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[两个遗传性凝血因子Ⅺ缺乏家系的表型与基因型分析]

[Phenotype and Genotype Analysis in Two Pedigrees with Hereditary Coagulation Factor Ⅺ Deficiency].

作者信息

Weng Miao-Shan, Lin Fen, Zhang Jin-Can, Wu Jiao-Ren, Yu Xue-Mei, Yang Li-Ye

机构信息

Clinical Laboratory, Chaozhou Central Hospital Affiliated to Southern Medical University, Chaozhou 521000, China.

Central Laboratory, Chaozhou Central Hospital Affiliated to Southern Medical University, Chaozhou 521000, China.

出版信息

Sichuan Da Xue Xue Bao Yi Xue Ban. 2020 Mar;51(2):252-256. doi: 10.12182/20200360601.

Abstract

OBJECTIVE

To analyze the phenotype and genotype in two pedigrees with hereditary coagulation factor Ⅺ (FⅪ) deficiency, and investigate the molecular mechanisms of FⅪ deficiency.

METHODS

Two patients with hereditary coagulation FⅪ deficiency were admitted to Chaozhou Central Hospital in Nov 2014 and Jan 2018. The prothrombin time (PT), activated partial thromboplastin time (APTT), FⅪ activity (FⅪ∶C) and FⅪ antigen (FⅪ∶Ag) were tested for phenotypic diagnosis. All the exons and exon-intron boundaries of FⅪ gene of proband were analyzed by PCR and sequencing. The family members were tested for the mutant site of proband. Then the mRNA of FⅪ in the proband was analyzed with RT-PCR.

RESULTS

The proband-1 was a 7-year-old boy, PT was 10.7 s and APTT was 97.4 s (reference range: 9-12.8 s; 24-40 s), FⅪ∶C (0.6%) and FⅪ∶Ag<1% (reference range: 65%-150%; 72.1%-122.3%). The proband-2 was a 30-year-old female, and showed the PT (11.7 s), APTT (71.3 s), FⅪ∶C (0.7%) and FⅪ∶Ag<1%. FⅧ∶C, FⅨ∶C and FⅫ∶C of two proband were within the normal range. DNA sequencing showed that the proband-1 had a combined mutation of c.326-1G>A and c.1107C>A (p.Tyr351X) in exon 10. His grandmother, mother and brother had a heterozygous splicing mutation of c.326-1G>A, his grandmother and father had a homozygous mutation of c.1107C>A. FXI mRNA was undetected in the proband-1. The proband-2 had a homozygous mutation of c.841C>T (p.Gln263X) in exon 8, and this mutation was also found in her father, mother, daughter and son.

CONCLUSION

The c.326-1G>A, c.1107C>A(p.Tyr351X) and c.841C>T (p.Gln263X) might be the molecular pathogenesis for two probands with hereditary coagulation factor Ⅺ deficiency.

摘要

目的

分析两个遗传性凝血因子Ⅺ(FⅪ)缺乏家系的表型和基因型,探讨FⅪ缺乏的分子机制。

方法

2014年11月和2018年1月,两名遗传性凝血FⅪ缺乏患者入住潮州市中心医院。检测凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、FⅪ活性(FⅪ∶C)和FⅪ抗原(FⅪ∶Ag)进行表型诊断。采用聚合酶链反应(PCR)和测序技术分析先证者FⅪ基因的所有外显子及外显子-内含子边界。对家系成员进行先证者突变位点检测。然后用逆转录-聚合酶链反应(RT-PCR)分析先证者FⅪ的信使核糖核酸(mRNA)。

结果

先证者1为7岁男孩,PT为10.7秒,APTT为97.4秒(参考范围:9 - 12.8秒;24 - 40秒),FⅪ∶C(0.6%),FⅪ∶Ag<1%(参考范围:65% - 150%;72.1% - 122.3%)。先证者2为30岁女性,PT为11.7秒,APTT为71.3秒,FⅪ∶C(0.7%),FⅪ∶Ag<1%。两名先证者的FⅧ∶C、FⅨ∶C和FⅫ∶C均在正常范围内。DNA测序显示,先证者1的第10外显子存在c.326 - 1G>A和c.1107C>A(p.Tyr351X)的复合突变。其祖母、母亲和哥哥存在c.326 - 1G>A的杂合剪接突变,其祖母和父亲存在c.1107C>A的纯合突变。先证者1未检测到FXI mRNA。先证者2的第8外显子存在c.841C>T(p.Gln263X)的纯合突变,其父亲、母亲、女儿和儿子也存在该突变。

结论

c.326 - 1G>A、c.1107C>A(p.Tyr351X)和c.841C>T(p.Gln263X)可能是两名遗传性凝血因子Ⅺ缺乏先证者的分子发病机制。

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