Genetic analysis and management of a familial hypercholesterolemia pedigree with polygenic variants : Case report

Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc..

RATIONALE: Familial hypercholesterolemia (FH) is an autosomal dominant genetic disorder typically caused by low density lipoprotein receptor (LDLR) gene mutation. Herein, we reported a FH pedigree with polygenic variants: LDLR, apolipoprotein B (APOB), and epoxide hydrolase 2 (EPHX2).

PATIENT CONCERNS: A 10-year-old boy mainly presented multiple skin xanthomas and hypercholesterolemia. His family visited our hospital and was performed with pedigree whole exome sequencing (WES) at 20 + 3 weeks gestation of the mother's second pregnancy.

DIAGNOSES: Based on the clinical features and genetic analysis, the pedigree was diagnosed with familial hypercholesterolemia.

INTERVENTIONS: After genetic counseling, the couple opted to continue the pregnancy. Treatment advice and follow-up were offered to them.

OUTCOMES: A novel compound heterozygous LDLR mutation: c.1009G>T and c.68-2A>G, derived from his parents respectively was revealed through pedigree WES, meanwhile, a maternal APOB gene variant: c.1670A>G and a paternal EPHX2 gene variant: c.548 dup of the proband were found together. Furthermore, the same compound heterozygous LDLR mutation as his was confirmed in his sister without APOB and EPHX2 variants in her fetal stage.

LESSONS: WES combined with clinical features is essential for the diagnosis of FH, however, prenatal genetic testing results might bring more challenges to prenatal genetic counseling. Furthermore, it is more important to provide the guidance and early intervention for such families in the long run.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:102

Enthalten in:

Medicine - 102(2023), 32 vom: 11. Aug., Seite e34534

Sprache:

Englisch

Beteiligte Personen:

Han, Yu [VerfasserIn]
Zhang, Lin [VerfasserIn]
Tao, Huimin [VerfasserIn]
Wu, Jiebin [VerfasserIn]
Zhai, Jingfang [VerfasserIn]

Links:

Volltext

Themen:

Apolipoproteins B
Case Reports
Journal Article

Anmerkungen:

Date Completed 14.08.2023

Date Revised 08.11.2023

published: Print

Citation Status MEDLINE

doi:

10.1097/MD.0000000000034534

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM360653952