgmd.org). Results Taken together, 181 mutations in 270 patients with different RBDs have been reported from India. Though the types of mutations reported from India and their percentage distribution with respect to the world data are largely similar, yet much higher percentage of small deletions, duplication mutations, insertions, indels were observed in this analysis. Besides the identification of novel mutations and polymorphisms, several common mutations have also been reported, which will allow to develop a strategy for mutation screening in Indian patients with RBDs. Conclusion There is a need for a consortium of Institutions working on the molecular pathology of RBDs in India. This will facilitate a quicker and cheaper diagnosis of RBDs besides its utility in first trimester prenatal diagnosis of the affected families.
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Affiliation(s)
- Bipin P Kulkarni
- National Institute of Immunohaematology (I.C.M.R.), MS Building, KEM Hospital campus, Parel, Mumbai, India
| | - Sona B Nair
- National Institute of Immunohaematology (I.C.M.R.), MS Building, KEM Hospital campus, Parel, Mumbai, India
| | - Manasi Vijapurkar
- National Institute of Immunohaematology (I.C.M.R.), MS Building, KEM Hospital campus, Parel, Mumbai, India
| | - Leenam Mota
- National Institute of Immunohaematology (I.C.M.R.), MS Building, KEM Hospital campus, Parel, Mumbai, India
| | - Sharda Shanbhag
- National Institute of Immunohaematology (I.C.M.R.), MS Building, KEM Hospital campus, Parel, Mumbai, India
| | - Shehnaz Ali
- National Institute of Immunohaematology (I.C.M.R.), MS Building, KEM Hospital campus, Parel, Mumbai, India
| | - Shrimati D Shetty
- National Institute of Immunohaematology (I.C.M.R.), MS Building, KEM Hospital campus, Parel, Mumbai, India
| | - Kanjaksha Ghosh
- National Institute of Immunohaematology (I.C.M.R.), MS Building, KEM Hospital campus, Parel, Mumbai, India
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Senapati J, Devasia AJ, David S, Manipadam MT, Nair S, Jayandharan GR, George B. Diffuse large B cell lymphoma in wiskott-Aldrich syndrome: a case report and review of literature. Indian J Hematol Blood Transfus 2014; 30:309-13. [PMID: 25332606 DOI: 10.1007/s12288-014-0377-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Accepted: 03/21/2014] [Indexed: 11/25/2022] Open
Abstract
Wiskott-Aldrich syndrome (WAS) is an X linked rare primary immunodeficiency syndrome with an increased propensity for infection, autoimmunity and malignancy. Here we report a male child, who was diagnosed with WAS at 1 year of age following evaluation for symptomatic thrombocytopenia and eczematous skin lesions. He presented later with lymphadenopathy, which was consistent with diffuse large B cell lymphoma on histopathology. He received 6 cycles of R-CHOP chemotherapy for the same and is presently in remission after 6 months. We review the major publications of lymphoma in WAS and discuss the pathological findings, treatment and prognosis of lymphoma in WAS.
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Affiliation(s)
- Jayastu Senapati
- Department of Clinical Haematology, Christian Medical College and Hospital, Vellore, 632004 India
| | - Anup J Devasia
- Department of Clinical Haematology, Christian Medical College and Hospital, Vellore, 632004 India
| | - Sachin David
- Department of Clinical Haematology, Christian Medical College and Hospital, Vellore, 632004 India
| | - Marie Therese Manipadam
- Department of General Pathology, Christian Medical College and Hospital, Vellore, 632004 India
| | - Sheila Nair
- Department of General Pathology, Christian Medical College and Hospital, Vellore, 632004 India
| | - Giridhara R Jayandharan
- Department of Clinical Haematology, Christian Medical College and Hospital, Vellore, 632004 India
| | - Biju George
- Department of Clinical Haematology, Christian Medical College and Hospital, Vellore, 632004 India
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Girolami A, Allemand E, Scandellari R, Lombardi AM, Girolami B. The clinical and laboratory significance of cases of congenital FX deficiency due to defects in the Gla-domain. Hematology 2013; 14:177-81. [DOI: 10.1179/102453309x426173] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Affiliation(s)
- Antonio Girolami
- University of Padua Medical School Department of Medical and Surgical Sciences, North Eastern Italy Association for the Study of Coagulation Disorders, Padua, Italy
| | - Emanuele Allemand
- University of Padua Medical School Department of Medical and Surgical Sciences, North Eastern Italy Association for the Study of Coagulation Disorders, Padua, Italy
| | - Raffaella Scandellari
- University of Padua Medical School Department of Medical and Surgical Sciences, North Eastern Italy Association for the Study of Coagulation Disorders, Padua, Italy
| | - Anna Maria Lombardi
- University of Padua Medical School Department of Medical and Surgical Sciences, North Eastern Italy Association for the Study of Coagulation Disorders, Padua, Italy
| | - Bruno Girolami
