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Next Generation Sequencing Identifies Double Homozygous Mutations in Two Distinct Genes (Exph5 and Col17a1) in a Patient With Concomitant Simplex and Junctional Epidermolysis Bullosa Publisher Pubmed



Vahidnezhad H1, 2 ; Youssefian L1, 3, 4 ; Saeidian AH1, 4 ; Touati A1, 5 ; Sotoudeh S6 ; Jazayeri A7 ; Guy A8 ; Lovell PA8 ; Liu L8 ; Kariminejad A9 ; Mcgrath JA10 ; Zeinali S2, 11 ; Uitto J1
Authors

Source: Human Mutation Published:2018


Abstract

Epidermolysis bullosa (EB) is a heterogeneous group of heritable blistering diseases. We developed a next generation sequencing (NGS) panel covering 21 genes associated with skin fragility disorders, and it was applied to DNA from 91 probands with the diagnosis of EB. In one patient, novel homozygous mutations were disclosed in two different, unlinked EB-associated genes: EXPH5, chr11 g.108510085G > A; p.Arg1808Ter and COL17A1, chr10 g.104077423delT; p.Thr68LeufsTer106. Consequences of the COL17A1 mutation were examined by RNAseq which revealed a complex splicing pattern predicting synthesis of a truncated polypeptide (85%) or in-frame deletion of exon 4 (15% of transcripts). Transmission electron microscopy (TEM) and immunostaining revealed findings consistent with EB simplex (EBS) and junctional EB (JEB), and clinical examination revealed a complex phenotype with features of both subtypes. This case illustrates the power of next generation sequencing in identifying mutations in patients with complex EB phenotype, with implications for genotype–phenotype correlations, prenatal testing, and genetic counseling of families at risk for recurrence. © 2018 Wiley Periodicals, Inc.
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