Abstract
Background: Haemophilia A and B (HA, HB) are the most frequent X-linked bleeding diseases; two-thirds of cases are severe.
Methods: We counselled 51 couples for prenatal diagnosis (PD) of haemophilia. In 7/51 (13.7%) cases, the couple decided not to undergo PD because counselling revealed that they were carriers of a mild form of the disease, while we performed 44 PD for severe HA (36 cases) or HB (8 cases). The indication for PD was a haemophilic child (30/44, 68.2%) or an affected family member (12/44, 27.3%); in two cases the non-carrier mother of isolated haemophilic patients requested PD because of the risk of mosaicism.
Results: We completed PD in 43/44 cases; in one case, the prenatal sample was contaminated by maternal DNA; however, molecular analysis revealed the female sex of the foetus. We performed PD for 16 of the 36 couples at risk of HA (44.4%) by analysing the intron (IVS)22 inversion; in 1/36 cases (2.8%) the mother had the IVS1 inversion, and in 8/36 (22.2%) the family mutation was identified by sequencing; in 11/36 (30.6%) cases the family mutation was unknown, and PD was performed by linkage (no recombination nor uninformative cases occurred). For HB, in 6/8 (75.0%) cases, PD was performed by DHPLC or by sequencing; in 2/8 cases we tested intragenic markers (again with no cases of recombination or uninformative families).
Conclusions: PD in well-equipped laboratories, and multidisciplinary counselling are an aid to planning reproductive and early therapeutic strategies in families with severe haemophilia.
Grants from the Regione Campania (DGRC 1901/09) are gratefully acknowledged. We are indebted to Jean Ann Gilder (Scientific Communication srl) for editing the text.
Conflict of interest statement
Authors’ conflict of interest disclosure: The authors stated that there are no conflicts of interest regarding the publication of this article.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
References
1. Castaldo G, D’Argenio V, Nardiello P, Zarrilli F, Sanna V, Rocino A, et al. Haemophilia A: molecular insights [review]. Clin Chem Lab Med 2007;45:450–61.10.1515/CCLM.2007.093Search in Google Scholar PubMed
2. Castaldo G, Nardiello P, Bellitti F, Santamaria R, Rocino A, Coppola A, et al. Haemophilia B: from molecular diagnosis to gene therapy [review]. Clin Chem Lab Med 2003;41: 445–51.10.1515/CCLM.2003.067Search in Google Scholar PubMed
3. Santacroce R, Acquila M, Belvini D, Castaldo G, Garagiola I, Giacomelli SH, et al. Identification of 217 unreported mutations in the F8 gene 3 in a group of 1,410 unselected Italian patients with hemophilia A. J Hum Genet 2008;53:275–8.http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=000253572300011&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f310.1007/s10038-007-0238-ySearch in Google Scholar PubMed
4. Belvini D, Salviato R, Radossi P, Pierobon F, Mori PG, Castaldo G, et al. Molecular genotyping of the Italian cohort of patients with haemophilia B. Haematologica 2005;90:635–42.Search in Google Scholar PubMed
5. Castaldo G, Nardiello P, Bellitti F, Rocino A, Coppola A, Di Minno G, et al. Denaturing HPLC procedure for factor IX gene scanning. Clin Chem 2003;49:815–8.10.1373/49.5.815Search in Google Scholar PubMed
6. Kasper CK, Buzin CH. Mosaics and haemophilia. Haemophilia 2009;15:1181–6.10.1111/j.1365-2516.2009.02003.xSearch in Google Scholar PubMed
7. Tagariello G, Belvini D, Salviato R, Are A, De Biasi E, Goodeve A, et al. Experience of a single Italian center in genetic counseling for hemophilia: from linkage analysis to molecular diagnosis. Haematologica 2000;85:525–9.Search in Google Scholar PubMed
8. Kulkarni R, Lusher J. Perinatal management of neonates with haemophilia. Br J Haematol 2001;112:264–74.10.1046/j.1365-2141.2001.02362.xSearch in Google Scholar PubMed
9. Maruotti GM, Frisso G, Calcagno G, Fortunato G, Castaldo G, Martinelli P, et al. Prenatal diagnosis of inherited diseases: the 20 years’ experience of an Italian Regional Reference Centre. Clin Chem Lab Med 2013;51:2211–7.10.1515/cclm-2013-0194Search in Google Scholar PubMed
10. Sanna V, Zarrilli F, Nardiello P, D’Argenio V, Rocino A, Coppola A. Mutational spectrum of F8 gene and prothrombotic gene variants in haemophilia A patients from Southern Italy. Haemophilia 2008;14:796–803.10.1111/j.1365-2516.2008.01705.xhttp://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=000257794400017&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f3Search in Google Scholar PubMed
11. Ljung R, Lindgren AC, Petrini P, Tengborn L. Normal vaginal delivery is recommended for haemophilia carrier gravidae. Acta Paediatr 1994;83:609–11.10.1111/j.1651-2227.1994.tb13090.xSearch in Google Scholar PubMed
12. Klinge J, Auberger K, Auerswald G, Brackmann HH, Mauz-Korholz C, Kreuz W. Prevalence and outcome of intracranial haemorrhage in haemophiliacs – a survey of the paediatric group of the German Society of Thrombosis and Haemostasis (GTH). Eur J Pediatr 1999;158:162–5.10.1007/PL00014346Search in Google Scholar PubMed
