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Blood, 15 October 2004, Vol. 104, No. 8, pp. 2394-2396.
Prepublished online as a Blood First Edition Paper on June 29, 2004; DOI 10.1182/blood-2004-04-1318.


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Submitted April 15, 2004
Accepted June 4, 2004

An Alu-mediated 31.5 kb deletion as the cause of Factor XI deficiency in two unrelated patients

Michael J Mitchell*, Letian Dai, Geoffrey F Savidge, and Anwar Alhaq

Centre for Haemostasis and Thrombosis, Haemophilia Reference Centre, Guy's and St. Thomas' Healthcare Trust, London, United Kingdom

* Corresponding author; email: Mike.Mitchell{at}gstt.sthames.nhs.uk.

Factor XI deficiency (MIM 264900) is an autosomal bleeding disorder of variable severity. Inheritance is not completely recessive as heterozygotes may display a distinct, if mild, bleeding tendency. Recent studies have shown the causative mutations of Factor XI deficiency, outside the Ashkanazi Jewish population, to be highly heterogeneous. We studied thirty-nine consecutively referred patients with factor XI deficiency in order to identify the molecular defect. Conventional mutation screening failed to identify a causative mutation in four of the thirty-nine patients. EBV transformed cells from these four patients were converted from a diploid to haploid chromosome complement. Subsequent analysis showed that two of the patients had a large deletion, which was masked in the heterozygous state by the presence of a normal allele. We report here the first confirmed whole gene deletion as the causative mutation of factor XI deficiency, the result of unequal homologous recombination between flanking Alu repeat sequences.


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