Identification of novel TTN gene variant in a patient exhibiting severe dilated cardiomyopathy co-occurring with acute fibrinoid organizing pneumonia
Dilated cardiomyopathy (DCM) is often hereditary, with 20% to 40% of nonischemic cases showing familial linkage, yet genetic testing is underused. This report describes an unreported pathogenic nonsense variant in the Titin (TTN) gene (NM_001267550.2:c.92603G>A) in a 24-year-old man with severe D...
Saved in:
Published in | American journal of clinical pathology |
---|---|
Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
Published |
England
24.08.2024
|
Subjects | |
Online Access | Get full text |
Cover
Loading…
Abstract | Dilated cardiomyopathy (DCM) is often hereditary, with 20% to 40% of nonischemic cases showing familial linkage, yet genetic testing is underused. This report describes an unreported pathogenic nonsense variant in the Titin (TTN) gene (NM_001267550.2:c.92603G>A) in a 24-year-old man with severe DCM and acute fibrinoid organizing pneumonia, highlighting a unique cardiopulmonary pathology.
We conducted detailed gross, histopathologic, immunophenotypic, and exome-based DNA sequencing analysis in the workup of this case. We also included the patient's clinical and radiologic findings in our study.
With rapid clinical deterioration and complex comorbidities, including substance abuse and psychiatric conditions, which precluded transplantation, the patient's cardiac function progressively worsened. Autopsy findings included extreme cardiomegaly, biventricular hypertrophy, and acute and chronic pericarditis. Significant pulmonary pathology consistent with acute fibrinoid organizing pneumonia was also noted. Molecular testing confirmed a deleterious maternally inherited TTN variant that was absent in the sibling of the proband and the extant medical literature, highlighting its rarity and significance.
This case contributes to the ongoing body of work on the impact of TTN variants on DCM. It suggests a potential link between genetic variants and complex cardiac injury patterns, emphasizing the need for further investigation into the interplay between cardiomyopathy and pulmonary pathology. |
---|---|
AbstractList | Abstract Objectives Dilated cardiomyopathy (DCM) is often hereditary, with 20% to 40% of nonischemic cases showing familial linkage, yet genetic testing is underused. This report describes an unreported pathogenic nonsense variant in the Titin (TTN) gene (NM_001267550.2:c.92603G>A) in a 24-year-old man with severe DCM and acute fibrinoid organizing pneumonia, highlighting a unique cardiopulmonary pathology. Methods We conducted detailed gross, histopathologic, immunophenotypic, and exome-based DNA sequencing analysis in the workup of this case. We also included the patient’s clinical and radiologic findings in our study. Results With rapid clinical deterioration and complex comorbidities, including substance abuse and psychiatric conditions, which precluded transplantation, the patient’s cardiac function progressively worsened. Autopsy findings included extreme cardiomegaly, biventricular hypertrophy, and acute and chronic pericarditis. Significant pulmonary pathology consistent with acute fibrinoid organizing pneumonia was also noted. Molecular testing confirmed a deleterious maternally inherited TTN variant that was absent in the sibling of the proband and the extant medical literature, highlighting its rarity and significance. Conclusions This case contributes to the ongoing body of work on the impact of TTN variants on DCM. It suggests a potential link between genetic variants and complex