Department of Microscopic Morphology, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania.
Department 8 - Medicine of Mother and Child "Grigore T. Popa", University of Medicine and Pharmacy, Iasi, Romania.
Gene. 2020 May 30;741:144565. doi: 10.1016/j.gene.2020.144565. Epub 2020 Mar 10.
Osteogenesis imperfecta (OI) is a rare disease characterized by increased bone fragility and predisposition to fractures, bone deformities and other major signs such as dentinogenesis imperfecta, blue sclera and deafness. Over 90% of OI cases are caused by mutations in the COL1A1 and COL1A2 genes and the inheritance is autosomal dominant.
We present a case of a couple requesting genetic counseling, because the man was diagnosed with OI on a clinical and radiological basis and the woman was pregnant. Whole exomes sequencing (WES) was performed in order to identify the mutation (s), followed by prenatal diagnosis.
WES identified a rare splicing mutation c.1155 + 1G > C in the COL1A1 gene recognized to be pathogenic and subsequently confirmed by next generation sequencing. The carrier state of the mutation was excluded for the fetus, so the pregnancy was further pursued and a healthy baby was born at term.
WES is a new and effective technique for detecting pathogenic variants in monogenic diseases and it is preferable to use such a technique in diseases with genetic heterogeneity especially when time does not allow another time-consuming diagnostic technique such classical Sanger sequencing. WES offers possibility to expand the global spectrum of OI pathogenic variants enabling the diagnosis of the disease.
成骨不全症(OI)是一种罕见的疾病,其特征是骨脆性增加,易发生骨折、骨骼畸形和其他主要症状,如牙本质发育不全、巩膜蓝色和耳聋。超过 90%的 OI 病例是由 COL1A1 和 COL1A2 基因突变引起的,遗传方式为常染色体显性遗传。
我们报告了一对夫妇要求遗传咨询的病例,因为该男子基于临床和影像学诊断为 OI,而该女子怀孕。为了确定突变(s),进行了全外显子组测序(WES),随后进行了产前诊断。
WES 发现 COL1A1 基因中罕见的剪接突变 c.1155+1G>C,被认为是致病性的,并随后通过下一代测序得到证实。排除了胎儿携带该突变的可能性,因此继续妊娠,足月时生下了一个健康的婴儿。
WES 是一种用于检测单基因疾病中致病性变异的新的有效技术,在遗传异质性疾病中,特别是在没有时间进行另一种耗时的诊断技术(如经典的 Sanger 测序)的情况下,最好使用这种技术。WES 提供了扩展 OI 致病性变异全球谱的可能性,从而能够诊断该疾病。