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Published on: August 14, 2017
A case of inherited type 1 and type 2A von Willebrand disease confirmed by diagnostic exome sequencing
Ye Jee Shim1, So Yun Park1, Nani Jung1
1Department of Pediatrics, Keimyung University School of Medicine and Dongsan Medical Center, Daegu, Republic of Korea.
Insights
This study identifies compound heterozygous mutations in von Willebrand disease (vWD) within a family. Genetic analysis confirmed distinct vWD type 1 and type 2A variants, guiding patient management.
Area of Science:
- Genetics
- Hematology
- Molecular Biology
Background:
- Von Willebrand disease (vWD) is a common inherited bleeding disorder.
- Accurate genetic diagnosis is crucial for effective management and genetic counseling.
- Pediatric coagulopathy necessitates thorough investigation of inherited bleeding disorders.
Observation:
- A pediatric patient and family members presented with coagulopathy.
- Laboratory tests revealed von Willebrand disease in all affected family members.
- Diagnostic exome sequencing was performed for genetic confirmation.
Findings:
- The patient was diagnosed as a compound heterozygote for vWD.
- He inherited a known vWD type 1 variant (c.2574C>G) from his father.
- He inherited a vWD type 2A variant (c.3390C>T) causing exon 26 skipping from his mother.
Implications:
- Understanding compound heterozygous mutations in vWD is essential for personalized treatment strategies.
- Management of vWD in pediatric patients requires careful consideration of genetic variants.
- Successful surgical outcomes can be achieved with appropriate hemostatic management in vWD patients.
Abstract:
A 10-year-old male and his family members visited a pediatric hematology clinic due to coagulopathy. Laboratory tests indicated von Willebrand disease (vWD) in all the family members. We conducted diagnostic exome sequencing for confirmation. The patient was confirmed to be a compound heterozygote for vWD: c.2574C > G (p.Cys858Trp) from his father (known variant of vWD type 1) and c.3390C > T (p.Pro1127_Gly1180delinsArg) from his mother (variant known to result in exon 26 skipping in vWD type 2A). He was managed with factor VIII and von Willebrand factor complex concentrate during palatoplasty due to bleeding despite pre-operative desmopressin injection. The operation was completed successfully.
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