cardiac injury patterns, emphasizing the need for further investigation into the interplay between cardiomyopathy and pulmonary pathology. Dilated cardiomyopathy (DCM) is often hereditary, with 20% to 40% of nonischemic cases showing familial linkage, yet genetic testing is underused. This report describes an unreported pathogenic nonsense variant in the Titin (TTN) gene (NM_001267550.2:c.92603G>A) in a 24-year-old man with severe DCM and acute fibrinoid organizing pneumonia, highlighting a unique cardiopulmonary pathology.OBJECTIVESDilated cardiomyopathy (DCM) is often hereditary, with 20% to 40% of nonischemic cases showing familial linkage, yet genetic testing is underused. This report describes an unreported pathogenic nonsense variant in the Titin (TTN) gene (NM_001267550.2:c.92603G>A) in a 24-year-old man with severe DCM and acute fibrinoid organizing pneumonia, highlighting a unique cardiopulmonary pathology.We conducted detailed gross, histopathologic, immunophenotypic, and exome-based DNA sequencing analysis in the workup of this case. We also included the patient's clinical and radiologic findings in our study.METHODSWe conducted detailed gross, histopathologic, immunophenotypic, and exome-based DNA sequencing analysis in the workup of this case. We also included the patient's clinical and radiologic findings in our study.With rapid clinical deterioration and complex comorbidities, including substance abuse and psychiatric conditions, which precluded transplantation, the patient's cardiac function progressively worsened. Autopsy findings included extreme cardiomegaly, biventricular hypertrophy, and acute and chronic pericarditis. Significant pulmonary pathology consistent with acute fibrinoid organizing pneumonia was also noted. Molecular testing confirmed a deleterious maternally inherited TTN variant that was absent in the sibling of the proband and the extant medical literature, highlighting its rarity and significance.RESULTSWith rapid clinical deterioration and complex comorbidities, including substance abuse and psychiatric conditions, which precluded transplantation, the patient's cardiac function progressively worsened. Autopsy findings included extreme cardiomegaly, biventricular hypertrophy, and acute and chronic pericarditis. Significant pulmonary pathology consistent with acute fibrinoid organizing pneumonia was also noted. Molecular testing confirmed a deleterious maternally inherited TTN variant that was absent in the sibling of the proband and the extant medical literature, highlighting its rarity and significance.This case contributes to the ongoing body of work on the impact of TTN variants on DCM. It suggests a potential link between genetic variants and complex cardiac injury patterns, emphasizing the need for further investigation into the interplay between cardiomyopathy and pulmonary pathology.CONCLUSIONSThis case contributes to the ongoing body of work on the impact of TTN variants on DCM. It suggests a potential link between genetic variants and complex cardiac injury patterns, emphasizing the need for further investigation into the interplay between cardiomyopathy and pulmonary pathology. Dilated cardiomyopathy (DCM) is often hereditary, with 20% to 40% of nonischemic cases showing familial linkage, yet genetic testing is underused. This report describes an unreported pathogenic nonsense variant in the Titin (TTN) gene (NM_001267550.2:c.92603G>A) in a 24-year-old man with severe DCM and acute fibrinoid organizing pneumonia, highlighting a unique cardiopulmonary pathology. We conducted detailed gross, histopathologic, immunophenotypic, and