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Chitlur M, Pipe SW, Reding MT, Kessler CM. Overcoming the diagnostic and monitoring challenges for very rare bleeding disorders in the US: the potential benefits of a centralized laboratory. Haemophilia 2016; 22:15-9. [PMID: 26809835 DOI: 10.1111/hae.12775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2015] [Indexed: 11/28/2022]
Affiliation(s)
- M Chitlur
- Wayne State University, Children's Hospital of Michigan, Detroit, USA
| | - S W Pipe
- University of Michigan, Ann Arbor, MI, USA
| | - M T Reding
- University of Minnesota, Minneapolis, MN, USA
| | - C M Kessler
- Georgetown University Medical Center, Washington, DC, USA
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Sánchez-Guiu I, Antón AI, Padilla J, Velasco F, Lucia JF, Lozano M, Cid AR, Sevivas T, Lopez-Fernandez MF, Vicente V, González-Manchón C, Rivera J, Lozano ML. Functional and molecular characterization of inherited platelet disorders in the Iberian Peninsula: results from a collaborative study. Orphanet J Rare Dis 2014; 9:213. [PMID: 25539746 PMCID: PMC4302577 DOI: 10.1186/s13023-014-0213-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 12/12/2014] [Indexed: 12/02/2022] Open
Abstract
Background The diagnostic evaluation of inherited platelet disorders (IPDs) is complicated and time-consuming, resulting in a relevant number of undiagnosed and incorrectly classified patients. In order to evaluate the spectrum of IPDs in individuals with clinical suspicion of these disorders, and to provide a diagnostic tool to centers not having access to specific platelets studies, we established the project “Functional and Molecular Characterization of Patients with Inherited Platelet Disorders” under the scientific sponsorship of the Spanish Society of Thrombosis and Haemostasis. Patients/methods Subjects were patients from a prospective cohort of individuals referred for clinical suspicion of IPDs as well as healthy controls. Functional studies included light transmission aggregation, flow cytometry, and when indicated, Western-blot analysis of platelet glycoproteins, and clot retraction analysis. Genetic analysis was mainly performed by sequencing of coding regions and proximal regulatory regions of the genes of interest. Results Of the 70 cases referred for study, we functionally and molecularly characterized 12 patients with Glanzmann Thrombasthenia, 8 patients with Bernard Soulier syndrome, and 8 with other forms of IPDs. Twelve novel mutations were identified among these patients. The systematic study of patients revealed that almost one-third of patients had been previously misdiagnosed. Conclusions Our study provides a global picture of the current limitations and access to the diagnosis of IPDs, identifies and confirms new genetic variants that cause these disorders, and emphasizes the need of creating reference centers that can help health care providers in the recognition of these defects.
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Affiliation(s)
- Isabel Sánchez-Guiu
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Arrixaca, Murcia, 30003, Spain.
| | - Ana I Antón
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Arrixaca, Murcia, 30003, Spain.
| | - José Padilla
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Arrixaca, Murcia, 30003, Spain.
| | - Francisco Velasco
- Servicio de Hematología y Hemoterapia, Instituto Maimonides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario, Córdoba, Spain.
| | - José F Lucia
- Servicio Hematología y Hemoterapia, Hospital Universitario Miguel Servet, Zaragoza, Spain.
| | - Miguel Lozano
- Servicio de Hemoterapia y Hemostasia, Hospital Clínico, Barcelona, Spain.
| | - Ana Rosa Cid
- Unidad de Hemostasia y Trombosis, Servicio Hematología y Hemoterapia, Hospital Universitario Politécnico de la Fe, Valencia, Spain.
| | - Teresa Sevivas
- Serviço de Hematologia do Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
| | - María F Lopez-Fernandez
- Servicio Hematología y Hemoterapia, Complejo Hospitalario Universitario A Coruña, La Coruña, Spain.
| | - Vicente Vicente
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Arrixaca, Murcia, 30003, Spain.
| | - Consuelo González-Manchón
- Departament Cellular and Molecular Medicine, Centro de Investigaciones Biológicas (C.S.I.C.),CIBER de Enfermedades Raras, Madrid, Spain.
| | - José Rivera
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Arrixaca, Murcia, 30003, Spain.
| | - María L Lozano
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Arrixaca, Murcia, 30003, Spain.
