Research article

Mutation spectrum of 122 hemophilia A families from Taiwanese population by LD-PCR, DHPLC, multiplex PCR and evaluating the clinical application of HRM

Shin-Yu Lin¹ , Yi-Ning Su¹ , Chia-Cheng Hung² , Woei Tsay³ , Shyh-Shin Chiou⁴ , Chieh-Ting Chang⁵ , Hong-Nerng Ho⁶ and Chien-Nan Lee⁶

¹Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan

²Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan

³Department of Hematology, National Taiwan University Hospital, Taipei, Taiwan

⁴Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan

⁵Department of Biology, University of California, Los angels, USA

⁶Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan

author email corresponding author email

BMC Medical Genetics 2008, 9:53doi:10.1186/1471-2350-9-53

Published:	20 June 2008

Abstract

Background

Hemophilia A represents the most common and severe inherited hemorrhagic disorder. It is caused by mutations in the F8 gene, which leads to a deficiency or dysfunctional factor VIII protein, an essential cofactor in the factor X activation complex.

Methods

We used long-distance polymerase chain reaction and denaturing high performance liquid chromatography for mutation scanning of the F8 gene. We designed the competitive multiplex PCR to identify the carrier with exonal deletions. In order to facilitate throughput and minimize the cost of mutation scanning, we also evaluated a new mutation scanning technique, high resolution melting analysis (HRM), as an alternative screening method.

Results

We presented the results of detailed screening of 122 Taiwanese families with hemophilia A and reported twenty-nine novel mutations. There was one family identified with whole exons deletion, and the carriers were successfully recognized by multiplex PCR. By HRM, the different melting curve patterns were easily identified in 25 out of 28 cases (89%) and 15 out of 15 (100%) carriers. The sensitivity was 93 % (40/43). The overall mutation detection rate of hemophilia A was 100% in this study.

Conclusion

We proposed a diagnostic strategy for hemophilia A genetic diagnosis. We consider HRM as a powerful screening tool that would provide us with a more cost-effective protocol for hemophilia A mutation identification.