Analysis of the genotypes and phenotypes of 37 unrelated patients with inherited factor VII deficiency

• Published in: European journal of human genetics : EJHG Vol. 9; no. 2; pp. 105 - 112
• Main Authors: Giansily-Blaizot, M, Aguilar-Martinez, P, Biron-Andreani, C, Jeanjean, P, Igual, H, Schved, J F
• Format: Journal Article
• Language: English
• Published: England Nature Publishing Group 01.02.2001
• Subjects: Alleles; Bleeding; Boundaries; Coagulation; Coagulation factors; Deoxyribonucleic acid; DNA; DNA Mutational Analysis; DNA Primers - chemistry; DNA sequencing; Electrophoresis, Agar Gel; Epidermal growth factor; Exons; Factor VII Deficiency - congenital; Factor VII Deficiency - diagnosis; Factor VII Deficiency - genetics; Female; Gel electrophoresis; Gene expression; Genotype; Genotypes; Hematology; Hereditary diseases; Humans; Laboratories; Male; Mutation; Mutation, Missense; Patients; Phenotype; Phenotypes; Polymerase Chain Reaction; Polymorphism, Genetic; Surveys and Questionnaires; France
• ISSN: 1018-4813; 1476-5438
• DOI: 10.1038/sj.ejhg.5200593

Severe inherited factor VII (FVII) deficiency is a rare autosomal recessive disorder with a poor relationship between FVII coagulant activity and bleeding tendency. Both clinical expression and mutational spectrum are highly variable. We have screened for mutations the FVII gene of 37 unrelated patients with a FVII coagulant activity less than 5% of normal pooled plasmas. The nine exons with boundaries and the 5' flanking region of the FVII gene were explored using a combination of denaturing gradient gel electrophoresis and direct DNA sequencing. This strategy allowed us to characterise 68 out of the 74 predicted FVII mutated alleles. They corresponded to a large panel of 40 different mutations. Among these, 18 were not already reported. Genotypes of the severely affected patients comprised, on both alleles, deleterious mutations which appeared to be related to a total absence of activated FVII. We suggest that this absence of functional FVII can explain the severe clinical expression. Whether a small release of FVII is sufficient to initiate the coagulation cascade and to prevent the expression of a severe phenotype, requires further investigations.