- University of Padua Medical School Department of Medical and Surgical Sciences, North Eastern Italy Association for the Study of Coagulation Disorders, Padua, Italy
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Sumitha E, Jayandharan GR, Arora N, Abraham A, David S, Devi GS, Shenbagapriya P, Nair SC, George B, Mathews V, Chandy M, Viswabandya A, Srivastava A. Molecular basis of quantitative fibrinogen disorders in 27 patients from India. Haemophilia 2013; 19:611-8. [DOI: 10.1111/hae.12143] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2013] [Indexed: 11/30/2022]
Affiliation(s)
- E. Sumitha
- Departments of Hematology; Christian Medical College; Vellore; India
| | - G. R. Jayandharan
- Departments of Hematology; Christian Medical College; Vellore; India
| | - N. Arora
- Departments of Hematology; Christian Medical College; Vellore; India
| | - A. Abraham
- Departments of Hematology; Christian Medical College; Vellore; India
| | - S. David
- Departments of Hematology; Christian Medical College; Vellore; India
| | - G. S. Devi
- Departments of Hematology; Christian Medical College; Vellore; India
| | - P. Shenbagapriya
- Departments of Immunohematology and Transfusion Medicine; Christian Medical College; Vellore; India
| | - S. C. Nair
- Departments of Immunohematology and Transfusion Medicine; Christian Medical College; Vellore; India
| | - B. George
- Departments of Hematology; Christian Medical College; Vellore; India
| | - V. Mathews
- Departments of Hematology; Christian Medical College; Vellore; India
| | - M. Chandy
- Departments of Hematology; Christian Medical College; Vellore; India
| | - A. Viswabandya
- Departments of Hematology; Christian Medical College; Vellore; India
| | - A. Srivastava
- Departments of Hematology; Christian Medical College; Vellore; India
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Congenital sucrase-isomaltase deficiency: heterogeneity of inheritance, trafficking, and function of an intestinal enzyme complex. J Pediatr Gastroenterol Nutr 2012; 55 Suppl 2:S13-20. [PMID: 23103643 DOI: 10.1097/01.mpg.0000421402.57633.4b] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
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15
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David S, Jayandharan GR, Abraham A, Jacob RR, Devi GS, Patkar N, Shaji RV, Nair SC, Viswabandya A, Ahmed R, George B, Mathews V, Chandy M, Srivastava A. Molecular basis of Wiskott-Aldrich syndrome in patients from India. Eur J Haematol 2012; 89:356-60. [PMID: 22679904 DOI: 10.1111/j.1600-0609.2012.01818.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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VISWABANDYA A, BAIDYA S, NAIR SC, ABRAHAM A, GEORGE B, MATHEWS V, CHANDY M, SRIVASTAVA A. Correlating clinical manifestations with factor levels in rare bleeding disorders: a report from Southern India. Haemophilia 2012; 18:e195-200. [DOI: 10.1111/j.1365-2516.2011.02730.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Severe factor X deficiency in three unrelated Palestinian patients is caused by homozygosity for the mutation c302delG-correlation with thrombin generation and thromboelastometry. Blood Coagul Fibrinolysis 2011; 22:673-9. [DOI: 10.1097/mbc.0b013e32834ad785] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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18
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Ghosh K, Ghosh K, Shetty S. Hemostasis research in India: past, present, and future. Clin Appl Thromb Hemost 2011; 18:128-33. [PMID: 21890571 DOI: 10.1177/1076029611418965] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Hemostasis research in India has a long history considering the fact that it is one of the youngest specialities in the world. If we take creation of prothrombin time (PT) test as one of the beginning of modern hemostsis research, then the specialty is no older than 60 years. School of Tropical Medicine Kolkata, Banaras Hindu University, All India Institute of Medical Sciences at Delhi, Christian Medical College at Vellore, Post Graduate Institute of Medical Education and Research at Chandigarh, and KEM Hospital at Mumbai contributed substantially in defining various bleeding disorders in our country. Unfortunately, some of these institutes are no longer as active in the field as they used to be. Currently, the Institute of Immunohaematology at Mumbai, Chrstian medical College at Vellore, and All India Institute of Medical Sciences at Delhi are actively engaged in hemostsis research in India. Developing prenatal diagnostic technologies, mutation detection of various hemostatic disorders, developing low-cost management technologies for hemophilia, and other bleeding disorders are becoming important present day research activity in the area of hemostasis in addition to age old areas of prevalence and unusual case description studies. Entry of many new corporate hospitals, development of structured postgraduate training program in hematology, and easy availability of instruments and reagents are likely to foster further growth in this area of medical research in India in future.
