Document Detail

Carrier detection and prenatal diagnosis of congenital adrenal hyperplasia must identify 'apparently mild' CYP21A2 alleles which associate neonatal salt-wasting disease.
MedLine Citation:
PMID:  20661889     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Couples at risk of severe congenital adrenal hyperplasia (CAH) may be offered prenatal treatment or preimplantation diagnosis. However, proper genetic counselling requires the accurate identification of apparently 'mild alleles' in partners of CAH-carriers/patients.
METHODS: CYP21A2 gene analyses were performed in 255 patients with severe 21-hydroxylase deficiency (21-OHD), 94 with mild 21-OHD, 752 parental samples, 233 clinically unaffected partners and 253 historic DNA samples. GENSCAN and ClustalX2.0 software were used for in silico analyses, and Epidat 3.1 software for statistical calculations.
RESULTS: Twenty-seven partners were carriers of p.Val282Leu (alias p.Val281Leu, allele frequency 11.7%, 7.4-16.1). 'Val282Leu alleles' were detected in 30 patients with salt-wasting (SW) disease, 21 with other pseudogene-derived and rare coding cis severe mutations, and 9 without. These CYP21A2 genes were compared to those of 94 fully characterized patients with mild deficiency carrying p.Val282Leu in compound heterozygosity with a severe allele. A rare intronic variant, c.292+5G>A, was detected in the nine 'severe Val282Leu alleles' and that was not seen in mild p.Val282Leu alleles, in other deficient alleles or in normal chromosomes. The in silico documented effect on splicing and the clinical association (p < 0.0001) confirmed p.Val282Leu; c.292+5G>A as a severe allele.
CONCLUSION: As only severe alleles require clinical intervention, CAH-carrier detection of p.Val282Leu should be followed by the analysis of c.292+5G>A.
Begoña Ezquieta; Luis Santomé; Raquel Barrio; Jose L Barrionuevo; Juan P López-Siguero; Antonio Oliver; Joaquín Ramírez; Ildefonso Rodríguez; Rafael Muñoz-Pacheco
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Prenatal diagnosis     Volume:  30     ISSN:  1097-0223     ISO Abbreviation:  Prenat. Diagn.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-27     Completed Date:  2010-11-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8106540     Medline TA:  Prenat Diagn     Country:  England    
Other Details:
Languages:  eng     Pagination:  758-63     Citation Subset:  IM    
Copyright Information:
(c) 2010 John Wiley & Sons, Ltd.
Laboratorio de Diagnóstico Molecular, Hospital Universitario Gregorio Marañón, Madrid, Spain.
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MeSH Terms
Adrenal Hyperplasia, Congenital / diagnosis,  enzymology*,  genetics
DNA / chemistry,  genetics
Genetic Counseling
Genetic Variation
Infant, Newborn
Microsatellite Repeats
Polymerase Chain Reaction
Polymorphism, Single Nucleotide
Prenatal Diagnosis / methods*
Steroid 21-Hydroxylase / genetics*
Reg. No./Substance:
9007-49-2/DNA; EC protein, human; EC 21-Hydroxylase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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