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Blood, 15 November 2000, Vol. 96, No. 10, pp. 3650-3652
BRIEF REPORT
Novel mutation in the -glutamyl carboxylase gene resulting in
congenital combined deficiency of all vitamin
K-dependent blood coagulation factors
Henri M. H. Spronk,
Roula
A. Farah,
George R. Buchanan,
Cees Vermeer, and
Berry A. M. Soute
From the Department of Pediatrics, Sainte-Therese
Hospital, Beirut, Lebanon; the Department of Pediatrics,
University of Texas Southwestern Medical Center, Dallas, TX; and the
Department of Biochemistry, Maastricht University, The
Netherlands.
A mutation in the -glutamyl carboxylase gene leading to a
combined congenital deficiency of all vitamin K-dependent coagulation factors was identified in a Lebanese boy. He is the first offspring of
consanguineous parents and was homozygous for a unique point mutation
in exon 11, resulting in the conversion of a tryptophan codon (TGG) to
a serine codon (TCG) at amino acid residue 501. Oral vitamin
K1 administration resulted in resolution of the clinical symptoms. Screening of several family members on this mutation with an
RFLP technique revealed 10 asymptomatic members who were heterozygous
for the mutation, confirming the autosomal recessive pattern of
inheritance of this disease. In 50 nonrelated normal subjects, the mutation was not found. This is the second time a
missense mutation in the -glutamyl carboxylase gene is described that has serious impact on normal hemostasis.

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