A patient with paroxysmal nocturnal hemoglobinuria bearing four independent PIG-A mutant clones

Blood. 1997 May 1;89(9):3470-6.

Abstract

Paroxysmal nocturnal hemoglobinuria (PNH) is characterized by clonal blood cells that are deficient in the surface expression of glycosylphosphatidylinositol-anchored proteins due to somatic mutation in the X-linked gene PIG-A. In some patients, more than one abnormal clone may be present. Analysis of bulk DNA/RNA from granulocytes has been useful in identifying the predominant PIG-A mutation in each patient. However, it is often not useful in determining the presence of minor clones. Many patients have cells with partial deficiency. Here, we analyzed the PIG-A gene in two B-cell lines bearing complete or partial deficiencies, cells of hematopoietic progenitor colonies and peripheral blood granulocytes from the same patient. We found that two B-cell lines had different mutations, the granulocytes contained at least two mutants, and the hematopoietic progenitors contained four mutants. Three of the four were shared by B cells and/or granulocytes whereas the other one was found only in the hematopoietic progenitors. The partial deficiency was caused by a point mutation near an alternative splice site within exon 2 that resulted in partial decreases of activity and quantity of the full-length transcript. These results further show the oligoclonal nature of PNH and differences in extent of expansion among mutant clones.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alternative Splicing
  • B-Lymphocytes
  • Base Sequence
  • Cell Line
  • Cells, Cultured
  • Cloning, Molecular
  • DNA Primers
  • Frameshift Mutation
  • Glycosylphosphatidylinositols / metabolism
  • Granulocytes / metabolism
  • Hematopoietic Stem Cells / metabolism
  • Hemoglobinuria, Paroxysmal / blood
  • Hemoglobinuria, Paroxysmal / genetics*
  • Humans
  • Male
  • Membrane Proteins / biosynthesis*
  • Membrane Proteins / blood
  • Membrane Proteins / genetics*
  • Molecular Sequence Data
  • Mutation*
  • Point Mutation
  • Polymerase Chain Reaction
  • Recombinant Proteins / biosynthesis
  • Sequence Deletion
  • X Chromosome*

Substances

  • DNA Primers
  • Glycosylphosphatidylinositols
  • Membrane Proteins
  • Recombinant Proteins
  • phosphatidylinositol glycan-class A protein