Case Report
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Clinical and genetic diagnosis of two Turkish patients with hereditary spherocytosis

Year 2024, EARLY ONLINE, 1 - 6
https://doi.org/10.18621/eurj.1512399

Abstract

Hereditary spherocytosis is a congenital disorder caused by defects in the erythrocyte membrane. It is characterized by hemolytic anemia, jaundice, splenomegaly, and cholelithiasis. The clinical presentation is variable. Especially in the neonatal period and cases without a family history, it isn't easy to diagnose with classical approaches. Here, we describe the genetic findings of a 1.5-month-old and a 2-month-old girl diagnosed with hereditary spherocytosis in Turkish families. Both cases presented with severe anemia and jaundice. Spherocytes were frequently seen in peripheral blood smears. Targeted next-generation sequencing (NGS) revealed that the 1.5-month-old girl was heterozygous for a novel frameshift mutation c.1617del (p.Leu540CysfsTer31) in exon 15 of the ANK1 gene, while the 2-month-old girl was heterozygous for a mutation c.1912C>T (p.Arg638Ter) in exon 13 of the SPTB gene, which leads to abnormal protein truncation. Parents did not carry these mutations. To our knowledge, the ANK1 mutation identified in a 7-month-old girl has not been reported previously. NGS may be helpful in diagnosing hereditary spherocytosis, especially in atypical cases.

References

  • 1. Da Costa L, Galimand J, Fenneteau O, Mohandas N. Hereditary spherocytosis, elliptocytosis, and other red cell membrane disorders. Blood Rev. 2013;27(4):167-178. doi: 10.1016/j.blre.2013.04.003.
  • 2. An X, Mohandas N. Disorders of red cell membrane. Br J Haematol. 2008;141(3):367-375. doi: 10.1111/j.1365-2141.2008.07091.x.
  • 3. Kocaağa A, Çakmak HM. Identification of Novel Mutations in Children with Hereditary Spherocytosis by Targeted Exome Sequencing: A Single Center Experience. Med J West Black Sea. 2022;6(3):296-301. doi: 10.29058/mjwbs.1200958.
  • 4. Russo R, Andolfo I. Hereditary spherocytosis and allied disorders. Hemasphere. 2019;3(Suppl):157-159. doi: 10.1097/HS9.0000000000000198.
  • 5. Shah S, Vega R. Hereditary spherocytosis. Pediatr Rev. 2004;25(5):168-172. doi: 10.1542/pir.25-5-168.
  • 6. Huang TL, Sang BH, Lei QL, et al. A de novo ANK1 mutation associated to hereditary spherocytosis: a case report. BMC Pediatr. 2019;19(1):62. doi: 10.1186/s12887-019-1436-4.
  • 7. Perrotta S, Gallagher PG, Mohandas N. Hereditary spherocytosis. Lancet. 2008;372(9647):1411-1426. doi: 10.1016/S0140-6736(08)61588-3.
  • 8. Mahajan V, Jain SK. Hereditary spherocytosis. NeoReviews. 2016;17(12):e697-e704. doi: 10.1542/neo.17-12-e697.
  • 9. Xi B, Liu S, Zhu Y, Zhang D, Zhang Y, Liu A. Case report: Genetic analysis of a novel intronic inversion variant in the SPTB gene associated with hereditary spherocytosis. Front Genet. 2023;14:1309040. doi: 10.3389/fgene.2023.1309040.
  • 10. Jang W, Kim SK, Nahm CH, Choi JW, Kim JJ, Moon Y. A Novel de novo Mutation in ANK Gene Identified through Targeted Next-Generation Sequencing in a Neonate with Hereditary Spherocytosis. Ann Clin Lab Sci. 2021;51(1):136-139.
