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Radic CP, Abelleyro MM, Ziegler B, Marchione VD, Nevado J, Lapunzina P, Sciuccati G, Neme D, Rossetti LC, Bonduel M, De Brasi CD. Haemophilia B, severe childhood obesity and other extra-haematological features associated with similar 4Mb-deletions on Xq27: Clinical findings, molecular insights and literature update. Haemophilia 2023; 29:844-854. [PMID: 36930806 DOI: 10.1111/hae.14779] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 02/28/2023] [Accepted: 03/02/2023] [Indexed: 03/19/2023]
Abstract
INTRODUCTION Haemophilia B (HB) is associated with pathogenic variants in F9. Hemizygous deletions encompassing the entire F9 and proximate genes may express extra-haematological clinical phenotypes. AIM To analyse the genotype/phenotype correlations in two unrelated boys with severe early childhood obesity (SCO), global developmental delay (GDD) and similar bleeding phenotype associated with comparable Xq27 deletions spanning the entire F9 and proximate genes, and characterise the pathogenic events estimating the most likely mutational mechanism involved. METHODS Entire F9-deletions were detected in three hemizygous unrelated probands with HB: two cases, C#1/C#2, presented SCO and GDD and a control patient (Co), who only had severe bleeding symptoms. Dense SNP-array and case-specific STS walking scan allowed characterisation of the deletion breakpoints. Extensive use of bioinformatics, statistics and clinical databases allowed the investigation of genotype-phenotype associations. RESULTS Patients C#1/C#2 and Co resulted in a complete F9 and additional gene deletions of variable extensions on Xq26.3-Xq27.2 (C#1/C#2/Co: 4.3Mb/3.9Mb/160Kb). C#1/C#2 common deleted gene SOX3 is directly associated with SCO, GDD and pituitary hypothyroidism (PH) whilst C#2 extra-deleted gene MAGEC2 indirectly relates to anal atresia (AA). Breakpoint analysis revealed the involvement of the mechanisms of Alu/Alu recombination for the first time in HB and non-homologous or alternative end-joining. CONCLUSION Our results represent the first report of unrelated patients with HB, SCO and GDD. This study and the literature update expand the spectrum of clinical findings and molecular insights observed in patients with HB caused by complete F9 and nearby SOX3 and MAGEC2 gene deletions, which may configure a contiguous gene syndrome.
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Affiliation(s)
- Claudia P Radic
- Laboratorio de Genética Molecular de la Hemofilia (GMH), Instituto de Medicina Experimental (IMEX, CONICET-Academia Nacional de Medicina (ANM)), Buenos Aires, Argentina
| | - Miguel M Abelleyro
- Laboratorio de Genética Molecular de la Hemofilia (GMH), Instituto de Medicina Experimental (IMEX, CONICET-Academia Nacional de Medicina (ANM)), Buenos Aires, Argentina
| | - Betiana Ziegler
- Laboratorio de Genética Molecular de la Hemofilia (GMH), Instituto de Medicina Experimental (IMEX, CONICET-Academia Nacional de Medicina (ANM)), Buenos Aires, Argentina
| | - Vanina D Marchione
- Laboratorio de Genética Molecular de la Hemofilia (GMH), Instituto de Medicina Experimental (IMEX, CONICET-Academia Nacional de Medicina (ANM)), Buenos Aires, Argentina
| | - Julián Nevado
- Instituto de Genética Médica y Molecular (INGEMM)-IdiPAZ, Hospital Universitario La Paz, Universidad Autónoma, Madrid, Spain.,CIBERER, Centro de Investigación Biomédica en Red de Enfermedades Raras, ISCIII, Madrid, Spain
| | - Pablo Lapunzina
- Instituto de Genética Médica y Molecular (INGEMM)-IdiPAZ, Hospital Universitario La Paz, Universidad Autónoma, Madrid, Spain.,CIBERER, Centro de Investigación Biomédica en Red de Enfermedades Raras, ISCIII, Madrid, Spain
| | - Gabriela Sciuccati
- Servicio de Hematología y Oncología, Hospital de Pediatría Prof. Dr Juan P. Garrahan (HPJG), CABA, Argentina
| | - Daniela Neme
- Fundación de la Hemofilia Alfredo Pavlovsky (FHAP), Hematology, Soler, Ciudad de Buenos Aires, Argentina
| | - Liliana C Rossetti
- Laboratorio de Genética Molecular de la Hemofilia (GMH), Instituto de Medicina Experimental (IMEX, CONICET-Academia Nacional de Medicina (ANM)), Buenos Aires, Argentina
| | - Mariana Bonduel
- Servicio de Hematología y Oncología, Hospital de Pediatría Prof. Dr Juan P. Garrahan (HPJG), CABA, Argentina
| | - Carlos D De Brasi
- Laboratorio de Genética Molecular de la Hemofilia (GMH), Instituto de Medicina Experimental (IMEX, CONICET-Academia Nacional de Medicina (ANM)), Buenos Aires, Argentina.,Instituto de Investigaciones Hematológicas Mariano R. Castex (IIHEMA, ANM), Buenos Aires, Argentina
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Jourdy Y, Chatron N, Carage ML, Fretigny M, Meunier S, Zawadzki C, Gay V, Negrier C, Sanlaville D, Vinciguerra C. Study of six patients with complete F9 deletion characterized by cytogenetic microarray: role of the SOX3 gene in intellectual disability. J Thromb Haemost 2016; 14:1988-1993. [PMID: 27477789 DOI: 10.1111/jth.13430] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Indexed: 11/26/2022]
