Skrypnyk Cristina, AlHarmi Rawan
Assistant Professor, Molecular Genetics, Princess Al-Jawhara Al-Ibrahim Center for Molecular Medicine, Genetics, and Inherited Disorders and Molecular Medicine Department, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain.
Consultant Medical Geneticist, University Medical Clinics, Manama, Bahrain.
Front Genet. 2024 May 27;15:1400295. doi: 10.3389/fgene.2024.1400295. eCollection 2024.
BACKGROUND: Rare genetic disorders may result in death before a definitive clinical diagnosis is established. AIM: This study aims to outline the processes and challenges in managing, from a genetic perspective, couples who lost children affected by rare genetic disorders. RESULTS: Six couples who experienced child loss due to rare genetic disorders, seen by the primary author at genetic evaluation and counseling sessions, were retrospectively analyzed. Four out of 6 couples reported consanguinity. Exome and genome sequencing were performed for the parents. Carrier status of two rare lethal metabolic disorders was confirmed in one consanguineous couple. Three couples were carriers of 3 other rare diseases. Variants of LYST, MPV17, HEXB, ITGB4, CD3E, ASPM, TK2, COL11A2, and LAMB3 genes were identified. Six out of 10 were pathogenic variants, out of which 4 correlated with the demised children's phenotypes. One couple was negative for pathogenic variants. The last couple did not undergo genetic testing since they were beyond the fertile window. CONCLUSION: Appropriate parental genetic evaluation and counseling are mandatory for selecting the right genetic test to certify the diagnosis , by virtue of molecular autopsy by proxy. Clarifying a rare disorder diagnosis can help couples to avoid recurrence and plan early for their next pregnancies.
背景:罕见遗传病可能在明确临床诊断之前导致死亡。 目的:本研究旨在从遗传学角度概述管理因罕见遗传病失去孩子的夫妇的过程和挑战。 结果:对第一作者在基因评估和咨询会议上见到的6对因罕见遗传病失去孩子的夫妇进行了回顾性分析。6对夫妇中有4对报告有血缘关系。对父母进行了外显子组和基因组测序。在一对有血缘关系的夫妇中证实了两种罕见致命代谢疾病的携带者状态。3对夫妇是其他3种罕见疾病的携带者。鉴定出LYST、MPV17、HEXB、ITGB4、CD3E、ASPM、TK2、COL11A2和LAMB3基因的变异。10个变异中有6个是致病变异,其中4个与死亡儿童的表型相关。一对夫妇的致病变异检测为阴性。最后一对夫妇由于已过生育期未进行基因检测。 结论:通过间接分子尸检选择合适的基因检测以确诊,进行适当的父母基因评估和咨询是必要的。明确罕见病诊断有助于夫妇避免复发并为下次怀孕尽早做好计划。
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