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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8883527PMC
http://dx.doi.org/10.3324/haematol.2021.279689DOI Listing

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Congenital thrombocytopenia results from mutations in genes implicated in megakaryocyte differentiation and/or platelet formation and clearance. We report the case of a 25 year old primigravida who presented with severe macro-thrombocytopenia from the age of 12 years. She delivered an alive female baby at 35 weeks of gestation.

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GNE encodes a rate-limiting enzyme that regulates the biosynthesis of a sialic acid precursor. As sialic acids are critical for the platelet membrane and muscle fibers, GNE variants cause GNE-related thrombocytopenia and GNE-related myopathy. Here, we report a neonate with thrombocytopenia that initially met the criteria for neonatal allo-immune thrombocytopenia (NAIT) but was resistant to treatments and then revealed novel biallelic heterozygous GNE variants without any symptoms of myopathy when diagnosed.

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Article Synopsis
  • - The study highlights the complexity of hereditary thrombocytopenia, emphasizing that diagnosing these diverse diseases based solely on symptoms (phenotypes) is challenging, and underscores the value of whole exome sequencing (WES) in improving patient management.
  • - Seven female patients with long-standing unexplained thrombocytopenia participated, with clinical features including macrothrombocytopenia and, for some, bleeding issues; WES was effective in identifying 11 specific mutant alleles, including some not previously documented.
  • - The results showcase the ability of WES to uncover genetic mutations associated with macrothrombocytopenia, enhancing the understanding of the disease and aiding in future correlations between genetic changes and clinical manifestations.
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