exome-based DNA sequencing analysis in the workup of this case. We also included the patient's clinical and radiologic findings in our study. With rapid clinical deterioration and complex comorbidities, including substance abuse and psychiatric conditions, which precluded transplantation, the patient's cardiac function progressively worsened. Autopsy findings included extreme cardiomegaly, biventricular hypertrophy, and acute and chronic pericarditis. Significant pulmonary pathology consistent with acute fibrinoid organizing pneumonia was also noted. Molecular testing confirmed a deleterious maternally inherited TTN variant that was absent in the sibling of the proband and the extant medical literature, highlighting its rarity and significance. This case contributes to the ongoing body of work on the impact of TTN variants on DCM. It suggests a potential link between genetic variants and complex cardiac injury patterns, emphasizing the need for further investigation into the interplay between cardiomyopathy and pulmonary pathology. |
Author | Ma, Weijie Wright, Dana L Baker, Michael L Parra, Ourania Black, Candice C Khan, Wahab A Shah, Nidhi D |
Author_xml | – sequence: 1 givenname: Weijie orcidid: 0000-0002-4434-1371 surname: Ma fullname: Ma, Weijie organization: Geisel School of Medicine at Dartmouth, Hanover, NH, US – sequence: 2 givenname: Dana L surname: Wright fullname: Wright, Dana L organization: Geisel School of Medicine at Dartmouth, Hanover, NH, US – sequence: 3 givenname: Ourania surname: Parra fullname: Parra, Ourania organization: Geisel School of Medicine at Dartmouth, Hanover, NH, US – sequence: 4 givenname: Nidhi D surname: Shah fullname: Shah, Nidhi D organization: Geisel School of Medicine at Dartmouth, Hanover, NH, US – sequence: 5 givenname: Candice C surname: Black fullname: Black, Candice C organization: Geisel School of Medicine at Dartmouth, Hanover, NH, US – sequence: 6 givenname: Michael L surname: Baker fullname: Baker, Michael L organization: Geisel School of Medicine at Dartmouth, Hanover, NH, US – sequence: 7 givenname: Wahab A surname: Khan fullname: Khan, Wahab A organization: Geisel School of Medicine at Dartmouth, Hanover, NH, US |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/39180762$$D View this record in MEDLINE/PubMed |
BookMark | eNo90T1v3DAMBmAhSNBc0m6ZC40d6oaS_DkWQT8CBM1ynQ1Kpu8U2JIjyZde_0f_b23k2okA-ZAD3yt27rwjxm4EfBLQqFt8MtMtPiMJgDO2EU2usqqS8pxtAEBmjajUJbuK8QlAyBryN-xSNaKGqpQb9ue-I5dsbw0m6x33PXf-QAPfbn_wHTniBwwWXeLWceTTohbP6dfeapus2_FIBwrEOztgoo4bDJ3149EvdH_kxmfemDmElb7YtOdo5kS8t3ppedtxH3bo7O91PjmaR-8svmUXPQ6R3p3qNfv59cv27nv28Pjt_u7zQ2ZEVacsN7XSWOhO1lUOYLRpdA2mLERfNJKKxvSi1g2VUEkQfacQQFNZmHXRoFTX7MPr3Sn455liakcbDQ0DOvJzbBU0ZVnmss4X-vGVmuBjDNS3U7AjhmMroF2DaNcg2lMQC39_ujzrkbr_-N_n1V8LfIsf |
Cites_doi | 10.1002/mgg3.1460 10.1007/s12551-017-0265-7 10.1186/s13000-021-01155-7 10.3389/fphys.2019.01436 10.1016/j.pathophys.2019.04.001 10.3389/fcvm.2021.657689 10.1097/GIM.0b013e3181f2481f 10.1126/science.1260419 10.1016/j.jacc.2021.08.039 10.1371/journal.pone.0169007 10.5858/2002-126-1064-AFAOP 10.1056/NEJMoa1110186 10.12688/f1000research.19444.1 10.1016/j.tcm.2019.12.009 10.1371/journal.pone.0249300 10.1038/gim.2015.30 |
ContentType | Journal Article |
Copyright | The Author(s) 2024. Published by Oxford University Press on behalf of American Society for Clinical Pathology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com. |
Copyright_xml | – notice: The Author(s) 2024. Published by Oxford University Press on behalf of American Society for Clinical Pathology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com. |
