Mutation analysis and clinical implications of von Willebrand factor-cleaving protease deficiency.

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Mutation analysis and clinical implications of von Willebrand factor-cleaving protease deficiency. / Assink, Karin; Schiphorst, Rikke; Allford, Sarah; Karpman, Diana; Etzioni, Amos; Brichard, Bénédicte; Van De Kar, Nicole; Monnens, Leo; Van Den Heuvel, Lambertus.

I: Kidney International, Vol. 63, Nr. 6, 2003, s. 1995-1999.

Forskningsoutput: TidskriftsbidragArtikel i vetenskaplig tidskrift

Harvard

Assink, K, Schiphorst, R, Allford, S, Karpman, D, Etzioni, A, Brichard, B, Van De Kar, N, Monnens, L & Van Den Heuvel, L 2003, 'Mutation analysis and clinical implications of von Willebrand factor-cleaving protease deficiency.', Kidney International, vol. 63, nr. 6, s. 1995-1999. https://doi.org/10.1046/j.1523-1755.63.6s.1.x

APA

Assink, K., Schiphorst, R., Allford, S., Karpman, D., Etzioni, A., Brichard, B., ... Van Den Heuvel, L. (2003). Mutation analysis and clinical implications of von Willebrand factor-cleaving protease deficiency. Kidney International, 63(6), 1995-1999. https://doi.org/10.1046/j.1523-1755.63.6s.1.x

CBE

Assink K, Schiphorst R, Allford S, Karpman D, Etzioni A, Brichard B, Van De Kar N, Monnens L, Van Den Heuvel L. 2003. Mutation analysis and clinical implications of von Willebrand factor-cleaving protease deficiency. Kidney International. 63(6):1995-1999. https://doi.org/10.1046/j.1523-1755.63.6s.1.x

MLA

Vancouver

Author

Assink, Karin ; Schiphorst, Rikke ; Allford, Sarah ; Karpman, Diana ; Etzioni, Amos ; Brichard, Bénédicte ; Van De Kar, Nicole ; Monnens, Leo ; Van Den Heuvel, Lambertus. / Mutation analysis and clinical implications of von Willebrand factor-cleaving protease deficiency. I: Kidney International. 2003 ; Vol. 63, Nr. 6. s. 1995-1999.

RIS

TY - JOUR

T1 - Mutation analysis and clinical implications of von Willebrand factor-cleaving protease deficiency.

AU - Assink, Karin

AU - Schiphorst, Rikke

AU - Allford, Sarah

AU - Karpman, Diana

AU - Etzioni, Amos

AU - Brichard, Bénédicte

AU - Van De Kar, Nicole

AU - Monnens, Leo

AU - Van Den Heuvel, Lambertus

PY - 2003

Y1 - 2003

N2 - Background. The pentad of thrombocytopenia, hemolytic anemia, mild renal dysfunction, neurologic signs, and fever, classically characterizes the syndrome of thrombotic thrombocytopenic purpura (TTP). TTP usually occurs in adults as an acquired form but a congenital form in children has also been described. In the latter case, the initial presentation is often with neonatal jaundice and thrombocytopenia. The disorder may subsequently take a relapsing course. Deficiency of a recently identified novel metalloprotease, the von Willebrand factor (vWF)-cleaving protease, originating from mutations in the ADAMTS13 gene plays a major role in the development of TTP. Methods. Blood for DNA analysis was collected from six unrelated TTP families, consisting of nine patients from four different countries, and was screened for mutations in the ADAMTS 13 gene. This gene spans 29 exons encompassing ~37 kb. Conventional techniques of DNA extraction, polymerase chain reaction (PCR), and direct cycle sequencing were used. Results. Eight novel ADAMTS 13 mutations are presented. Half of the total number of mutant ADAMTS13 alleles are amino acid substitutions. The disease-causing mutations are spread over the gene. The pathogenicity of the individual mutations is based upon their predicted effect on the ADAMTS13 protein and segregation in family members. Although most of the patients (seven out of nine) had symptoms during the neonatal period, they were in a remarkably good condition. Only one of the nine patients had a decreased glomerular filtration rate (GFR) with proteinuria and hematuria. Another patient had epileptic seizures. Conclusion. We confirm that deficiency of ADAMTS13 is a molecular mechanism responsible for familial TTP. An early diagnosis allows prophylactic treatment with fresh plasma infusions.

AB - Background. The pentad of thrombocytopenia, hemolytic anemia, mild renal dysfunction, neurologic signs, and fever, classically characterizes the syndrome of thrombotic thrombocytopenic purpura (TTP). TTP usually occurs in adults as an acquired form but a congenital form in children has also been described. In the latter case, the initial presentation is often with neonatal jaundice and thrombocytopenia. The disorder may subsequently take a relapsing course. Deficiency of a recently identified novel metalloprotease, the von Willebrand factor (vWF)-cleaving protease, originating from mutations in the ADAMTS13 gene plays a major role in the development of TTP. Methods. Blood for DNA analysis was collected from six unrelated TTP families, consisting of nine patients from four different countries, and was screened for mutations in the ADAMTS 13 gene. This gene spans 29 exons encompassing ~37 kb. Conventional techniques of DNA extraction, polymerase chain reaction (PCR), and direct cycle sequencing were used. Results. Eight novel ADAMTS 13 mutations are presented. Half of the total number of mutant ADAMTS13 alleles are amino acid substitutions. The disease-causing mutations are spread over the gene. The pathogenicity of the individual mutations is based upon their predicted effect on the ADAMTS13 protein and segregation in family members. Although most of the patients (seven out of nine) had symptoms during the neonatal period, they were in a remarkably good condition. Only one of the nine patients had a decreased glomerular filtration rate (GFR) with proteinuria and hematuria. Another patient had epileptic seizures. Conclusion. We confirm that deficiency of ADAMTS13 is a molecular mechanism responsible for familial TTP. An early diagnosis allows prophylactic treatment with fresh plasma infusions.

U2 - 10.1046/j.1523-1755.63.6s.1.x

DO - 10.1046/j.1523-1755.63.6s.1.x

M3 - Article

VL - 63

SP - 1995

EP - 1999

JO - Kidney International

T2 - Kidney International

JF - Kidney International

SN - 1523-1755

IS - 6

ER -