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High frequency of the c.3207C>A (p.H1069Q) mutation in ATP7B gene of Lithuanian patients with hepatic presentation of Wilson's disease

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World Journal of Gastroenterology 2008年第38期14卷 5876-5879页

作者： Laimutis Kucinskas Jolanta Jeroch Astra Vitkauskiene Raimundas Sakalauskas Vitalija Petrenkiene Vaidutis Kucinskas Rima Naginiene Hartmut Schmidt Limas Kupcinskas Institute of Biology of Kaunas University of Medicine Mickeviiaus 9 Kaunas LT-44307 Lithuania Institute of Biomedical Research of Kaunas University of Medicine Eiveniu 4 Kaunas LT-50009 Lithuania Laboratory of Immunology and Genetics Kaunas University of Medicine Eiveniu 2 Kaunas LT-50009 Lithuania Department of Pulmonology and Immunology Kaunas University of Medicine Eiveniu 2Kaunas LT-50009 Lithuania Department of Gastroenterology Kaunas University of Medicine Eiveniu 2Kaunas LT-50009 Lithuania Department of Human and Medical Genetics Faculty of Medicine Vilnius University Santariskiu 2Vilnius LT-08661 Lithuania Institute of Biomedical Research of Kaunas University of Medicine Eiveniu 4Kaunas LT-50009 Lithuania Department of Hepatotransplanthology University of Munster Schlossplatz 2Munster D-48149 Germany Department of Gastroenterology Kaunas University of Medicine Eiveniu 2 Kaunas LT-50009 Lithuania

AIM： To investigate the prevalence of the ATP7B gene mutation in patients with hepatic presentation of Wilson＇s disease （WD） in Lithuania. METHODS： Eleven unrelated Lithuanian families, including 13 WD patients were tested. Clinically WD diagnosis was established in accordance to the Leipzig scoring system. Genomic DNA was extracted from whole venous blood using a salt precipitation method. Firstly, the semi-nested polymerase chain reaction （PCR） technique was used to detect the c.3207C〉A （p.H1069Q） mutation. Patients not homozygous for the c.3207C〉A （p.H1069Q） mutation were further analyzed. The 21 exons of the WD gene were amplified in a thermal cycler （Biometra T3 Thermocycler, G0ttingen, Germany）. Direct sequencing of the amplified PCR products was performed by cycle sequencing using fluorescent dye terminators in an automatic sequencer （Applied Biosystems, Darmstadt, Germany）. RESULTS： Total of 13 WD patients （mean age 26.4 years; range 17-40; male/female 3/10） presented with hepatic disorders and 16 their first degree relatives （including 12 siblings） were studied. Some of WD patients, in addition to hepatic symptoms, have had extrahepatic disorders （hemolytic anemia 3; Fanconi syndrome 1; neurophsychiatric and behavioural disorder 2）. Liver biopsy specimens were available in all of 13 WD patients （8 had cirrhosis; 1-chronic hepatitis; 3-acute liver failure, 1-1iver steatosis）. Twelve of 13 （92.3%） WD patients had the c.3207C〉A （***069Q） mutation, 6 of them in both chromosomes, 6 were presented as compound heterozygotes with additional c.3472-82delGGTTTAACCAT, c.3402delC, c.3121C〉T （***041W） or unknown mutations. For one patient with liver cirrhosis and psychiatric disorder （Leipzig score 6）, no mutations were found. Out of 16 first degree WD relatives, 11 （68.7%） were heterozygous for the c.3207C〉A （p.H1069Q） mutation. Two patients with fulminant WD died from acute liver failure and ii are in full remission under peniciilamine or zinc acetate treatment. Thr

关键词： Wilson disease ATP7B gene c.3207C〉A(p.H1069Q) mutation Cirrhosis urine copper copper in liver biopsies

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