DBID | NPM AAYXX CITATION 7X8 |
DOI | 10.1093/ajcp/aqae100 |
DatabaseName | PubMed CrossRef MEDLINE - Academic |
DatabaseTitle | PubMed CrossRef MEDLINE - Academic |
DatabaseTitleList | CrossRef MEDLINE - Academic PubMed |
Database_xml | – sequence: 1 dbid: NPM name: PubMed url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database |
DeliveryMethod | fulltext_linktorsrc |
Discipline | Medicine Biology |
EISSN | 1943-7722 |
ExternalDocumentID | 10_1093_ajcp_aqae100 39180762 |
Genre | Journal Article |
GroupedDBID | --- .55 0R~ 1CY 23M 4.4 48X 53G 5GY 5RE 5WD 6J9 7RV 7X7 AABZA AACZT AAIMJ AAMDB AAMVS AAPQZ AAPXW AAQQT AARHZ AAUAY AAVAP AAWTL ABCQX ABEUO ABIXL ABJNI ABLJU ABMNT ABNHQ ABPPZ ABPTD ABQNK ABWST ABXVV ACGFO ACGFS ACPRK ACUFI ACYHN ADBBV ADFRT ADGZP ADHKW ADIPN ADQBN ADRTK ADVEK AELWJ AEMDU AENEX AENZO AEPUE AETBJ AEWNT AFFZL AFGWE AFIYH AFOFC AFXEN AGINJ AGQXC AGSYK AGUTN AHMBA AJEEA ALIPV ALMA_UNASSIGNED_HOLDINGS ALUQC APIBT ARIXL ATGXG AVWKF AYOIW BAWUL BAYMD BCRHZ BENPR BEYMZ BHONS BHPHI BQDIO BSWAC BTRTY BVRKM C45 CDBKE CS3 DAKXR DIK DILTD E3Z EBS EMB ENERS EX3 F5P FECEO FHSFR FLUFQ FOEOM FOTVD FQBLK GAUVT GJXCC GX1 H13 HCIFZ IAO IH2 J21 KOP KQ8 KSI KSN L7B LID LSO M7P MHKGH NLBLG NOMLY NOYVH NPM O9- OAUYM OAWHX OBOKY OCZFY ODMLO OJQWA OJZSN OK1 OPAEJ OVD OWPYF P2P P6G PAFKI PEELM ROX RUSNO SJN TEORI TJX TLC TPV TR2 TWZ WH7 WOW X7M YAYTL YKOAZ YXANX AASNB AAYXX CITATION 7X8 ABSAR |
ID | FETCH-LOGICAL-c178t-4c83ba5bd287400cbc9b80c651f592e59cf18b9e607201fd3a00be65c4c83ca23 |
ISSN | 0002-9173 1943-7722 |
IngestDate | Sun Aug 25 17:02:37 EDT 2024 Thu Sep 26 21:19:03 EDT 2024 Wed Oct 23 09:24:58 EDT 2024 |
IsPeerReviewed | true |
IsScholarly | true |
Keywords | acute fibrinoid organizing pneumonia Titin (TTN) dilated (familial) cardiomyopathy next-generation sequencing molecular autopsy |
Language | English |
License | The Author(s) 2024. Published by Oxford University Press on behalf of American Society for Clinical Pathology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com. |
LinkModel | OpenURL |
MergedId | FETCHMERGED-LOGICAL-c178t-4c83ba5bd287400cbc9b80c651f592e59cf18b9e607201fd3a00be65c4c83ca23 |
Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ORCID | 0000-0002-4434-1371 |
PMID | 39180762 |
PQID | 3096664284 |
PQPubID | 23479 |
ParticipantIDs | proquest_miscellaneous_3096664284 crossref_primary_10_1093_ajcp_aqae100 pubmed_primary_39180762 |
PublicationCentury | 2000 |
PublicationDate | 2024-Aug-24 2024-08-24 20240824 |
PublicationDateYYYYMMDD | 2024-08-24 |
PublicationDate_xml | – month: 08 year: 2024 text: 2024-Aug-24 day: 24 |
PublicationDecade | 2020 |
PublicationPlace | England |
PublicationPlace_xml | – name: England |
PublicationTitle | American journal of clinical pathology |
PublicationTitleAlternate | Am J Clin Pathol |
PublicationYear | 2024 |
References | Herman (2024082418460357800_CIT0007) 2012; 366 Beasley (2024082418460357800_CIT0012) 2002; 126 Ross (2024082418460357800_CIT0006) 2020; 9 Rich (2024082418460357800_CIT0010) 2020; 8 Richards (2024082418460357800_CIT0003) 2015; 17 Santos (2024082418460357800_CIT0013) 2019; 26 Uhlén (2024082418460357800_CIT0015) 2015; 347 Tharp (2024082418460357800_CIT0005) 2019; 10 Ramalho (2024082418460357800_CIT0016) 2021; 31 Tabish (2024082418460357800_CIT0004) 2017; 9 Escobar-Lopez (2024082418460357800_CIT0002) 2021; 78 Onishi (2024082418460357800_CIT0014) 2021; 16 Franaszczyk (2024082418460357800_CIT0008) 2017; 12 Chen (2024082418460357800_CIT0011) 2021; 16 Xiao (2024082418460357800_CIT0009) 2021; 8 Hershberger (2024082418460357800_CIT0001) 2010; 12 |
