04 February 2019 by Shine Kumar

Novel bone morphogenic protein receptor 2 mutation in a patient with hereditary pulmonary arterial hypertension

Background:

Hereditary Pulmonary Arterial Hypertension (HPAH) is associated with Bone Morphogenic Protein Receptor 2 (BMPR2) mutations.

Aim

We aim to describe a novel mutation of BMPR2 in a patient with HPAH.

Materials and methods

A 29-year-old gentleman diagnosed with Idiopathic Pulmonary Arterial Hypertension (IPAH) was analysed for mutations in the BMPR2 gene by sequencing. His mother and younger sister (only sibling) had IPAH and succumbed to disease. Interestingly he had followed the same path on dual therapy (sildenafil and ambrisentan), was initiated on imatinib mesylate and currently has improved to functional class I from IV with complete resolution of heart failure.

Results

Sequence analysis revealed a novel missense mutation, a T-to-C transition at position c.346T>C in exon 3 of the BMPR2 gene. This missense mutation leads to the replacement of cytosine by arginine at the position 116 (C116R), which is within the extracellular domain of the BMPR2.

Conclusion

We describe a novel BMPR2 mutation in a patient with HPAH. The therapeutic response to imatinib specific to this mutation needs to be explored

Key Contributors

1 Shine Kumar, 2 Lalitha Biswas, 3 Arul Arasan, 4 Neethu Zachariah, 5 Krishna Kumar 1 Associate Professor and in charge Pulmonary Hypertension Clinic, Dept. of Pediatric Cardiology, 2 Assistant Professor, Dept. of Molecular Biology, 3 M Tech Resident, Amrita Centre for Nano Sciences and Molecular Medicine, 4 Medical Social Worker, Dept of Pediatric Cardiology, 5 Professor and Head, Dept of Pediatric Cardiology, AIMS, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India


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