4.2 Article

Clinical, Pathological, and Genetic Analysis of Ten Patients with MYH9-Related Disease

期刊

ACTA HAEMATOLOGICA
卷 129, 期 2, 页码 106-113

出版社

KARGER
DOI: 10.1159/000342123

关键词

Gene mutation; Macrothrombocytopenia; MYH9-related disease; Neutrophil inclusion; Pathological analysis

资金

  1. National Science Foundation of China [81070395]
  2. Jiangsu Province's Key Medical Center [ZX201102]
  3. Priority Academic Program Development of Jiangsu Higher Education Institutions

向作者/读者索取更多资源

MYH9-related disease (MYH9-RD) is an autosomal dominant disorder caused by mutations in the MYH9 gene. It is characterized by a triad of giant platelets, thrombocytopenia, and characteristic Dohle body-like granulocyte inclusions. In this study we report 10 unrelated patients with MYH9-RD in whom the following seven MYH9 gene mutations were found: W33R, p.Q1443_K1445dup, R702H, D1424N, E1841K, R1933X, and E1945X (the first two were novel mutations). The region of the MYH9 mutation determines in some regards the phenotype, but clinical expression can vary between individuals with the same mutation. The neutrophil inclusion bodies of two patients were too small to be detected, but could be found with immunofluorescence staining. Immunoblotting analysis revealed that the calculated NMMHCIIA/beta-actin ratio for MYH9-RD neutrophils was 39% of normal controls. Kidney biopsy showed segmental glomerulosclerosis and NMMHC-IIA expression was decreased in podocytes. This disease is not as rare as originally thought. In any individual with persistent macrothrombocytopenia and no response to corticosteroids and immunosuppressive agents, even if neutrophil inclusions were inconspicuous in routine staining, MYH9-RD should be suspected. Copyright (C) 2012 S. Karger AG, Basel

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