13. Kenet G, Chan AK, Soucie JM, Kulkarni R. Bleeding disorders in neonates. Haemophilia 2010;16:168–74.10.1111/j.1365-2516.2010.02316.xSearch in Google Scholar PubMed
14. Chi C, Lee CA, Shiltagh N, Khan A, Pollard D, Kadir RA. Pregnancy in carriers of haemophilia. Haemophilia 2008;14: 56–64.http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=000251860900009&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f3Search in Google Scholar PubMed
15. Peyvandi F, Bidlingmaier C, Garagiola I. Management of pregnancy and delivery in women with inherited bleeding disorders. Semin Fetal Neonatal Med 2011;16:311–7.10.1016/j.siny.2011.07.006http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=000296545500005&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f3Search in Google Scholar PubMed
16. Karimi M, Peyvandi F, Siboni S, Ardeshiri R, Gringeri A, Mannucci PM. Comparison of attitudes towards prenatal diagnosis and termination of pregnancy for haemophilia in Iran and Italy. Haemophilia 2004;10:367–9.10.1111/j.1365-2516.2004.00927.xSearch in Google Scholar PubMed
17. Balak DM, Gouw SC, Plug I, Maser-Bunschoten EP, Vriends HJ, Van Diemen-Homan JE, et al. Prenatal diagnosis for haemophilia: a national survey among female carriera in the Netherlands. Haemophilia 2012;18:584–92.10.1111/j.1365-2516.2011.02742.xSearch in Google Scholar PubMed
18. Tomaiuolo R, Nardiello P, Martinelli P, Sacchetti L, Salvatore F, Castaldo G. Prenatal diagnosis of cystic fibrosis: an experience of 181 cases. Clin Chem Lab Med 2013;51:2227–32.10.1515/cclm-2013-0200Search in Google Scholar PubMed
19. Esposito G, Ruggiero R, Savarese M, Savarese G, Tremolaterra MR, Salvatore F, et al. Prenatal molecular diagnosis of inherited neuromuscular diseases: Duchenne/Becker muscular dystrophy, myotonic dystrophy type 1 and spinal muscular atrophy. Clin Chem Lab Med 2013;51:2239–45.10.1515/cclm-2013-0209Search in Google Scholar PubMed
20. Grosso M, Puzone S, Storino MR, Sessa R, Izzo P. Prenatal diagnosis of hemoglobinopathies: our experience on 523 cases. Clin Chem Lab Med 2013;51:2219–25.10.1515/cclm-2013-0195Search in Google Scholar PubMed
21. Ljiung RC. Prenatal diagnosis of haemophilia. Haemophilia 1999;5:84–7.10.1046/j.1365-2516.1999.00295.xSearch in Google Scholar PubMed
22. Margaglione M, Castaman GC, Morfini M, Rocino A, Santagostino E, Tagariello G, et al. The Italian AICE-Genetics Hemophilia A database: results and correlation with clinical phenotype. Haematologica 2008;93:722–8.10.3324/haematol.12427http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=000255443600012&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f3Search in Google Scholar PubMed
©2013 by Walter de Gruyter Berlin Boston
Articles in the same Issue
- Letters to the Editor
- The addition of MESNA in vitro prolongs prothrombin time similar to N-acetyl cysteine
- Detection of unknown β-thalassemia cases from atypical HbA1c chromatograms
- Analytical study of a new turbidimetric assay for urinary neutrophil gelatinase-associated lipocalin (NGAL) determination
- The rare bipolar-contracted red cell significance and correlation with red cell volume
- Howell-Jolly body interference in reticulocyte counts
- PBMC expressed adiponectin mRNA is predictive of survival in patients with gastric cancer
- Comparison study of two commercially available methods for the determination of infliximab, adalimumab, etanercept and anti-drug antibody levels
- Development and validation of a rapid and reliable high-performance liquid chromatography method for methadone quantification in human plasma and saliva
- Reply to Ruiz-Argüello et al.: Comparison study of two commercially available methods for the determination of infliximab, adalimumab, etanercept and anti-drug antibody levels
- Still more discussion on the journal impact factor
- The order of draw, myth or science
- Masthead
- Masthead
- Editorial
- Multidisciplinarity and interdisciplinarity at work: the prenatal diagnosis
- Research Articles
- Prenatal diagnosis of inherited diseases: 20 years’ experience of an Italian Regional Reference Centre
- Prenatal diagnosis of haemoglobinopathies: our experience of 523 cases
- Prenatal diagnosis of cystic fibrosis: an experience of 181 cases
- Prenatal diagnosis of haemophilia: our experience of 44 cases
- Prenatal molecular diagnosis of inherited neuromuscular diseases: Duchenne/Becker muscular dystrophy, myotonic dystrophy type 1 and spinal muscular atrophy
- Editorials
- Journal impact factor: the debate continues
- Estimation of uncertainty in measurements in the clinical laboratory
- Review
- Searching for genes involved in hypertension development in special populations: children and pre-eclamptic women. Where are we standing now?