  • 11. Guan H, Liang X, Zhang R, et al. Identification of a de novo ANK1 mutation in a Chinese family with hereditary spherocytosis. Hematology. 2018;23(6):357-361. doi: 10.1080/10245332.2017.1398210.
  • 12. Du Z, Luo G, Wang K, Bing Z, Pan S. Identification of a novel heterozygous SPTB mutation by whole genome sequencing in a Chinese patient with hereditary spherocytosis and atrial septal defect: a case report. BMC Pediatr. 2021;21(1):291. doi: 10.1186/s12887-021-02771-4.
  • 13. Fu P, Jiao YY, Chen K, et al. Targeted next-generation sequencing identifies a novel nonsense mutation in ANK1 for hereditary spherocytosis: A case report. World J Clin Cases. 2022;10(15):4923-4928. doi: 10.12998/wjcc.v10.i15.4923.
  • 14. Wu Y, Liao L, Lin F. The diagnostic protocol for hereditary spherocytosis-2021 update. J Clin Lab Anal. 2021;35(12):e24034. doi: 10.1002/jcla.24034.
  • 15. Yamamoto KS, Utshigisawa T, Ogura H, et al. Clinical and genetic diagnosis of thirteen Japanese patients with hereditary spherocytosis. Hum Genome Var. 2022;9(1):1. doi: 10.1038/s41439-021-00179-1.
  • 16. Christensen RD, Yaish HM, Gallagher PG. A pediatrician's practical guide to diagnosing and treating hereditary spherocytosis in neonates. Pediatrics. 2015;135(6):1107-1114. doi: 10.1542/peds.2014-3516.
  • 17. Gallagher PG. Difficulty in Diagnosis of Hereditary Spherocytosis in the Neonate. Pediatrics. 2021;148(3):e2021051100. doi: 10.1542/peds.2021-051100.
  • 18. Aggarwal A, Jamwal M, Sharma P, et al. Deciphering molecular heterogeneity of Indian families with hereditary spherocytosis using targeted next-generation sequencing: First South Asian study. Br J Haematol. 2020;188(5):784-795. doi: 10.1111/bjh.16244.
  • 19. Kager L, Jimenez‐Heredia R, Zeitlhofer P, et al. A single‐center cohort study of patients with hereditary spherocytosis in Central Europe reveals a high frequency of novel disease‐causing genotypes. Hemasphere. 2024;8(1):e31. doi: 10.1002/hem3.31.
  • 20. Bolton‐Maggs PH, Langer JC, Iolascon A, Tittensor P, King MJ; General Haematology Task Force of the British Committee for Standards in Haematology. Guidelines for the diagnosis and management of hereditary spherocytosis–2011 update. Br J Haematol. 2012;156(1):37-49. doi: 10.1111/j.1365-2141.2011.08921.x.
  • 21. Park J, Jeong DC, Yoo J, et al. Mutational characteristics of ANK1 and SPTB genes in hereditary spherocytosis. Clin Genet. 2016;90(1):69-78. doi: 10.1111/cge.12749.
  • 22. Nakanishi H, Kanzaki A, Yawata A, Yamada O, Yawata Y. Ankyrin gene mutations in japanese patients with hereditary spherocytosis. Int J Hematol. 2001;73(1):54-63. doi: 10.1007/BF02981903.
  • 23. He BJ, Liao L, Deng ZF, Tao YF, Xu YC, Lin FQ. Molecular Genetic Mechanisms of Hereditary Spherocytosis: Current Perspectives. Acta Haematol. 2018;139(1):60-66. doi: 10.1159/000486229.
  • 24. Wang Y, Liu L, Liu D, Liu W. A de novo ANK1 mutation in a childhood hereditary spherocytosis: a case report. BMC Pediatr. 2023;23(1):267. doi: 10.1186/s12887-023-04092-0.
Year 2024, EARLY ONLINE, 1 - 6
https://doi.org/10.18621/eurj.1512399

