Percorrer por autor "Jacinto, Sandra"
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- Doenças mitocondriais na era da sequenciação de nova geração: estudo de 450 doentesPublication . Nogueira, Célia; Pereira, Cristina; Silva, Lisbeth; Laranjeira, Mateus; Lopes, Altina; Neiva, Raquel; Rodrigues, Esmeralda; Campos, Teresa; Martins, Esmeralda; Bandeira, Anabela; Coelho, Margarida; Magalhães, Marina; Damásio, Joana; Gaspar, Ana; Janeiro, Patrícia; Gomes, Levy; Ferreira, Ana Cristina; Jacinto, Sandra; Vieira, José Pedro; Diogo, Luísa; Santos, Helena; Mendonça, Carla; Vilarinho, LauraAs doenças mitocondriais (DM) são doenças raras, clínica e geneticamente heterogéneas, de difícil diagnóstico, para as quais não existe uma terapia eficaz. O desenvolvimento da tecnologia de sequenciação de nova geração (NGS) revolucionou o diagnóstico molecular deste grupo de doenças, permitindo a identificação de novos genes associados a estas patologias. Nesta nova era genética, através da utilização da tecnologia de NGS, estudamos um grupo de 450 doentes suspeitos de DM, sem etiologia molecular. A nossa estratégia combinada de NGS, englobou a sequenciação de um painel de 213 genes nucleares associados a DM e do DNA mitocondrial completo. Neste estudo, identificamos variantes causais em 134 (30%) doentes analisados, 88 dos quais apresentaram variantes no DNA nuclear e 46 no DNA mitocondrial, tratando-se na maioria de doentes pediátricos (66%). Neste grupo de doentes, identificamos 72 variantes patogénicas descritas na literatura e 20 novas variantes provavelmente patogénicas, assim como 62 variantes de significado indeterminado. Como laboratório nacional de referência para o estudo e investigação das DM, demonstramos o contributo da tecnologia de NGS para esclarecer a etiologia molecular destes doentes, para expandir o espectro mutacional associado a estas patologias e oferecer um diagnóstico pré-natal e aconselhamento genético aos casais em risco.
- Reverse phenotyping after ngs panel of x-linked intellectual disability unravels creatine transporter (SLC6A8) deficiencyPublication . Padeira, Gonçalo; Jacinto, Sandra; Venâncio, Margarida; Marcão, Ana; Conceição, Carla; Ferreira, Ana CristinaX-linked intellectual disability (XLID) is characterized by extensive genetic heterogeneity. Next-generation sequencing (NGS) have been used in these cases as a cost-effective diagnosis approach. Genetic findings often reveal variants unforeseen during clinical investigation, prompting the need for reevaluation of specific features designated as reverse phenotyping (RP). X-linked creatine transporter deficiency (CTD) is a potentially treatable intellectual disability caused by pathogenic variants in the SLC6A8 gene leading to impaired creatine transport into the brain. A 7-year-old boy with intellectual disability, speech delay, hyperactivity and epilepsy was referred to Metabolic and Neuropediatric Clinic. Family history identified a mother with learning difficulties and a maternal uncle with intellectual disability, indicating a possible X-linked inheritance. NGS intellectual disability panel identified a variant classified as probably pathogenic (c.880_881del (p(Lys294Alafs*2)) in the SLC6A8 gene, in hemizygosity which prompted referral to Metabolic and Neuropediatric Clinic. Reverse phenotyping was carried out with biochemical and imaging assessment that showed: high urinary Creatine-Creatinine ratio (2.17; RV 0.04-1.07) with normal guanidinoacetate acid and absence of creatine peak in brain MRI spectroscopy, confirming the diagnosis. Genetic studies on female family members are ongoing. He started treatment with creatine, arginine and glycine in the last appointment. CTD is a rare disease that has been reported in more than 150 individuals worldwide. We present a case in which the diagnostic approach was reverse phenotyping, through biochemical and imaging studies, after the identification of pathogenic variants in SLC6A8 by NGS panel. The efficacy of its treatment remains controversial with variable results, and a close evaluation will be needed.