Cooperating G6PD mutations associated with severe neonatal hyperbilirubinemia and cholestasis |
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Authors: | Mizukawa Benjamin George Alex Pushkaran Suvarnamala Weckbach Lana Kalinyak KarenAnn Heubi James E Kalfa Theodosia A |
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Affiliation: | Department of Hematology-Oncology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio 45229, USA. |
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Abstract: | We report a novel glucose-6-phosphate dehydrogenase (G6PD) mutation, which we propose to name G6PD Cincinnati (c.1037A > T, p.N346I), found in combination with G6PD Gastonia (c.637G > T, p.V213L) in an infant who presented with neonatal cholestasis. The G6PD Cincinnati mutation results in a non-conservative amino acid substitution at the tetramer interface disturbing its formation, as seen by native gel electrophoresis and immunoblotting. G6PD Gastonia disrupts dimerization of the enzyme and by itself causes chronic non-spherocytic hemolytic anemia. The G6PD Cincinnati mutation may have aggravated the clinical picture of G6PD Gastonia with the result of severe perinatal hemolysis causing cholestasis and associated liver injury. |
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Keywords: | cholestasis G6PD deficiency neonatal jaundice |
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