References_xml | – volume: 8 start-page: e1460 issue: 10 year: 2020 ident: 2024082418460357800_CIT0010 article-title: Novel heterozygous truncating titin variants affecting the A-band are associated with cardiomyopathy and myopathy/muscular dystrophy publication-title: Mol Genet Genomic Med. doi: 10.1002/mgg3.1460 contributor: fullname: Rich – volume: 9 start-page: 207 issue: 3 year: 2017 ident: 2024082418460357800_CIT0004 article-title: Genetic epidemiology of titin-truncating variants in the etiology of dilated cardiomyopathy publication-title: Biophys Rev. doi: 10.1007/s12551-017-0265-7 contributor: fullname: Tabish – volume: 16 start-page: 90 issue: 1 year: 2021 ident: 2024082418460357800_CIT0011 article-title: Acute fibrinous and organizing pneumonia: two case reports and literature review publication-title: Diagn Pathol. doi: 10.1186/s13000-021-01155-7 contributor: fullname: Chen – volume: 10 start-page: 1436 year: 2019 ident: 2024082418460357800_CIT0005 article-title: The giant protein titin’s role in cardiomyopathy: genetic, transcriptional, and post-translational modifications of TTN and their contribution to cardiac disease publication-title: Front Physiol. doi: 10.3389/fphys.2019.01436 contributor: fullname: Tharp – volume: 26 start-page: 213 issue: 3-4 year: 2019 ident: 2024082418460357800_CIT0013 article-title: Pathophysiology of acute fibrinous and organizing pneumonia—clinical and morphological spectra publication-title: Pathophysiology doi: 10.1016/j.pathophys.2019.04.001 contributor: fullname: Santos – volume: 8 start-page: 657689 year: 2021 ident: 2024082418460357800_CIT0009 article-title: Clinical significance of variants in the TTN gene in a large cohort of patients with sporadic dilated cardiomyopathy publication-title: Front Cardiovasc Med doi: 10.3389/fcvm.2021.657689 contributor: fullname: Xiao – volume: 12 start-page: 655 issue: 11 year: 2010 ident: 2024082418460357800_CIT0001 article-title: Clinical and genetic issues in dilated cardiomyopathy: a review for genetics professionals publication-title: Genet Med. doi: 10.1097/GIM.0b013e3181f2481f contributor: fullname: Hershberger – volume: 347 start-page: 1260419 issue: 6220 year: 2015 ident: 2024082418460357800_CIT0015 article-title: Proteomics. Tissue-based map of the human proteome publication-title: Science. doi: 10.1126/science.1260419 contributor: fullname: Uhlén – volume: 78 start-page: 1682 issue: 17 year: 2021 ident: 2024082418460357800_CIT0002 article-title: Association of genetic variants with outcomes in patients with nonischemic dilated cardiomyopathy publication-title: J Am Coll Cardiol. doi: 10.1016/j.jacc.2021.08.039 contributor: fullname: Escobar-Lopez – volume: 12 start-page: e0169007 issue: 1 year: 2017 ident: 2024082418460357800_CIT0008 article-title: Titin truncating variants in dilated cardiomyopathy—prevalence and genotype-phenotype correlations publication-title: PLoS One. doi: 10.1371/journal.pone.0169007 contributor: fullname: Franaszczyk – volume: 126 start-page: 1064 issue: 9 year: 2002 ident: 2024082418460357800_CIT0012 article-title: Acute fibrinous and organizing pneumonia: a histological pattern of lung injury and possible variant of diffuse alveolar damage publication-title: Arch Pathol Lab Med. doi: 10.5858/2002-126-1064-AFAOP contributor: fullname: Beasley – volume: 366 start-page: 619 issue: 7 year: 2012 ident: 2024082418460357800_CIT0007 article-title: Truncations of titin causing dilated cardiomyopathy publication-title: N Engl J Med. doi: 10.1056/NEJMoa1110186 contributor: fullname: Herman – volume: 9 start-page: 336 year: 2020 ident: 2024082418460357800_CIT0006 article-title: Exome sequencing