Analysis of factor VIII gene inversion mutations in 166 unrelated haemophilia A families: Frequency and utility in genetic counselling

Cindy L. Vnencak-Jones, John A. Phillips, Robert L. Janco, Melinda P. Cohen, William D. Dupont, Haig H. Kazazian, Judith P. Rossiter

Research output: Contribution to journalArticle

Abstract

Haemophilia A is an X-linked recessive bleeding disorder of variable severity that is caused by a deficiency of coagulation factor VIII (FVIII). The disease results from mutations in the FVIII gene which are heterogenous both in type and position within the gene. Recently, however, inversion mutations were found to be common to patients with severe disease. These mutations result from intrachromosomal recombinations between DNA sequences in the A gene (located in intron 22 of the FVIII gene) and one of two A genes upstream to the FVIII gene. To determine the frequency of these inversions we performed Southern blot analysis on banked DNA from 166 consecutive, unrelated haemophilia A families previously referred for carrier or prenatal testing. In 57/166 (34%) families an inversion or other unique mutation was detected. The distal and proximal A genes lying upstream to the FVIII gene were involved in 79% and 18% of the mutations, respectively, but in 3% of the families the sequences involved in the mutation have not been identified. In 20/38 (53%) families with severe disease a mutation was detected. Interestingly, the relative risk of developing inhibitors in patients with FVIII gene inversions or other 3' mutations detected by this assay, as compared to patients with no detectable mutation by this assay, was 3.8. In families for which a mutation is detected, direct DNA testing is an accurate and inexpensive alternative to linkage analysis for prenatal or haemophilia A carrier testing.

Original languageEnglish (US)
Pages (from-to)18-23
Number of pages6
JournalHaemophilia
Volume2
Issue number1
Publication statusPublished - 1996

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Keywords

  • Direct DNA testing
  • Factor VIII inhibitors
  • Genetic counselling
  • Haemophilia A
  • Inversion mutations
  • Severe disease

ASJC Scopus subject areas

  • Hematology

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