Qiao Yingli, Zhang Qisi, Xu Poshi, Deng Yuhui
Department of Laboratory Medicine, Henan Provincial People s Hospital, Department of Laboratory Medicine of Central China Fuwai Hospital, Central China Fuwai Hospital of Zhengzhou University, No. 1 Fuwai Road, Zhengzhou, Henan, 450003, China.
Open Med (Wars). 2020 Aug 3;15(1):769-773. doi: 10.1515/med-2020-0214. eCollection 2020.
Congenital dysfibrinogenemia (CD) is a rare hereditary fibrinogen disorder characterized by normal fibrinogen antigen levels associated with lower functional activities. The aim of this study is to analyze the phenotype and genotype of a family of CD. Routine coagulation screening tests were performed on the proband, her parents, and her grandparents. Then, the purified genomic DNA extracted from peripheral blood was amplified by PCR, and Sanger sequencing was performed to further confirm the mutation. The prothrombin time and activated partial thromboplastin time of the proband were normal, thrombin time prolonged, and the activity of fibrinogen (Fg:Ac) decreased significantly, but fibrinogen antigen (Fg:Ag) level was normal. The coagulation function indices of the proband's father and grandfather were similar to her, and the indices of her mother and grandmother were normal. Sequencing results showed that the proband had a heterozygous missense mutation in FGA gene c.92G > A, which caused the mutation of amino acid 31 from glycine to glutamic acid (p.Gly31Glu). Her father had the same heterozygous mutation. In conclusion, the proband suffered from CD. The change of Gly31Glu in A chain due to the c.92G > A heterozygous missense mutation in the FGA gene is the cause of CD in the family. To the best of our knowledge, the mutation site is new and first reported so far.
先天性纤维蛋白原异常血症(CD)是一种罕见的遗传性纤维蛋白原疾病,其特征是纤维蛋白原抗原水平正常但功能活性较低。本研究旨在分析一个先天性纤维蛋白原异常血症家系的表型和基因型。对先证者、其父母及祖父母进行常规凝血筛查试验。然后,提取外周血中的纯化基因组DNA,通过聚合酶链反应(PCR)进行扩增,并进行桑格测序以进一步确认突变。先证者的凝血酶原时间和活化部分凝血活酶时间正常,凝血酶时间延长,纤维蛋白原活性(Fg:Ac)显著降低,但纤维蛋白原抗原(Fg:Ag)水平正常。先证者的父亲和祖父的凝血功能指标与她相似,而她的母亲和祖母的指标正常。测序结果显示,先证者的FGA基因c.92G>A存在杂合错义突变,导致第31位氨基酸由甘氨酸突变为谷氨酸(p.Gly31Glu)。她的父亲也有相同的杂合突变。综上所述,先证者患有先天性纤维蛋白原异常血症。FGA基因c.92G>A杂合错义突变导致A链中Gly31Glu的改变是该家系先天性纤维蛋白原异常血症的病因。据我们所知,该突变位点是新的,迄今为止首次报道。