- Opinion Paper
- More discussion on journal impact factor
- General Clinical Chemistry and Laboratory Medicine
- Category-specific uncertainty modeling in clinical laboratory measurement processes
- The order of draw: myth or science?
- Planned variation in preanalytical conditions to evaluate biospecimen stability in the National Children’s Study (NCS)
- Longitudinal evaluation of thyroid autoimmunity and function in pregnant Korean women
- Evaluation of the N Latex free light chain assay in the diagnosis and monitoring of AL amyloidosis
- Identification of an important potential confound in CSF AD studies: aliquot volume
- Cancer Diagnostics
- Double heterozygosity in the BRCA1 and BRCA2 genes in Italian family
- Quantification of EGFR autoantibodies in the amplification phenomenon of HER2 in breast cancer
- Diabetes
- SAA1 genetic polymorphisms are associated with plasma glucose concentration in non-diabetic subjects
- Acknowledgment
- Acknowledgment
Articles in the same Issue
- Letters to the Editor
- The addition of MESNA in vitro prolongs prothrombin time similar to N-acetyl cysteine
- Detection of unknown β-thalassemia cases from atypical HbA1c chromatograms
- Analytical study of a new turbidimetric assay for urinary neutrophil gelatinase-associated lipocalin (NGAL) determination
- The rare bipolar-contracted red cell significance and correlation with red cell volume
- Howell-Jolly body interference in reticulocyte counts
- PBMC expressed adiponectin mRNA is predictive of survival in patients with gastric cancer
- Comparison study of two commercially available methods for the determination of infliximab, adalimumab, etanercept and anti-drug antibody levels
- Development and validation of a rapid and reliable high-performance liquid chromatography method for methadone quantification in human plasma and saliva
- Reply to Ruiz-Argüello et al.: Comparison study of two commercially available methods for the determination of infliximab, adalimumab, etanercept and anti-drug antibody levels
- Still more discussion on the journal impact factor
- The order of draw, myth or science
- Masthead
- Masthead
- Editorial
- Multidisciplinarity and interdisciplinarity at work: the prenatal diagnosis
- Research Articles
- Prenatal diagnosis of inherited diseases: 20 years’ experience of an Italian Regional Reference Centre
- Prenatal diagnosis of haemoglobinopathies: our experience of 523 cases
- Prenatal diagnosis of cystic fibrosis: an experience of 181 cases
- Prenatal diagnosis of haemophilia: our experience of 44 cases
- Prenatal molecular diagnosis of inherited neuromuscular diseases: Duchenne/Becker muscular dystrophy, myotonic dystrophy type 1 and spinal muscular atrophy
- Editorials
- Journal impact factor: the debate continues
- Estimation of uncertainty in measurements in the clinical laboratory
- Review
- Searching for genes involved in hypertension development in special populations: children and pre-eclamptic women. Where are we standing now?
- Opinion Paper
- More discussion on journal impact factor
- General Clinical Chemistry and Laboratory Medicine
- Category-specific uncertainty modeling in clinical laboratory measurement processes
- The order of draw: myth or science?
- Planned variation in preanalytical conditions to evaluate biospecimen stability in the National Children’s Study (NCS)
- Longitudinal evaluation of thyroid autoimmunity and function in pregnant Korean women
- Evaluation of the N Latex free light chain assay in the diagnosis and monitoring of AL amyloidosis
- Identification of an important potential confound in CSF AD studies: aliquot volume
- Cancer Diagnostics
- Double heterozygosity in the BRCA1 and BRCA2 genes in Italian family
- Quantification of EGFR autoantibodies in the amplification phenomenon of HER2 in breast cancer
- Diabetes
- SAA1 genetic polymorphisms are associated with plasma glucose concentration in non-diabetic subjects
- Acknowledgment
- Acknowledgment