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Combined use of multiplex ligation-dependent probe amplification and automatic sequencing for identification of KAL1 defects in patients with Kallmann syndrome.
[kallmann syndrome]
To
investigate
the
role
of
KAL
1
abnormalities
in
Brazilian
patients
with
Kallmann
syndrome
.
In
Â
vitro
experiments
.
Academic
medical
center
.
One
hundred
fifteen
Brazilian
patients
(
98
men
)
with
Kallmann
syndrome
.
Peripheral
blood
leukocytes
were
used
to
obtain
DNA
.
Direct
sequencing
and
multiplex
ligation-dependent
probe
amplification
were
used
to
identify
KAL
1
abnormalities
.
We
identified
four
KAL
1
mutations
(
p
.
Met
1
?
,
p
.
Ala
33
Glyfs
,
p
.
Arg
257
*
,
and
p
.
Trp
462
*
)
and
two
multiple
exon
deletions
(
exons
1
-
2
and
3
-
14
)
in
six
new
male
patients
.
Overall
,
17
KAL
1
defects
(
14
.
8
%
)
were
identified
in
the
entire
cohort
of
patients
with
Kallmann
syndrome
,
including
previously
studied
cases
.
KAL
1
-
mutated
patients
presented
with
a
more
severe
reproductive
and
nonreproductive
phenotype
(
synkinesia
,
renal
malformations
,
cryptorchidism
,
and
anatomic
olfactory
abnormalities
)
in
comparison
with
patients
without
KAL
1
mutations
.
Intragenic
deletions
were
one
of
the
most
often
encountered
defects
(
29
.
4
%
)
.
These
Â
deletions
can
be
missed
by
polymerase
chain
reaction
(
PCR
)
due
to
Yq
11
.
2
KAL
1
pseudogene
(
KALP
)
spurious
amplification
.
These
results
indicate
that
intragenic
multiexon
deletions
are
one
of
the
most
frequent
KAL
1
abnormalities
,
which
can
be
more
accurately
detected
by
multiplex
ligation-dependent
probe
amplification
.
In
addition
,
KAL
1
sequencing
results
should
be
interpreted
with
caution
,
and
stringency
conditions
of
the
PCR
reaction
should
be
adjusted
to
avoid
pseudogene
amplification
.
Diseases
Validation
Diseases presenting
"kal1 mutations"
symptom
kallmann syndrome
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