A Novel Frameshift Mutation in the FGA Gene (c.196 delT) Leading to Congenital Afibrinogenemia.


Journal

Journal of pediatric hematology/oncology
ISSN: 1536-3678
Titre abrégé: J Pediatr Hematol Oncol
Pays: United States
ID NLM: 9505928

Informations de publication

Date de publication:
03 2020
Historique:
pubmed: 15 11 2019
medline: 14 8 2020
entrez: 15 11 2019
Statut: ppublish

Résumé

Congenital afibrinogenemia is characterized by the absence of fibrinogen. Congenital fibrinogen disorders result from several mutations in FGA, FGB, or FGG. Their epidemiology is not well known. The present study reports on 2 children with congenital afibrinogenemia. The first child, a male who is now 9 years old, was diagnosed with afibrinogenemia after spontaneous intracranial bleeding at the age of 3 years. The second child is a 2-year-old female cousin of the first patient, who was diagnosed with afibrinogenemia after coagulation tests were carried out due to frequent epistaxis and mucocutaneous bleeding. At follow-up, blood samples of the patients and their parents were sent to the Department of Genetic Medicine and Development, University Medical Center, Switzerland, for polymerase chain reaction analysis. In both patients, the novel homozygous frameshift mutation in the FGA exon 3: c.196 delT was detected. The parents of the patients were both heterozygous for the same mutation. Congenital afibrinogenemia is a rare coagulation disease. The molecular epidemiology of congenital fibrinogen disorders is complex, and the identification of new mutations will help shed light on this complex molecular structure. Therefore, a genetic analysis that includes more centers is needed.

Sections du résumé

BACKGROUND
Congenital afibrinogenemia is characterized by the absence of fibrinogen. Congenital fibrinogen disorders result from several mutations in FGA, FGB, or FGG. Their epidemiology is not well known.
OBSERVATION
The present study reports on 2 children with congenital afibrinogenemia. The first child, a male who is now 9 years old, was diagnosed with afibrinogenemia after spontaneous intracranial bleeding at the age of 3 years. The second child is a 2-year-old female cousin of the first patient, who was diagnosed with afibrinogenemia after coagulation tests were carried out due to frequent epistaxis and mucocutaneous bleeding. At follow-up, blood samples of the patients and their parents were sent to the Department of Genetic Medicine and Development, University Medical Center, Switzerland, for polymerase chain reaction analysis. In both patients, the novel homozygous frameshift mutation in the FGA exon 3: c.196 delT was detected. The parents of the patients were both heterozygous for the same mutation.
CONCLUSIONS
Congenital afibrinogenemia is a rare coagulation disease. The molecular epidemiology of congenital fibrinogen disorders is complex, and the identification of new mutations will help shed light on this complex molecular structure. Therefore, a genetic analysis that includes more centers is needed.

Identifiants

pubmed: 31725541
doi: 10.1097/MPH.0000000000001658
pii: 00043426-202003000-00021
doi:

Substances chimiques

FGA protein, human 0
Fibrinogen 9001-32-5

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e98-e99

Références

Levy JH, Goodnough LT. How I use fibrinogen replacement therapy in acquired bleeding. Blood. 2015;125:1387–1393.
Medved L, Weisel JW. Fibrinogen and Factor XIII Subcommittee of Scientific Standardization Committee of International Society on Thrombosis and Haemostasis. Recommendations for nomenclature on fibrinogen and fibrin. J Thromb Haemost. 2009;7:355–359.
Arcagök BC, Özdemir N, Tekin A, et al. Spontaneous splenic rupture in a patient with congenital afibrinogenemia. Turk Pediatri Ars. 2014;49:247–249.
Neerman-Arbez M, de Moerloose P. Mutations in the fibrinogen gene cluster accounting for congenital afibrinogenemia: an update and report of 10 novel mutations. Hum Mutat. 2007;28:540–553.
De Moerloose P, Casini A, Neerman-Arbez M. Congenital fibrinogen disorders: an update. Semin Thromb Hemost. 2013;39:585–595.
Vu D, Neerman-Arbez M. Molecular mechanisms accounting for fibrinogen deficiency: from large deletions to intracellular retention of misfolded proteins. J Thromb Haemost. 2007;5(suppl 1):125–131.
Maghzal GJ, Brennan SO, Homer VM, et al. The molecular mechanisms of congenital hypofibrinogenaemia. Cell Mol Life Sci. 2004;61:1427–1438.
Casini A, Blondon M, Lebreton A, et al. Natural history of patients with congenital dysfibrinogenemia. Blood. 2015;125:553–561.
Casini A, Blondon M, Tintillier V, et al. Mutational epidemiology of congenital fibrinogen disorders. Thromb Haemost. 2018;118:1867–1874.
Acharya SS, Dimichele DM. Rare inherited disorders of fibrinogen. Haemophilia. 2008;14:1151–1158.
Mannucci PM, Duga S, Peyvandi F. Recessively inherited coagulation disorders. Blood. 2004;104:1243–1252.
Peyvandi F, Haertel S, Knaub S, et al. Incidence of bleeding symptoms in 100 patients with inherited afibrinogenemia or hypofibrinogenemia. J Thromb Haemost. 2006;4:1634–1637.
Bornikova L, Peyvandi F, Allen G, et al. Fibrinogen replacement therapy for congenital fibrinogen deficiency. J Thromb Haemost. 2011;9:1687–1704.

Auteurs

Sultan Aydin Köker (S)

Division of Pediatric Hematology and Oncology.

Alper Köker (A)

Division of Pediatrics, Hatay State Hospital, Hatay, Turkey.

Marguerite Neerman-Arbez (M)

Department of Genetic Medicine and Development, Faculty of Medicine, University of Geneva, Geneva, Switzerland.

Gökçen Ö Tunçer (G)

Division of Pediatrics, Hatay State Hospital, Hatay, Turkey.

Yilmaz Akbas (Y)

Division of Pediatrics, Hatay State Hospital, Hatay, Turkey.

Tugce T Kara (TT)

Division of Pediatrics, Hatay State Hospital, Hatay, Turkey.

Yasemin Coban (Y)

Division of Pediatrics, Hatay State Hospital, Hatay, Turkey.

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