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Rare variants in $\textit{GP1BB}$ are responsible for autosomal dominant macrothrombocytopenia

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Sivapalaratnam, S 
Westbury, SK 
Stephens, JC 
Greene, D 


The von Willebrand receptor complex, which is composed of the glycoproteins Ibα, Ibβ, GPV, and GPIX, plays an essential role in the earliest steps in hemostasis. During the last 4 decades, it has become apparent that loss of function of any 1 of 3 of the genes encoding these glycoproteins (namely, GP1BBA, GP1BB, and GP9) leads to autosomal recessive macrothrombocytopenia complicated by bleeding. A small number of variants in GP1BA have been reported to cause a milder and dominant form of macrothrombocytopenia, but only 2 tentative reports exist of such a variant in GP1BB By analyzing data from a collection of more than 1000 genome-sequenced patients with a rare bleeding and/or platelet disorder, we have identified a significant association between rare monoallelic variants in GP1BB and macrothrombocytopenia. To strengthen our findings, we sought further cases in 2 additional collections in the United Kingdom and Japan. Across 18 families exhibiting phenotypes consistent with autosomal dominant inheritance of macrothrombocytopenia, we report on 27 affected cases carrying 1 of 9 rare variants in GP1BB.



Alleles, Blood Platelets, Case-Control Studies, Female, Gene Expression, Genes, Dominant, Genome, Human, Hemorrhage, High-Throughput Nucleotide Sequencing, Humans, Male, Mutation, Pedigree, Platelet Count, Platelet Glycoprotein GPIb-IX Complex, Thrombocytopenia

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American Society of Hematology
Cambridge University Hospitals NHS Foundation Trust (CUH) (BRC 2012-2017)
Medical Research Council (MR/L003120/1)
British Heart Foundation (None)
British Heart Foundation (None)
M.A.L. acknowledges support from the NIHR Imperial College Biomedical Research Centre. The NIHR BioResource–Rare Diseases is funded by the National Institute for Health Research of England (award number RG65966). Research in the W.H.O. laboratory is supported by the British Heart Foundation, European Commission, Medical Research Council, NIHR, and the Wellcome Trust, and also receives support from National Health Service Blood and Transplant. C.L. and S.K.W. are supported by Medical Research Council Clinical Training Fellowships (MR/K023489/1).