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Blood, Vol. 96 No. 1 (July 1), 2000:
pp. 149-152
Mutations in the fibrinogen A gene account for the majority of
cases of congenital afibrinogenemia
Marguerite Neerman-Arbez,
Philippe de Moerloose,
Claire Bridel,
Ariane Honsberger,
Anni Schönbörner,
Colette Rossier,
Kathelijne Peerlinck,
Ségolène Claeyssens,
Donna Di Michele,
Roseline d'Oiron,
Marie Dreyfus,
Monique Laubriat-Bianchin,
Jacelyne Dieval,
Stylianos E. Antonarakis, and
Michael A. Morris
From the Division of Medical Genetics, University Medical
School and University Hospital, and the Division of Angiology and
Hemostasis, University Hospital, Geneva, Switzerland; the
Center for Molecular and Vascular Biology, Leuven, Belgium; the
Hemophilia Center, Hôpital Purpan, Toulouse, France; the
Department of Pediatrics, Weill Medical College of Cornell Hospital,
New York, New York; the Hemophilia Center and the
Hematology Laboratory, Hôpital Bicêtre, AP-HP
LeKremlin-Bicêtre; the Centre de Transfusion, Annecy; and the
Hematology Laboratory, CHR Amiens, France.
Congenital afibrinogenemia is a rare, autosomal, recessive disorder
characterized by the complete absence of detectable fibrinogen. We
previously identified the first causative mutations in a
nonconsanguineous Swiss family; the 4 affected persons have homozygous
deletions of approximately 11 kb of the fibrinogen alpha (FGA)
gene. Haplotype data implied that these deletions occurred on distinct
ancestral chromosomes, suggesting that this region may be susceptible
to deletion by a common mechanism. We subsequently showed that all the
deletions were identical to the base pair and probably resulted from a
nonhomologous recombination mediated by 7-bp direct repeats. In this
study, we have collected data on 13 additional unrelated patients to
identify the causative mutations and to determine the prevalence of the
11-kb deletion. A common recurrent mutation, at the donor splice site
of FGA intron 4 (IVS4 + 1 G > T), accounted for 14 of the
26 (54%) alleles. One patient was heterozygous for the previously
identified deletion. Three more frameshift mutations, 2 nonsense
mutations, and a second splice site mutation were also identified.
Consequently, 86% of afibrinogenemia alleles analyzed to date have
truncating mutations of FGA, though mutations in all 3 fibrinogen genes, FGG, FGA, and FGB, might be predicted to cause congenital afibrinogenemia.

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