Zhang D L, Xue F, Dou X Q, Liu X F, Fu R F, Chen Y F, Liu W, Jia Y J, Wang Y H, Xiao Z J, Zhang L, Yang R C
State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China.
Zhonghua Xue Ye Xue Za Zhi. 2021 Apr 14;42(4):302-307. doi: 10.3760/cma.j.issn.0253-2727.2021.04.006.
To analyze the clinical phenotype and molecular pathogenesis of nine patients with hereditary factor Ⅴ (FⅤ) deficiency. Nine patients with hereditary FⅤ deficiency who were admitted to the Institute of Hematology and Blood Diseases Hospital from April 1999 to September 2019 were analyzed. The activated partial thromboplastin time, prothrombin time, and FⅤ procoagulant activity (FⅤ∶C) were measured for phenotypic diagnosis. High-throughput sequencing was employed for the F5 gene mutation screening, Sanger sequencing was adopted to confirm candidate variants and parental carrying status, Swiss-model was used for three-dimensional structure analysis, and ClustalX v.2.1 was used for homologous analysis. The FⅤ∶C of the nine patients ranged from 0.1 to 10.6. Among them, eight had a hemorrhage history, with kin/mucosal bleeding as the most common symptom (three cases, 37.5%) , whereas one case had no bleeding symptom. There were five homozygotes and four compound heterozygotes. A total of 12 pathogenic or likely pathogenic mutations were detected, of which c.6100C>A/p.Pro2034Thr, c.6575T>C/p.Phe2192Ser, c.1600_1601delinsTG/p. Gln534*, c.4713C>A/p.Tyr1571*, and c.952+5G>C were reported for the first time. The newly discovered gene mutations enriched the F5 gene mutation spectrum associated with hereditary FⅤ deficiency. High-throughput sequencing could be an effective method to detect F5 gene mutations.
分析9例遗传性因子Ⅴ(FⅤ)缺乏症患者的临床表型及分子发病机制。对1999年4月至2019年9月在血液学和血液疾病研究所住院的9例遗传性FⅤ缺乏症患者进行分析。检测活化部分凝血活酶时间、凝血酶原时间及FⅤ促凝活性(FⅤ∶C)以进行表型诊断。采用高通量测序进行F5基因突变筛查,采用Sanger测序确认候选变异及父母携带状态,使用Swiss-模型进行三维结构分析,使用ClustalX v.2.1进行同源性分析。9例患者的FⅤ∶C范围为0.1至10.6。其中,8例有出血史,以皮肤/黏膜出血最为常见(3例,37.5%),而1例无出血症状。有5例纯合子和4例复合杂合子。共检测到12个致病性或可能致病性突变,其中c.6100C>A/p.Pro2034Thr、c.6575T>C/p.Phe2192Ser、c.1600_1601delinsTG/p.Gln534*、c.4713C>A/p.Tyr1571*和c.952+5G>C为首次报道。新发现的基因突变丰富了与遗传性FⅤ缺乏症相关的F5基因突变谱。高通量测序可能是检测F5基因突变的有效方法。