Bioinformatics Project
Hutchinson Gilford progeria Syndrome
Robert Kelleghan
C15386361
DT204/2
Review of the disorder:
Hutchinson Gilford progeria syndrome is a rare genetic disorder associated with the accelerated aging in children. The children appear to be normal at birth, however, they begin to face difficulties within their first year of life as they grow slower than other children and fail to thrive (Hui et al, 2011). The affected individuals face many problems which are commonly associated with aging such as joint issues, cardiovascular problems and alopecia to name just a few. The affected children also have very distinctive facial features which give an overall senile appearance. It occurs sporadically and according to Hui et al (2011) it has “an incidence of 1 in 8 million live births” and is more often seen in Caucasian males. According to Eriksson et al (2001) this rare condition is caused by a de novo point mutation of the lamin A (LMNA) gene.
Symptoms:
Signs and symptoms of the disease generally develop within the first year of the individual’s life, but the age of onset can vary, as well as the severity of
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Restriction Map for normal LMNA.
Figure 14. Restriction map for Mutated LMNA (achieved through the same process to get the normal restriction map).
Figure 15. Comparison of the normal and mutated Restriction maps.
This comparison indicates the changes which occur due to the mutation as there is a complete lack of enzymes MwoI, HpyF10VI, Cac8I and Bs1I in the mutated version of the gene.
In order to diagnose this disease, a PCR must be ran. In order to do this there must be a forward and reverse primer.
Figure 16. Copy of the sequence used previously from NCBI copied into the website Primer 3.
It is important that the position affected by the disease is within these primers, i.e. position 1824. This can be ensured when using Primer 3, as seen in Figure 16.
Figure 17. Primers to use in
Gait Markedly antalgic. Equivocal Romberg. DTRs 2+ in the upper extremities and knees, trace at the ankles. Labs/Studies CAT scan and C-spine are as noted
The reviewer in this case has been asked to address the following concerns related to this member: 1. Is the genetic testing [CPT code 812929 – First Step Dx Plus Testing] that was performed on 02/29/2016 considered experimental and/or investigational? Please explain. 2. Was the genetic testing [CPT code 812929 – First Step Dx Plus Testing], which was performed on 02/29/2016 medically necessary for the treatment of this member’s condition?
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The Lamin A gene is a dominant gene which is not X-linked, and almost always happen through an accidental mutation. With Progeria, it is not the gene that directly causes the disease, it is caused by a poorly or a non-functioning protein which is created by using the code, Prelamin A. Progeria is formed by an modification in LMNA which causes the gene to change, which then leads to a change in protein with a different function and form. Since Progeria is an autosomal disease, the mutation mostly always occurs after conception in the child. But there are rare cases where the parent does have the mutation in their sex-cells, which will lead to a very high chance that their child will have Progeria. Also if the child has the majority of the cells
Once your child is diagnosed with Hutchinson Gilford Progeria Syndrome their lifestyle is massively affected. There are many steps every family with a family member with progeria has to take. A few of these steps include keeping your child well hydrated, provide frequent small meals, regular physical activity, custom comfortable shoes, lots of sunscreen, social and educational adaptations (Mayo Clinic). Living with Progeria is definitely a challenge, and it takes overcoming new obstacles everyday. Children with Progeria don’t have decreased learning capabilities as kids that don’t have Progeria.