Congenital Fibrocystic Disease of the Pancreas: A Report of Two Proved Cases of Dissimilar Clinical Types in Siblings

Macgregor, Agnes R.; Rhaney, K.

doi:10.1136/adc.23.113.56

Cited by 9 publications

(1 citation statement)

References 7 publications

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“…Variations in disease onset and/or severity have been observed in siblings with cystic fibrosis (CF) for decades (Macgregor and Rhaney 1948). The most notable differences relate to CF lung disease.…”

Section: Introductionmentioning

confidence: 99%

Applying whole-genome sequencing in relation to phenotype and outcomes in siblings with cystic fibrosis

Wilk

Braun

Farrell

et al. 2020

Cold Spring Harb Mol Case Stud

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Variations in disease onset and/or severity have often been observed in siblings with cystic fibrosis (CF), despite the same CFTR genotype and environment. We postulated that genomic variation (modifier and/or pharmacogenomic variants) might explain these clinical discordances. From a cohort of patients included in the Wisconsin randomized clinical trial (RCT) of newborn screening (NBS) for CF, we identified two brothers who showed discordant lung disease courses as children, with one milder and the other more severe than average, and a third, eldest brother, who also has severe lung disease. Leukocytes were harvested as the source of DNA, and whole-genome sequencing (WGS) was performed. Variants were identified and analyzed using in-house-developed informatics tools. Lung disease onset and severity were quantitatively different between brothers during childhood. The youngest, less severely affected brother is homozygous for HFE p.H63D. He also has a very rare PLG p.D238N variant that may influence host-pathogen interaction during chronic lung infection. Other variants of interest were found differentially between the siblings. Pharmacogenomics findings were consistent with the middle, most severely affected brother having poor outcomes to common CF treatments. We conclude that genomic variation between siblings with CF is expected. Variable lung disease severity may be associated with differences acting as genetic modifiers and/or pharmacogenomic factors, but large cohort studies are needed to assess this hypothesis.

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Section: Introductionmentioning

confidence: 99%