Xu Ming-Li, Qin Jia-Chun, Chen Bi-Yan, Yang Xue-Xi, Liu Hai-Ping, Yuan Wei-Xi, Zhong Jian-Mei, Huang Li-Min, Zhou Wan-Jun
Department of Medical Genetics, School of Basic Medical Sciences, Southern Medical University, Guangzhou, Guangdong Province, People's Republic of China.
Department of Genetic Metabolism, Prenatal Diagnostic Center, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, People's Republic of China.
Hemoglobin. 2020 Jul;44(4):259-263. doi: 10.1080/03630269.2020.1790385. Epub 2020 Jul 10.
Thalassemia is the most common monogenic disorder around the world. Based on the principle of genotype-phenotype correlation, identification of thalassemia mutations is the essential prerequisite for clinical diagnosis and management. Because only common mutations are routinely detected, the identification of rare or undetermined mutations is a challenge for clinical laboratories. Herein, a proband presenting with inconsistent phenotype-genotype correlation after routine molecular screening was investigated by multiplex ligation-dependent probe amplification (MLPA), targeted-next generation sequencing (targeted-NGS), gap-polymerase chain reaction (gap-PCR) and Sanger sequencing. Eventually, a novel 71.8 kb deletion (- -) was identified and characterized, which included (ζ), (α2), and (α1) genes and was causing α-thalassemia (α-thal). Furthermore, we summarized a practical procedure based on accumulated experience in studies and clinical practice, which can be a guide for molecular screening and clinical diagnosis of thalassemia, especially for identification of undetermined or novel mutations.
地中海贫血是全球最常见的单基因疾病。基于基因型-表型相关性的原则,鉴定地中海贫血突变是临床诊断和管理的必要前提。由于通常仅检测常见突变,因此鉴定罕见或未确定的突变对临床实验室来说是一项挑战。在此,通过多重连接依赖探针扩增(MLPA)、靶向新一代测序(targeted-NGS)、缺口聚合酶链反应(gap-PCR)和桑格测序,对一名在常规分子筛查后出现表型-基因型相关性不一致的先证者进行了研究。最终,鉴定并表征了一个新的71.8 kb缺失(--),其包含ζ、α2和α1基因,并导致α地中海贫血(α-thal)。此外,我们根据研究和临床实践中的积累经验总结了一个实用流程,可为地中海贫血的分子筛查和临床诊断提供指导,特别是用于鉴定未确定或新的突变。