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Affiliation(s)
- Kanjaksha Ghosh
- National Institute of Immunohaematology, KEM Hospital Campus, Mumbai, India.
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Sumitha E, Jayandharan GR, David S, Jacob RR, Sankari Devi G, Bargavi B, Shenbagapriya S, Nair SC, Abraham A, George B, Viswabandya A, Mathews V, Chandy M, Srivastava A. Molecular basis of Bernard-Soulier syndrome in 27 patients from India. J Thromb Haemost 2011; 9:1590-8. [PMID: 21699652 DOI: 10.1111/j.1538-7836.2011.04417.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Bernard-Soulier syndrome (BSS) is an extremely rare (1:1 million) bleeding disorder of platelet adhesion, caused by defects in the glycoprotein (GP)Ib/IX/V complex. PATIENTS AND METHODS The diagnosis in 27 patients was based on low platelet count, presence of giant platelets and aggregometry studies. Flow cytometry to assess the surface GPIb/IX/V complex showed reduced (7.7-57%) expression. gDNA was screened for mutations in the GPIBA, GPIBB, GP9 genes using PCR-conformation sensitive gel electrophoresis (CSGE). RESULTS Thirteen different disease-causing mutations, including missense (54%), frameshifts (38%) and nonsense (8%) mutations, were identified in 27 patients. Eleven of them were novel including five novel frameshifts (GPIbα: p.Gln97_98fsX113, p.Pro402_403fsX52; GPIbβ: p.Arg17fsX14; GPIX: p.Gly24fsX43, p. Pro130fs, a nonsense mutation (GPIX, p.94, Gln>X) and five novel missense mutations (GPIbα: p.492, Tyr>His; GPIbβ: p.65, Pro>Arg, p.129, Gln>His, p.132, Leu>Pro; GPIX: p.55, Phe>Cys). Interestingly, four common mutations, Cys8Arg (n = 6) and Phe55Ser (n = 2), Phe55Cys (n = 2) in GPIX and a novel 22-bp deletion in the GPIBB gene predicting p.Arg17fsX 14 (n = 10) were seen in 20 patients. CONCLUSION The molecular data presented here is the largest series of BSS patients to be reported so far, adding significantly to the mutation database of this condition and also useful for its genetic diagnosis in India.
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Affiliation(s)
- E Sumitha
- Department of Hematology, Christian Medical College, Vellore, Tamil Nadu, India
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20
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Ghosh K. Haematology research in India: past, present and future. Indian J Hematol Blood Transfus 2011; 27:55-64. [PMID: 22654293 PMCID: PMC3136671 DOI: 10.1007/s12288-011-0062-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2008] [Accepted: 03/21/2011] [Indexed: 10/18/2022] Open
Abstract
Haematology research in India is relatively recent in origin. However the pioneers in the field not only did exemplary work when compared to advanced western countries, they also made it a point to develop centres of excellence and human resources for future of haematology work in this country. In this brief overview an effort has been made to give a taste of quality and expanse of haematology research in this country. This review does not claim to have described every bit of haematology research in this country. Our pioneers worked under extremely difficult and trying circumstances on a subject which was limited to funding available from Indian Council of Medical Research. Now the times have changed, several funding agencies in the country are able to provide substantial fund for research. Modern state of the art basic research institutions are tying up with medical colleges for good quality research and the seeds which our pioneers had planted have grown into a mighty tree. It would not be an exaggeration to say we are on the threshold of the golden era of haematology research in this country.
