Caracterización de variantes en el exón 28 del gen VWF y su correlación genotipo-fenotipo en una muestra de pacientes con enfermedad de Von Willebrand tipo 2
Characterization of variants in exon 28 of the VWF gene and their genotype-phenotype correlation in a sample of patients with von Willebrand disease type 2.
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Introducción: la enfermedad de Von Willebrand es la coagulopatía hereditaria más común en la población, el abordaje del análisis molecular como apoyo diagnóstico ha sido limitado en la enfermedad de Von Willebrand (EvW) de tipo 2. El objetivo de este estudio es caracterizar las variantes en el exón 28 del gen VWF y realizar la correlación genotipo-fenotipo en una muestra de pacientes con EvW tipo 2. Métodos: se analizaron 20 muestras de pacientes previamente diagnosticados con EvW tipo 2 con edades entre 8 y 56 años. Se realizó análisis del Exón 28 del gen VWF, por amplificación, verificación por electroforesis en geles de agarosa y secuenciación con el Kit Big Dye Terminator V3.1 Resultados: se identificó la variante patogénica en 15 (88.2%) pacientes no relacionados. La variante p.Gly1609Arg fue identificada en el 52.9% de los pacientes analizados (n=9) sola o en combinación, seguido en frecuencia por p.Ile1425Phe (n=3), y p.Ala1437Thr (n=3) sola o en combinación, un paciente con p.Arg1597Trp y otro con p.Arg1334Trp. Adicionalmente, en el 31.6% (n=6) de los pacientes se identificaron dos variantes patogénicas (dos pacientes con p.Gly1609Arg/p.Ala1437Thr; un paciente p.Gly1609Arg/p.Ser1506Leu; un paciente p.Gly1609Arg/p.Arg1597Trp; un paciente p.Gly1609Arg/p.Val1279Phe; y un paciente p.Ile1628Thr/p.Ser1325Phe). No se identificó variante en dos pacientes (11.8%). Se pudo reclasificar el subtipo EvW tipo 2 en el 40% (n=8) de pacientes. Conclusiones: este es el primer estudio realizado en Colombia que permite identificar la causa genética de EvW, mediante la secuenciación de exones específicos en una cohorte de seguimiento.
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