Origin of Swedish hemophilia A mutations

Christer Halldén, Daniel Nilsson, Torbjorn Säll, Christina Lind-Halldén, Annika C. Lidén, R. Ljung

Research output: Contribution to journalArticlepeer-review

16 Citations (Scopus)

Abstract

 Background: Hemophilia A (HA) has a high level of variation within the disease class, with more than 1000 mutations being listed in the HAMSTeRS database. At the same time a number of F8 mutations are present in specific populations at high frequencies. Objectives: The simultaneous presence of large numbers of rare mutations and a small number of high-frequency mutations raises questions about the origins of HA mutations. The present study was aimed at describing the origins of HA mutations in the complete Swedish population. The primary issue was to determine what proportion of identical mutations are identical by descent (IBD) and what proportion are attributable to recurrent mutation events. The age of IBD mutations was also determined. Patients/Methods: In Sweden, the care of HA is centralized, and the Swedish HA population consists of ∼ 750 patients from > 300 families (35% severe, 15% moderate, and 50% mild). Identical haplotypes were defined by single-nucleotide polymorphism and microsatellite haplotyping, and the ages of the mutations were estimated with estiage. Results: Among 212 presumably unrelated patients with substitution mutations, 97 (46%) had mutations in common with other patients. Haplotyping of the 97 patients showed that 47 had IBD mutations (22%) with estimated ages of between two and 35 generations. The frequency of mild disease increased with an increasing number of patients sharing the mutations. Conclusions: A majority of the IBD mutations are mild and have age estimates of a few hundred years, but some could date back to the Middle Ages.

Original languageEnglish
Pages (from-to)2503-2511
Number of pages8
JournalJournal of Thrombosis and Haemostasis
Volume10
Issue number12
DOIs
Publication statusPublished - 2012

Swedish Standard Keywords

  • Hematology (30202)

Keywords

  • founder
  • haplotype
  • hemophilia A
  • identical by descent
  • recurrent mutation

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