1 Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands.
2 Sanquin Diagnostic Services, Amsterdam, the Netherlands.
Lupus. 2019 Sep;28(10):1255-1260. doi: 10.1177/0961203319865029. Epub 2019 Jul 29.
C1q is an essential part of the classical pathway of complement activation. Genetic deficiencies, caused by homozygous mutations in one of the C1q genes, are rare and are strongly associated with development of systemic lupus erythematosus (SLE). Here we describe a C1q-deficient patient with a compound heterozygous mutation.
Serum was analysed with enzyme-linked immunosorbent assay (ELISA) and Western blot for the presence of C1q, and DNA and RNA sequencing was performed to identify the mutations and confirm that these were located on different chromosomes.
The medical history of the patient includes SLE diagnosis at age 11 years with cerebral involvement at age 13, various infections, osteonecrosis and hemophagocytic syndrome. Using ELISA and Western blot, we confirmed the absence of C1q in the serum of the patient. Using DNA sequencing, two mutations in the gene were identified: c.100G > A p.(Gly34Arg) and c.205C > T p.(Arg69X). With RNA sequencing we confirmed that the mutations are located on different chromosomes.
The patient described in this case report has a compound heterozygous mutation in resulting in C1q deficiency.
C1q 是补体经典激活途径的重要组成部分。由于 C1q 基因之一的纯合突变引起的遗传缺陷非常罕见,并且与系统性红斑狼疮(SLE)的发展密切相关。在这里,我们描述了一位 C1q 缺乏的患者,他存在复合杂合突变。
通过酶联免疫吸附测定(ELISA)和 Western blot 分析血清中 C1q 的存在情况,并进行 DNA 和 RNA 测序以鉴定突变并确认这些突变位于不同的染色体上。
该患者的病史包括 11 岁时被诊断为 SLE,13 岁时出现脑受累,以及各种感染、骨坏死和噬血细胞综合征。使用 ELISA 和 Western blot,我们确认了患者血清中 C1q 的缺失。通过 DNA 测序,在 基因中发现了两个突变:c.100G > A p.(Gly34Arg) 和 c.205C > T p.(Arg69X)。通过 RNA 测序,我们证实了突变位于不同的染色体上。
本病例报告中描述的患者存在 基因的复合杂合突变,导致 C1q 缺乏。