in genetic disease: recent advances and considerations publication-title: F1000Res doi: 10.12688/f1000research.19444.1 contributor: fullname: Ross – volume: 31 start-page: 93 issue: 2 year: 2021 ident: 2024082418460357800_CIT0016 article-title: Lung function and cardiovascular disease: a link publication-title: Trends Cardiovasc Med. doi: 10.1016/j.tcm.2019.12.009 contributor: fullname: Ramalho – volume: 16 start-page: e0249300 issue: 4 year: 2021 ident: 2024082418460357800_CIT0014 article-title: Clinical features of acute fibrinous and organizing pneumonia: an early histologic pattern of various acute inflammatory lung diseases publication-title: PLoS One. doi: 10.1371/journal.pone.0249300 contributor: fullname: Onishi – volume: 17 start-page: 405 issue: 5 year: 2015 ident: 2024082418460357800_CIT0003 article-title: Standards and guidelines for the interpretation of sequence variants: a joint consensus recommendation of the American College of Medical Genetics and Genomics and the Association for Molecular Pathology publication-title: Genet Med. doi: 10.1038/gim.2015.30 contributor: fullname: Richards |
SSID | ssj0012804 |
Score | 2.479187 |
Snippet | Dilated cardiomyopathy (DCM) is often hereditary, with 20% to 40% of nonischemic cases showing familial linkage, yet genetic testing is underused. This report... Abstract Objectives Dilated cardiomyopathy (DCM) is often hereditary, with 20% to 40% of nonischemic cases showing familial linkage, yet genetic testing is... |
SourceID | proquest crossref pubmed |
SourceType | Aggregation Database Index Database |
Title | Identification of novel TTN gene variant in a patient exhibiting severe dilated cardiomyopathy co-occurring with acute fibrinoid organizing pneumonia |
URI | https://www.ncbi.nlm.nih.gov/pubmed/39180762 https://www.proquest.com/docview/3096664284/abstract/ |
hasFullText | 1 |
inHoldings | 1 |
isFullTextHit | |
isPrint | |
link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1bb9MwFLZgCMQLgnErNxkJnqIw5-IkfkRo0wRbByIVfYscx1EzjWSUdlL3P_i_nGO7SauBNHhJK0s5UXI-HX_n5kPIGyGkkCqtfKGTxI85z3wJtNgXXIqsqmsdR9jvfDxODifxxymfDlEl012yKN-pyz_2lfyPVmEN9Ipdsv-g2V4oLMB_0C9cQcNwvZaObZdt7cJupiaju9BnXp6PcTSy9i7AE4ZPh0ENuT5C1dM4E7sx5c6wLeq59qrmTCLzVKY49fuqwznFK091fqcUxgjXAVupsKygxjaBtmsqNxPq0nS0t3oJL97ITbrb54M2DqjoezHxIVtB_WNDZL_p5rQZMkZ99ADwKb0-VP1Zzs2EJO9kCbtt028uX2dyZhFezRpXzuyCGmGMUVrbS-3ssIgjJP7WUOura1csvz0VS56qc_z5IXXA2LDHrfP645PiYHJ0VOT70_wmuRWmgmMd6KcvQ-opzJgtRXBPc90SIH8Ppe852ds85i_OiSEp-X1yz3kX9L2FygNyQ7e75LadN7raJXeOXSXFQ_JrGzu0q6nBDgXsUMQOddihTUslddihA3aoxQ512KHb2KGb2KGIHWqwQ3vs0AE7tMfOIzI52M8_HPpuRIevgjRb-LHKolLyssKxCYypUokyYyrhQc1FqLlQdZCVYAdYCkyzriLJWKkTrvBGJcPoMdlpu1Y_JRR81yApU8WyWMRhVWWpULxMU5ADLFqnI_J2_cGLc3sSS2ErKKICFVM4xYzI67U2CjCVmP-Sre6WP4sI3PUE_e14RJ5YNfWSIhFkDIjBs2vc_ZzcHTD7guws5kv9EqjponxloPQbYAGZTQ |
link.rule.ids | 315,786,790,27955,27956 |
linkProvider | Colorado Alliance of Research Libraries |
openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Identification+of+novel+TTN+gene+variant+in+a+patient+exhibiting+severe+dilated+cardiomyopathy+co-occurring+with+acute+fibrinoid+organizing+pneumonia&rft.jtitle=American+journal+of+clinical+pathology&rft.au=Ma%2C+Weijie&rft.au=Wright%2C+Dana+L&rft.au=Parra%2C+Ourania&rft.au=Shah%2C+Nidhi+D&rft.date=2024-08-24&rft.issn=1943-7722&rft.eissn=1943-7722&rft_id=info:doi/10.1093%2Fajcp%2Faqae100&rft.externalDBID=NO_FULL_TEXT |
thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0002-9173&client=summon |
thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0002-9173&client=summon |
thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0002-9173&client=summon |