Clinical and molecular genetic analysis of a Chinese family with hereditary elliptocytosis caused by a novel mutation in the EPB41 gene

Abstract

Background: Hereditary elliptocytosis (HE) is a heterogeneous red blood cell membrane disorder characterized by the presence of elliptocytes on a peripheral blood smear. Clinical manifestations of HE vary widely from asymptomatic carriers to patients with severe transfusion-dependent anemia. Most patients are asymptomatic or have mild anemia, which hinders diagnosis. The proband in this case had mild anemia and jaundice over a period of 4 years, the etiology of which was unclear. Hence, he was admitted to our hospital for further diagnosis.Methods: Peripheral blood smears and routine blood tests were performed and biochemical parameters of the proband, and his family members were determined.To confirm the diagnosis, gene mutations were screened in the proband using nextgeneration sequencing (NGS) and verified by Sanger sequencing in other family members.Results: A novel mutation (c.1294delA, p.Ser432 fs) in exon 15 of the EPB41 gene was detected in the proband and his family members. This mutation results in a frameshift and a premature stop codon at position 455, encoding a truncated protein. The variant was likely pathogenic according to the criteria of the American College of Medical Genetics and Genomics. SWISS-MODEL protein structure prediction indicated partial loss of the spectrin and actin binding and C-terminal domains. Conclusion:A heterozygous mutation 1294delA in exon 15 of the EPB41 gene was identified using NGS and Sanger sequencing in members of a Chinese family. This identification expands the spectrum of EPB41 mutations and contributes to the genetic diagnosis of families with HE.

Case report: Whole-exome sequencing for a hereditary elliptocytosis case with an unexpectedly low HbA1c

“…The heterogenous SPTA1 IVS33-1G>A mutation was responsible for HE ( 15 ). Cao et al identified a heterozygous mutation 1294delA in exon 15 of the EPB41 gene using high-throughput sequencing and Sanger sequencing in members of a Chinese family ( 16 ).…”

A Systematic review on diagnostic methods of red cell membrane disorders in Asia

“…16 However, HE is also found in Europe, Mediterranean, Middle East, Japan, and India. 17 It is caused by mutations in α-spectrin, β-spectrin, and protein 4.1 which cause a defect in horizontal interactions of RBC cytoskeleton. The presence of elliptical shaped RBC is a morphological trait of HE.…”