Yan Lulu, Cao Juan, Zhang Yuxin, Li Dongmei, Liu Yingwen, Yang Xiangchun, Li Haibo
Ningbo Women and Children's Hospital, Central Laboratory for Birth Defects Prevention and Control, Ningbo, Zhejiang 315012, China.
Zhonghua Yi Xue Yi Chuan Xue Za Zhi. 2024 Jan 10;41(1):92-95. doi: 10.3760/cma.j.cn511374-20220909-00616.
To explore the genetic basis for a fetus with Cardiac valvular dysplasia type 1 (CVDP1).
A CVDP1 fetus identified at the Ningbo Women and Children's Hospital on July 7, 2022 was selected as the study subject. Clinical data of the fetus was collected. The fetus and its parents were subjected to trio-whole exome sequencing (trio-WES), and candidate variants were verified by Sanger sequencing.
The fetus had exhibited generalized edema, complex cardiac malformation, abdominal effusion, and enhanced intestinal and renal parenchymal echoes. Trio-WES revealed that it has harbored compound heterozygous variants of the PLD1 gene, namely c.2977C>T (p.R993*) and c.1460G>A (p.W487*), which were respectively inherited from its father and mother. Neither variant was reported previously. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), the c.2977C>T (p.R993*) variant was evaluated to be likely pathogenic (PVS1_Moderate+PM2_Supporting+PM3+PP4), whilst the c.1460G>A (p.W487*) variant was evaluated to be pathogenic (PVS1+PM2_Supporting+PP4).
The c.2977C>T (p.R993*) and c.1460G>A (p.W487*) compound heterozygous variants of the PLD1 gene probably underlay the CVDP1 in the fetus. Above discovery has enriched the mutational spectrum of the PLD1 gene and provided a guidance for genetic counseling and prenatal diagnosis in this family.
探究1型心脏瓣膜发育异常(CVDP1)胎儿的遗传基础。
选取2022年7月7日在宁波市妇女儿童医院确诊的1例CVDP1胎儿作为研究对象,收集该胎儿的临床资料。对胎儿及其父母进行三联体全外显子测序(trio-WES),并通过Sanger测序验证候选变异。
该胎儿表现为全身水肿、复杂心脏畸形、腹腔积液以及肠和肾实质回声增强。三联体全外显子测序显示,该胎儿携带PLD1基因的复合杂合变异,即c.2977C>T(p.R993*)和c.1460G>A(p.W487*),分别遗传自其父亲和母亲。此前均未见这两种变异的报道。根据美国医学遗传学与基因组学学会(ACMG)的指南,c.2977C>T(p.R993*)变异被评估为可能致病(PVS1_Moderate+PM2_Supporting+PM3+PP4),而c.1460G>A(p.W487*)变异被评估为致病(PVS1+PM2_Supporting+PP4)。
PLD1基因的c.2977C>T(p.R993*)和c.1460G>A(p.W487*)复合杂合变异可能是该胎儿CVDP1的病因。上述发现丰富了PLD1基因的突变谱,并为该家庭的遗传咨询和产前诊断提供了指导。