Clinical and molecular characterization of patients with hereditary hemorrhagic telangiectasia: Experience from an HHT Center of Excellence

Muhammad A. Latif, Nara Lygia D. Sobreira, Kelsey S. Guthrie, Mina Motaghi, Gina M. Robinson, Omid Shafaat, Anna J. Gong, Clifford R. Weiss

Research output: Contribution to journalArticlepeer-review

Abstract

In this retrospective single-center study, we evaluated whether/how pathogenic/likely pathogenic variants of three hereditary hemorrhagic telangiectasia (HHT)–associated genes (ENG, ACVRL1, and SMAD4) are associated with specific clinical presentations of HHT. We also characterized the morphological features of pulmonary arteriovenous malformations (AVMs) in patients with these variants. Pathogenic or likely pathogenic variants were detected in 64 patients. Using nonparametric statistical tests, we compared the type and prevalence of specific HHT diagnostic features associated with these three variants. Pathogenic variants in these genes resulted in gene-specific HHT clinical presentations. Epistaxis was present in 93%, 94%, and 100% of patients with ENG, ACVRL1, and SMAD4 variants, respectively (p = 0.79). Pulmonary AVMs were more common in patients with the ENG variant (p = 0.034) compared with other subgroups. ACVRL1 variant was associated with the lowest frequency of pulmonary AVMs (p = 0.034) but the highest frequency of hepatic AVMs (p = 0.015). Patients with the ACVRL1 variant did not have significantly more pancreatic AVMs compared with the other groups (p = 0.72). ENG, ACVRL1, and SMAD4 pathogenic or likely pathogenic variants are associated with gene-specific HHT presentations, which is consistent with results from other HHT centers.

Original languageEnglish (US)
Pages (from-to)1981-1990
Number of pages10
JournalAmerican Journal of Medical Genetics, Part A
Volume185
Issue number7
DOIs
StatePublished - Jul 2021

Keywords

  • HHT pathogenic variant
  • Osler–Weber–Rendu syndrome
  • arteriovenous malformation
  • genetic testing
  • hereditary hemorrhagic telangiectasia

ASJC Scopus subject areas

  • Genetics
  • Genetics(clinical)

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