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Blood, 1 April 2006, Vol. 107, No. 7, pp. 2759-2765.
Prepublished online as a Blood First Edition Paper on December 8, 2005; DOI 10.1182/blood-2005-09-3702.


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Submitted September 14, 2005
Accepted November 22, 2005

Lack of F8 mRNA: a novel mechanism leading to Hemophilia A

Osman El-Maarri*, Heike Singer, Claudia Klein, Matthias Watzka, Ursula Herbiniaux, Hans H Brackmann, Jorg Schroder, Jochen Graw, Clemens R Muller, Wolfram Schramm, Rainer Schwaab, Thomas Haaf, Peter Hanfland, and Johannes Oldenburg

Institut of Experimental Haematology and Transfusion Medicine, University of Bonn, Bonn, Germany
Institut of Experimental Haematology and Transfusion Medicine, University of Bonn, Bonn, Germany; Institute of Human Genetics, Wuerzburg, Germany
Institute of Developmental Genetics, GSF-National Research Center for Envirenment and Health, Neuherberg, Germany
Institute of Human Genetics, Wuerzburg, Germany
Medical Clinic Dept of Transfusion Medicine, Munich, Germany
Institute of Human Genetics, Mainz, Germany
Institut of Experimental Haematology and Transfusion Medicine, University of Bonn, Bonn, Germany; Institute of Human Genetics, Wuerzburg, Germany; Institute of Transfusion Medecine and Immunhaematology, DRK Blood Donor, Frankfurt, Germany

* Corresponding author; email: osman.elmaarri{at}ukb.uni-bonn.de.

Haemophilia A (HA) is caused by partial or total deficiency of F8 protein activity. In a small group, about 1.8% of HA patients, no mutation is found in the F8 gene. Among this group, we report here on one patient with severe HA in whom no mRNA of the F8 gene was detected. Using two common polymorphisms in F8 exon 14, we were able to show that the same allele shared by the patient, his mother and his sister was not detected by reverse transcription PCR (RT-PCR) from total blood mRNA. Skewed X-chromosome inactivation in both the mother and the sister was excluded by studying the methylation profile of the androgen receptor gene (HUMARA locus). These findings strongly suggest that the cause of HA in this patient is either absence or rapid degradation of the F8 mRNA which points to a novel mechanism leading to HA.


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