Wong Wai-Yu, Wong Helen, Au Elaine, Chan Eric
Division of Clinical Immunology, Department of Pathology, Queen Mary Hospital, Hong Kong.
Case Rep Genet. 2019 Feb 24;2019:7052062. doi: 10.1155/2019/7052062. eCollection 2019.
We report a heterozygous, 2,009 base pairs (bps) genomic DNA deletion within the gene that has not previously been reported in a case of type I hereditary angioedema (HAE). The patient is a 28-year-old Han Chinese female living in Hong Kong who has suffered from recurrent angioedema since adolescence, with increasing attack frequency as she entered adulthood; in the past, episodes occurred annually, but now occur every two to three months. The affected areas are not itchy and include common sites such as the left and right forearms, but without throat involvement. The patient also experiences epigastric pain. The patient's mother suffers from similar symptoms. A mutation in the serine protease inhibitor, clade G, member 1 () gene is associated with HAE. Patients with HAE type I commonly carry either a small deletion within or a truncated transcript. We performed a multiplex ligation-dependent probe amplification (MLPA) assay on our indexed patient. Our result suggests a 2,009 bps deletion spanning across exons 5 and 6 within . Although earlier literature has described other large DNA deletions encasing exons 5 and 6 in , these DNA rearrangements were larger in size between 4 and 6 kbps, and the breakpoint locations were generally not determined due to technical constraints (Pappalardo et al., 2000; Duponchel et al., 2001; Roche et al., 2005; Loules et al., 2018; and Göwein et al., 2008). Our report describes mapping of this 2,009 bps in . Using a combination of molecular techniques, we were able to confirm and locate this large heterozygous genomic DNA deletion that includes both exons 5 and 6 of .
我们报告了1例I型遗传性血管性水肿(HAE)患者,其基因内存在杂合性2009个碱基对(bps)的基因组DNA缺失,此前未见报道。该患者为一名28岁的中国汉族女性,居住在香港,自青春期起反复出现血管性水肿,成年后发作频率增加;过去每年发作一次,现在每两到三个月发作一次。受累部位无瘙痒,包括左右前臂等常见部位,但无咽喉部受累。患者还伴有上腹部疼痛。患者的母亲也有类似症状。丝氨酸蛋白酶抑制剂G1()基因突变与HAE相关。I型HAE患者通常携带基因内的小缺失或截短转录本。我们对该索引患者进行了多重连接依赖探针扩增(MLPA)检测。结果显示基因内跨越外显子5和6的2009 bps缺失。尽管早期文献描述了基因中包含外显子5和6的其他大DNA缺失,但由于技术限制,这些DNA重排的大小在4至6 kbps之间,且断点位置通常未确定(Pappalardo等人,2000年;Duponchel等人,2001年;Roche等人,2005年;Loules等人,2018年;以及Göwein等人,2008年)。我们的报告描述了该基因中2009 bps缺失的定位。通过结合多种分子技术,我们能够确认并定位这个包含基因外显子5和6的大的杂合基因组DNA缺失。