Computational Functional Genomics-Based AmpliSeq™ Panel for Next-Generation Sequencing of Key Genes of Pain

The genetic background of pain is becoming increasingly well understood, which opens up possibilities for predicting the individual risk of persistent pain and the use of tailored therapies adapted to the variant pattern of the patient’s pain-relevant genes. The individual variant pattern of pain-relevant genes is accessible via next-generation sequencing, although the analysis of all “pain genes” would be expensive. Here, we report on the development of a cost-effective next generation sequencing-based pain-genotyping assay comprising the development of a customized AmpliSeq™ panel and bioinformatics approaches that condensate the genetic information of pain by identifying the most representative genes. The panel includes 29 key genes that have been shown to cover 70% of the biological functions exerted by a list of 540 so-called “pain genes” derived from transgenic mice experiments. These were supplemented by 43 additional genes that had been independently proposed as relevant for persistent pain. The functional genomics covered by the resulting 72 genes is particularly represented by mitogen-activated protein kinase of extracellular signal-regulated kinase and cytokine production and secretion. The present genotyping assay was established in 61 subjects of Caucasian ethnicity and investigates the functional role of the selected genes in the context of the known genetic architecture of pain without seeking functional associations for pain. The assay identified a total of 691 genetic variants, of which many have reports for a clinical relevance for pain or in another context. The assay is applicable for small to large-scale experimental setups at contemporary genotyping costs.

A Case Report of Prurigo Nodularis-Like Lesions in a Patient with Lepromatous Leprosy

Leprosy or Hansen’s disease is a chronic granulomatous infection that primarily affects the peripheral nerves and, consequently, the skin. Clinical manifestations vary from hypopigmentation to erythematous plaques, and it can present with leonine facies. We report a case of a patient with an uncommon clinical presentation of prurigo nodularis-like lesions without loss of sensation, for which two biopsy specimens demonstrated different histological subtypes. The first was the classic histology of lepromatous leprosy, whereas the other specimen revealed an atypical histoid leprosy variant pattern. This case report describes a patient with an atypical presentation of leprosy.

Endometrial Stromal Sarcoma With Hyalinizing Giant Rosettes, Mimicking Low-Grade Fibromyxoid Sarcoma

We highlight a rare variant pattern of low-grade endometrial stromal sarcoma showing extensive collagenous rosette formation, closely mimicking low-grade fibromyxoid sarcoma. Additionally, this neoplasm showed diffuse and strong expression of muscle markers, favoring an initial diagnosis of leiomyosarcoma. Reverse transcription-polymerase chain reaction showed the presence of JAZF1-SUZ12 fusion transcripts, and this highlights the broad morphologic and immunophenotypic spectrum of endometrial stromal sarcoma.

Frequency of turner syndrome: findings from a tertiary healthcare diagnostic laboratory of India

Background: Turner syndrome (TS) is the most common chromosomal abnormality reported in the females. Objective of this retrospective study was to determine the frequency of turner Syndrome and its various cytogenetic types in samples suspected to be of turner syndrome, received in the Department of Cytogenetics, Metropolis Healthcare laboratory, Mumbai, Maharashtra, India. Methods: The current study was performed on 935 clinically suspected samples with Turner Syndrome within the age group of 01-16 years. Peripheral blood (2-3 ml) in Sodium heparin Vacutainers was collected from all the patients, the cultures were set & analysed by GTG–banding at 450-550 band level Results were reported as per the guidelines of the International System for Human Cytogenomic Nomenclature (ISCN) and The College of American Pathologists (CAP) and National Accreditation Board for Testing and Calibration Laboratories (NABL).Results: In our study, out of the total 935 samples referred to Metropolis Healthcare Ltd, about 348 had cytogenetically turner or Turner variant findings. Further, out of 348 cases, 69 cases were detected to have presence of single X chromosome (19.83%), mosaic pattern in 116 cases (33.33%), presence of Y chromosome in 63 cases (18.10%) polymorphic variation in 58 cases (16.67%), presence of only isochromosome Xq in 9 cases (2.59%) and 33 cases (9.48%) with other or additional abnormalities. Conclusions: The cytogenetic confirmation and pattern of chromosomal aberration is very important as early detection may help to improve the quality of life especially in patients with cytogenetically Turner variant pattern with presence of Y chromosome.

Niemann-Pick disease type C: a case series of Brazilian patients

The aim of the study was to analyze a series of Brazilian patients with Niemann-Pick disease type C (NP-C). Method Correlations between clinical findings, laboratory data, molecular findings and treatment response are presented. Result The sample consisted of 5 patients aged 8 to 26 years. Vertical supranuclear gaze palsy, cerebellar ataxia, dementia, dystonia and dysarthria were present in all cases. Filipin staining showed the “classical” pattern in two patients and a “variant” pattern in three patients. Molecular analysis found mutations in the NPC1 gene in all alleles. Miglustat treatment was administered to 4 patients. Conclusion Although filipin staining should be used to confirm the diagnosis, bone marrow sea-blue histiocytes often help to diagnosis of NP-C. The p.P1007A mutation seems to be correlated with the “variant” pattern in filipin staining. Miglustat treatment response seems to be correlated with the age at disease onset and disability scale score at diagnosis.