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Affiliation(s)
- Kanjaksha Ghosh
- National Institute of Immunohaematology, 13th Fl KEM Hospital, Parel, Mumbai, 400012 India
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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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Alfalah M, Keiser M, Leeb T, Zimmer KP, Naim HY. Compound heterozygous mutations affect protein folding and function in patients with congenital sucrase-isomaltase deficiency. Gastroenterology 2009; 136:883-92. [PMID: 19121318 DOI: 10.1053/j.gastro.2008.11.038] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2008] [Revised: 10/31/2008] [Accepted: 11/13/2008] [Indexed: 12/30/2022]
Abstract
BACKGROUND & AIMS Congenital sucrase-isomaltase (SI) deficiency is an autosomal-recessive intestinal disorder characterized by a drastic reduction or absence of sucrase and isomaltase activities. Previous studies have indicated that single mutations underlie individual phenotypes of the disease. We investigated whether compound heterozygous mutations, observed in some patients, have a role in disease pathogenesis. METHODS We introduced mutations into the SI complementary DNA that resulted in the amino acid substitutions V577G and G1073D (heterozygous mutations found in one group of patients) or C1229Y and F1745C (heterozygous mutations found in another group). The mutant genes were expressed transiently, alone or in combination, in COS cells and the effects were assessed at the protein, structural, and subcellular levels. RESULTS The mutants SI-V577G, SI-G1073D, and SI-F1745C were misfolded and could not exit the endoplasmic reticulum, whereas SI-C1229Y was transported only to the Golgi apparatus. Co-expression of mutants found on each SI allele in patients did not alter the protein's biosynthetic features or improve its enzymatic activity. Importantly, the mutations C1229Y and F1745C, which lie in the sucrase domains of SI, prevented its targeting to the cell's apical membrane but did not affect protein folding or isomaltase activity. CONCLUSIONS Compound heterozygosity is a novel pathogenic mechanism of congenital SI deficiency. The effects of mutations in the sucrase domain of SIC1229Y and SIF1745C indicate the importance of a direct interaction between isomaltase and sucrose and the role of sucrose as an intermolecular chaperone in the intracellular transport of SI.
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Affiliation(s)
- Marwan Alfalah
- Department of Physiological Chemistry, University of Veterinary Medicine, Hannover, Germany
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Abstract
The rapidly developing countries of Asia are witnessing substantial progress in the awareness of bleeding and thrombotic disorders as important health care problems. It has been thought for a long time that venous thromboembolism is very rare in Asia. Recent large studies that involved the majority of Asian countries demonstrated that this is not true, so that the practice of not using thromboprophylaxis in high-risk medical and surgical cases should be abandoned. The management of hemophilia and allied coagulation disorders has also dramatically improved in several Asian countries, due to the increased availability of blood products for replacement therapy coupled with the leadership role exerted by a few charismatic physicians, particularly in India and Thailand. As to the future, countries such as China and India have the capacity and expertise in biotechnology to consider the production of recombinant factors and gene transfer as the best strategies to tackle the management of persons with hemophilia in these densely populated and huge countries.
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Affiliation(s)
- P M Mannucci
- Angelo Bianchi Bonomi Hemophilia, Thrombosis Center, Department of Medicine and Medical Specialties, University of Milan and IRCCS Maggiore Hospital, Mangiagalli and Regina Elena Foundation, Milan, Italy.
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Akhavan S, Chafa O, Obame FN, Torchet MF, Reghis A, Fischer AM, Tapon-Bretaudière J. Recurrence of a Phe31Ser mutation in the Gla domain of blood coagulation factor X, in unrelated Algerian families: a founder effect? Eur J Haematol 2007; 78:405-9. [PMID: 17391309 DOI: 10.1111/j.1600-0609.2007.00836.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The presence of gene lesions in blood coagulation factor X (FX) was investigated in eight FX-deficient patients with severe bleeding symptoms, originating from five unrelated Algerian families (FX coagulant activity <1%, FX antigen ranging from 2% to 16%). A missense mutation (p.Phe31Ser) in the Gla domain was found in homozygous form for all patients but one, who is a compound heterozygote for the Phe31Ser mutation and for a non-sense mutation, Tyr130Term in EGF-2 domain. The haplotypes of FX alleles were determined by the following allelic variants located in the promoter: g.1323_1330delTTGTGA (A1/A2), g.1449T>C, g.1451C>A, upstream to exon 3: g.17257C>T and downstream to exon 3: g.17396A>C. The A1-C-A-T-C haplotype was found on each allele bearing the Phe31Ser mutation in the eight FX deficient patients contrasting with its low frequency (8%) in a control Algerian population (in which the Phe31Ser substitution was absent). The patients came from the same geographical area of Algeria (5/8 are certainly from Kabyle origin) and the haplotype analysis suggests a founder effect. Transient expression study reveals that, for the mutant FX-Phe31Ser, FX antigen level was 60% in conditioned media and 140% in cell lysates compared with the wild type FX. The partial retention and intracellular accumulation of the mutant FX might be due to impaired folding and/or conformational changes, and the discrepancies observed between the FX antigen level in COS-7 cell supernatant (60%) and in the patients plasma (2-16%) to an in vivo increased clearance of the secreted unstable FX mutant.
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