A 34 year old female patient was scheduled to undergo surgical resection due to a "breast nodule". Preoperative examination revealed an activated partial thromboplastin time (APTT) of 66.2 seconds, coagulation factor Ⅺ activity (FⅪ: C) of 2%, and FⅪ antigen (FⅪ: Ag) of 40.3%. The patient and family members showed no abnormal bleeding symptoms. Diagnosed as hereditary coagulation factor Ⅺ deficiency. Genetic testing revealed that the F11 gene had a heterozygous nonsense mutation in exon 10, c.1107C>A (p.Tyr351stop), and a heterozygous missense mutation in exon 13, c.1562A>G (p.Tyr503Cys). The father and son were p Heterozygous carriers of Tyr351stop mutation, while the mother and daughter are p Heterozygous carriers of Tyr503Cys mutations. The in vitro expression results showed that p The Tyr351stop mutation resulted in a significant decrease in the transcription level of F11 gene, while p The Tyr503Cys mutation has no effect on the transcription level and protein expression level of F11 gene, but it leads to a significant decrease in the level of FⅪ:C in the cell culture supernatant.
1例34岁女性患者因"乳房结节"拟行手术切除,术前检查发现活化部分凝血活酶时间(APTT)66.2 s、凝血因子Ⅺ活性(FⅪ∶C)2%、FⅪ抗原(FⅪ∶Ag)40.3%,患者及家系成员均无异常出血表现。诊断为遗传性凝血因子Ⅺ缺陷症。基因检测发现其F11基因第10外显子c.1107C>A(p.Tyr351stop)杂合无义突变、第13外显子c.1562A>G(p.Tyr503Cys)杂合错义突变,其父亲和儿子为p.Tyr351stop突变的杂合携带者,而母亲和女儿为p.Tyr503Cys突变的杂合携带者。体外表达结果显示,p.Tyr351stop突变导致F11基因转录水平显著降低,而p.Tyr503Cys突变对F11基因转录水平以及蛋白表达水平无影响,但该突变导致细胞培养上清液中FⅪ∶C水平显著降低。.