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Junctional epidermolysis bullosa of late onset explained by mutations in COL17A1.
[junctional epidermolysis bullosa]
 
Junctional
epidermolysis
bullosa
of
late
onset
(
JEB-lo
)
is
a
rare
disease
characterized
by
blistering
of
primarily
the
hands
and
feet
starting
in
childhood
.
The
pathogenesis
remains
unclear
.
To
clarify
the
pathogenesis
of
JEB-lo
.
Two
patients
with
JEB-lo
,
a
brother
and
a
sister
,
were
examined
using
electron
microscopy
(
EM
)
,
immunofluorescence
(
IF
)
antigen
mapping
and
molecular
analysis
.
We
found
subtle
changes
in
IF
antigen
mapping
and
EM
.
The
most
remarkable
changes
were
loss
of
the
apical-
lateral
staining
of
monoclonal
antibodies
(
mAbs
)
against
type
XVII
collagen
(
Col
17
)
,
and
a
broadened
distribution
of
mAb
staining
against
the
ectodomain
of
Col
17
,
laminin-
332
and
type
VII
collagen
.
Mutation
analysis
of
COL
17
A
1
,
encoding
Col
17
,
showed
a
compound
heterozygosity
for
a
novel
mutation
c
.
1992
_
1995
delGGGT
and
the
known
mutation
c
.
3908
G
>
A
in
both
patients
.
The
deletion
c
.
1992
_
1995
delGGGT
results
in
a
premature
termination
codon
and
mRNA
decay
,
leaving
the
patients
functionally
hemizygous
for
the
missense
mutation
c
.
3908
G
>
A
(
p
.
R
1303
Q
)
in
the
noncollagenous
4
domain
of
Col
17
.
JEB-lo
is
an
autosomal
recessive
disorder
caused
by
mutations
in
COL
17
A
1
,
and
subtle
aberrations
in
EM
and
IF
antigen
mapping
are
clues
to
diagnosis
.
Diseases
Validation
Diseases presenting
"mutations in col17a1"
symptom
junctional epidermolysis bullosa
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