Abstract

References

  • 1. Da Costa L, Galimand J, Fenneteau O, Mohandas N. Hereditary spherocytosis, elliptocytosis, and other red cell membrane disorders. Blood Rev. 2013;27(4):167-178. doi: 10.1016/j.blre.2013.04.003.
  • 2. An X, Mohandas N. Disorders of red cell membrane. Br J Haematol. 2008;141(3):367-375. doi: 10.1111/j.1365-2141.2008.07091.x.
  • 3. Kocaağa A, Çakmak HM. Identification of Novel Mutations in Children with Hereditary Spherocytosis by Targeted Exome Sequencing: A Single Center Experience. Med J West Black Sea. 2022;6(3):296-301. doi: 10.29058/mjwbs.1200958.
  • 4. Russo R, Andolfo I. Hereditary spherocytosis and allied disorders. Hemasphere. 2019;3(Suppl):157-159. doi: 10.1097/HS9.0000000000000198.
  • 5. Shah S, Vega R. Hereditary spherocytosis. Pediatr Rev. 2004;25(5):168-172. doi: 10.1542/pir.25-5-168.
  • 6. Huang TL, Sang BH, Lei QL, et al. A de novo ANK1 mutation associated to hereditary spherocytosis: a case report. BMC Pediatr. 2019;19(1):62. doi: 10.1186/s12887-019-1436-4.
  • 7. Perrotta S, Gallagher PG, Mohandas N. Hereditary spherocytosis. Lancet. 2008;372(9647):1411-1426. doi: 10.1016/S0140-6736(08)61588-3.
  • 8. Mahajan V, Jain SK. Hereditary spherocytosis. NeoReviews. 2016;17(12):e697-e704. doi: 10.1542/neo.17-12-e697.
  • 9. Xi B, Liu S, Zhu Y, Zhang D, Zhang Y, Liu A. Case report: Genetic analysis of a novel intronic inversion variant in the SPTB gene associated with hereditary spherocytosis. Front Genet. 2023;14:1309040. doi: 10.3389/fgene.2023.1309040.
  • 10. Jang W, Kim SK, Nahm CH, Choi JW, Kim JJ, Moon Y. A Novel de novo Mutation in ANK Gene Identified through Targeted Next-Generation Sequencing in a Neonate with Hereditary Spherocytosis. Ann Clin Lab Sci. 2021;51(1):136-139.
  • 11. Guan H, Liang X, Zhang R, et al. Identification of a de novo ANK1 mutation in a Chinese family with hereditary spherocytosis. Hematology. 2018;23(6):357-361. doi: 10.1080/10245332.2017.1398210.
  • 12. Du Z, Luo G, Wang K, Bing Z, Pan S. Identification of a novel heterozygous SPTB mutation by whole genome sequencing in a Chinese patient with hereditary spherocytosis and atrial septal defect: a case report. BMC Pediatr. 2021;21(1):291. doi: 10.1186/s12887-021-02771-4.
  • 13. Fu P, Jiao YY, Chen K, et al. Targeted next-generation sequencing identifies a novel nonsense mutation in ANK1 for hereditary spherocytosis: A case report. World J Clin Cases. 2022;10(15):4923-4928. doi: 10.12998/wjcc.v10.i15.4923.
  • 14. Wu Y, Liao L, Lin F. The diagnostic protocol for hereditary spherocytosis-2021 update. J Clin Lab Anal. 2021;35(12):e24034. doi: 10.1002/jcla.24034.
  • 15. Yamamoto KS, Utshigisawa T, Ogura H, et al. Clinical and genetic diagnosis of thirteen Japanese patients with hereditary spherocytosis. Hum Genome Var. 2022;9(1):1. doi: 10.1038/s41439-021-00179-1.
  • 16. Christensen RD, Yaish HM, Gallagher PG. A pediatrician's practical guide to diagnosing and treating hereditary spherocytosis in neonates. Pediatrics. 2015;135(6):1107-1114. doi: 10.1542/peds.2014-3516.
  • 17. Gallagher PG. Difficulty in Diagnosis of Hereditary Spherocytosis in the Neonate. Pediatrics. 2021;148(3):e2021051100. doi: 10.1542/peds.2021-051100.
  • 18. Aggarwal A, Jamwal M, Sharma P, et al. Deciphering molecular heterogeneity of Indian families with hereditary spherocytosis using targeted next-generation sequencing: First South Asian study. Br J Haematol. 2020;188(5):784-795. doi: 10.1111/bjh.16244.
  • 19. Kager L, Jimenez‐Heredia R, Zeitlhofer P, et al. A single‐center cohort study of patients with hereditary spherocytosis in Central Europe reveals a high frequency of novel disease‐causing genotypes. Hemasphere. 2024;8(1):e31. doi: 10.1002/hem3.31.
  • 20. Bolton‐Maggs PH, Langer JC, Iolascon A, Tittensor P, King MJ; General Haematology Task Force of the British Committee for Standards in Haematology. Guidelines for the diagnosis and management of hereditary spherocytosis–2011 update. Br J Haematol. 2012;156(1):37-49. doi: 10.1111/j.1365-2141.2011.08921.x.
  • 21. Park J, Jeong DC, Yoo J, et al. Mutational characteristics of ANK1 and SPTB genes in hereditary spherocytosis. Clin Genet. 2016;90(1):69-78. doi: 10.1111/cge.12749.
  • 22. Nakanishi H, Kanzaki A, Yawata A, Yamada O, Yawata Y. Ankyrin gene mutations in japanese patients with hereditary spherocytosis. Int J Hematol. 2001;73(1):54-63. doi: 10.1007/BF02981903.
  • 23. He BJ, Liao L, Deng ZF, Tao YF, Xu YC, Lin FQ. Molecular Genetic Mechanisms of Hereditary Spherocytosis: Current Perspectives. Acta Haematol. 2018;139(1):60-66. doi: 10.1159/000486229.
  • 24. Wang Y, Liu L, Liu D, Liu W. A de novo ANK1 mutation in a childhood hereditary spherocytosis: a case report. BMC Pediatr. 2023;23(1):267. doi: 10.1186/s12887-023-04092-0.
There are 24 citations in total.

Details

Primary Language English
Subjects Pediatric Hematology and Oncology
Journal Section Case Reports
Authors

Çağrı Coşkun 0000-0001-9725-8355

Early Pub Date August 20, 2024
Publication Date
Submission Date July 8, 2024
Acceptance Date August 10, 2024
Published in Issue Year 2024 EARLY ONLINE

Cite

AMA Coşkun Ç. Clinical and genetic diagnosis of two Turkish patients with hereditary spherocytosis. Eur Res J. Published online August 1, 2024:1-6. doi:10.18621/eurj.1512399

e-ISSN: 2149-3189 


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