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Coagulation Factor XII Gene Mutation in Brazilian Families with Hereditary Angioedema with Normal C1 Inhibitor

Authors: Adriana S. Moreno; Solange O.R. Valle; Soloni Levy; Alfeu T. França; Faradiba S. Serpa; Helen A. Arcuri; Mario S. Palma; +8 Authors

Coagulation Factor XII Gene Mutation in Brazilian Families with Hereditary Angioedema with Normal C1 Inhibitor

Abstract

<b><i>Background:</i></b> Hereditary angioedema (HAE) with normal C1 inhibitor (C1-INH) is a rare disorder. Mutations of the gene encoding coagulation factor XII have been identified in a subset of patients with this condition. Our aim was to investigate mutations in the <i>F12 </i>gene in patients with HAE with normal C1-INH from Brazil. <b><i>Methods:</i></b> We studied 5 Brazilian families with index female patients who presented with recurrent angioedema with normal C1-INH and C4 levels. Genomic DNA was isolated from whole blood and PCR was performed. Mutations were detected by the sequencing of exon 9 of the <i>F12 </i>gene and allelic discrimination. <b><i>Results:</i></b> The c.983C>A (p.Thr328Lys) mutation was identified in 16 subjects, from 4 of the 5 families studied, including 8 patients with symptoms of HAE with normal C1-INH (87.5% women) and 8 subjects asymptomatic for HAE (25% women). Mean age at onset of symptoms among the FXII-HAE patients was 13.8 years (range 6-25 years). Recurrent abdominal pain (100%) and subcutaneous angioedema (87.5%) were the most frequent clinical presentations. Two patients presented with associated laryngeal edema. In keeping with previous observations in patients with both C1-INH-HAE and HAE with normal C1-INH, all 7 women with FXII-HAE reported triggering or worsening of symptoms upon intake of estrogen-containing oral contraceptives and/or pregnancy. <b><i>Conclusions:</i></b> We report for the first time in Brazil a mutation in the <i>F12 </i>gene as a likely cause of HAE with normal C1-INH in patients with recurrent attacks of angioedema and/or abdominal pain. A higher frequency of abdominal pain attacks and onset of symptoms at a younger age were observed among Brazilian patients when compared to those from other parts of the world.

Country
Brazil
Keywords

Adult, Adolescent, 610, Complement C1 Inactivator Proteins, Polymerase Chain Reaction, Young Adult, 616, Humans, Point Mutation, Age of Onset, Coagulation factor XII, Alleles, Aged, Hereditary angioedema, C1 inhibitor, Angioedemas, Hereditary, DNA, Sequence Analysis, DNA, Middle Aged, Pedigree, Factor XII, Female, Complement C1 Inhibitor Protein, Brazil

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    Top 10%
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    Top 10%
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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
19
Top 10%
Top 10%
Top 10%
bronze