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Hamamy H, Makrythanasis P, Al-Allawi N, Muhsin AA, Antonarakis SE. Recessive thrombocytopenia likely due to a homozygous pathogenic variant in the FYB gene: case report. BMC MEDICAL GENETICS 2014; 15:135. [PMID: 25516138 PMCID: PMC4411870 DOI: 10.1186/s12881-014-0135-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 12/08/2014] [Indexed: 11/23/2022]
Abstract
Background Inherited thrombocytopenias (IT) are a heterogeneous group of rare diseases characterized by a reduced number of blood platelets. The frequency of IT is probably underestimated because of diagnostic difficulties and because not all the existing forms have as yet been identified, with some patients remaining without a definitive diagnosis. Exome Sequencing has made possible the identification of almost all variants in the coding regions of protein-coding genes, thereby providing the opportunity to identify the disease causing gene in a number of patients with indefinite diagnoses, specifically in consanguineous families. Case presentation Familial thrombocytopenia with small size platelets was present in several members of a highly consanguineous family from Northern Iraq. Genotyping of all affected, their unaffected siblings and parents, followed by exome sequencing revealed a strong candidate loss of function variant in a homozygous state: a frameshift mutation in the FYB gene. The protein encoded by this gene is known to be a cytosolic adaptor molecule expressed by T, natural killer (NK), myeloid cells and platelets, and is involved in platelet activation and controls the expression of interleukin-2. Knock-out mice were reported to show isolated thrombocytopenia. Conclusion Inherited thrombocytopenias differ in their presentation, associated features, and molecular etiologies. An accurate diagnosis is needed to provide appropriate management as well as counseling for the individuals and their family members. Exome sequencing may become a first diagnostic tool to identify the molecular basis of undiagnosed familial IT. In this report, the clinical evaluation combined with the power and efficiency of genomic analysis defined the FYB gene as the possible underlying cause of autosomal recessive thrombocytopenia with small platelet size. This is the first report linking pathogenic variants in FYB and thrombocytopenia in humans.
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Affiliation(s)
- Hanan Hamamy
- Department of Genetic Medicine and Development, University of Geneva, Geneva, Switzerland.
| | - Periklis Makrythanasis
- Department of Genetic Medicine and Development, University of Geneva, Geneva, Switzerland.
| | - Nasir Al-Allawi
- Department of Pathology, College of Medicine, University of Dohuk, Dohuk, Iraq.
| | | | - Stylianos E Antonarakis
- Department of Genetic Medicine and Development, University of Geneva, Geneva, Switzerland. .,Service of Genetic Medicine, University Hospitals of Geneva, Geneva, Switzerland.
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Daly ME, Leo VC, Lowe GC, Watson SP, Morgan NV. What is the role of genetic testing in the investigation of patients with suspected platelet function disorders? Br J Haematol 2014; 165:193-203. [DOI: 10.1111/bjh.12751] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Martina E. Daly
- Department of Cardiovascular Science; University of Sheffield Medical School; University of Sheffield; Sheffield UK
| | - Vincenzo C. Leo
- Department of Cardiovascular Science; University of Sheffield Medical School; University of Sheffield; Sheffield UK
| | - Gillian C. Lowe
- Centre for Cardiovascular Sciences; School of Clinical and Experimental Medicine; College of Medical and Dental Sciences; University of Birmingham; Birmingham UK
| | - Steve P. Watson
- Centre for Cardiovascular Sciences; School of Clinical and Experimental Medicine; College of Medical and Dental Sciences; University of Birmingham; Birmingham UK
| | - Neil V. Morgan
- Centre for Cardiovascular Sciences; School of Clinical and Experimental Medicine; College of Medical and Dental Sciences; University of Birmingham; Birmingham UK
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