Abstract
Essentials Some hemophilia B (HB) patients with complete F9 deletion present with intellectual disability (ID). We delineate six F9 complete deletions and investigate genotype/phenotype correlation. We identify SOX3 as a candidate gene for ID, acting through haploinsufficiency, in HB patients. All complete F9 deletions in ID patients should be explored with cytogenetic microarrays. SUMMARY Background Large deletions encompassing both the complete F9 gene and contiguous genes have been detected in patients with severe hemophilia B (HB). Some of these patients present other clinical features, such as intellectual disability (ID). Objectives/Methods In this study, we characterized six unrelated large deletions encompassing F9, by cytogenetic microarray analysis (CMA), to investigate genotype/phenotype correlation. Results Five of the six patients included in this study presented with ID associated with HB. CMA showed that the six large deletions, ranging in size from approximately 933 kb to 9.19 Mb, were located within the Xq26.3 to Xq28 bands. In all cases, the complete deletion of F9 was associated with the loss of various neighboring genes (5-28 other genes). The smallest region of overlap for ID was a 1.26-Mb region encompassing seven OMIM genes (LOC389895, SOX3, LINC00632, CDR1, SPANXF1, LDOC1, SPANXC). SOX3, our candidate gene for ID, encodes an early transcription factor involved in pituitary development. All of the patients studied who had both HB and ID had deletion of the SOX3 gene. Conclusions All HB patients with an atypical phenotype, especially if complete deletion of F9 is suspected, should be referred to a geneticist for possible pangenomic assessment, because haploinsufficiency of genes flanking F9, such as SOX3 in particular, may result in a broader phenotype, including ID. Such assessment would be of particular value for the genetic counseling of female carriers with F9 deletions, as it would facilitate analysis of the risk of transmitting HB associated with ID.
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Affiliation(s)
- Y Jourdy
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Service d'Hématologie Biologique, Lyon, France
- EAM 4174 Hémostase, Inflammation et Sepsis, Université Claude Bernard Lyon 1, Lyon, France
| | - N Chatron
- Hospices Civils de Lyon, Groupe Hospitalier Est, Laboratoire de Cytogénétique Constitutionnelle, Bron, France
| | - M-L Carage
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Service d'Hématologie Biologique, Lyon, France
| | - M Fretigny
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Service d'Hématologie Biologique, Lyon, France
| | - S Meunier
- Hospices Civils de Lyon, Hôpital Cardiologique Louis Pradel, Unité d'Hémostase Clinique, Bron, France
| | - C Zawadzki
- Laboratoire d'Hématologie, CHRU de Lille, Lille, France
| | - V Gay
- Centre de Traitement de l'Hémophilie, CHG, Chambery, France
| | - C Negrier
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Service d'Hématologie Biologique, Lyon, France
- EAM 4174 Hémostase, Inflammation et Sepsis, Université Claude Bernard Lyon 1, Lyon, France
- Hospices Civils de Lyon, Hôpital Cardiologique Louis Pradel, Unité d'Hémostase Clinique, Bron, France
| | - D Sanlaville
- Hospices Civils de Lyon, Groupe Hospitalier Est, Laboratoire de Cytogénétique Constitutionnelle, Bron, France
- CRN, équipe TIGER, INSERM U1028, CNRS UMR5292, Université Claude Bernard, Lyon1, France
| | - C Vinciguerra
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Service d'Hématologie Biologique, Lyon, France.
- EAM 4174 Hémostase, Inflammation et Sepsis, Université Claude Bernard Lyon 1, Lyon, France.
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Abelleyro MM, Radic CP, Tetzlaff T, Marchione V, Fundia AF, Larripa IB, Rossetti LC, De Brasi CD. Reliable and cost-effective approach for diagnosis of heterozygous F8/F9 large deletions by quantitative real-time PCR. Haemophilia 2015; 21:e247-e251. [PMID: 25753911 DOI: 10.1111/hae.12656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2015] [Indexed: 11/30/2022]
Affiliation(s)
- M M Abelleyro
- Instituto de Medicina Experimental (IMEX), CONICET-Academia Nacional de Medicina, Buenos Aires, Argentina
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Devi GS, Arora N, Rajkumar SV, Edison ES, Srivastava A, Jayandharan GR. Fluorescent PCR-based gene dose analysis for detection of deletion mutations in carriers of haemophilia. Haemophilia 2013; 19:e377-80. [PMID: 23855319 DOI: 10.1111/hae.12233] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2013] [Indexed: 11/30/2022]
Affiliation(s)
- G Sankari Devi
- Department of Haematology, Christian Medical College, Vellore, Tamil Nadu, India
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