Background/Aims: Hereditary spherocytosis (HS) is a common pediatric hemolytic anemia caused by congenital red blood cell defects. HS due to ankyrin 1 (ANK1) mutations is the most common type. We explored an ANK1 mutation from an HS patient and reviewed the literature. Methods: We detected the mutation in a Chinese family in which 2 members were diagnosed with HS by next-generation sequencing. The proband was diagnosed with HS in the newborn period, based on clinical manifestations, laboratory data, and family history. The mutation spectrum of the ANK1 gene was summarized based on 85 patients diagnosed with HS carrying ANK1 mutations, and the ANK1 mutation spectrum was summarized and analyzed. Results: We identified a novel mutation affecting ANK1 gene splicing (a splicing mutation) in both the patient and her mother, which is a substitution of T>G 2 nt after exon 25 in intron 26. The study expands our knowledge of the ANK1 gene mutation spectrum, providing a molecular basis for HS. Conclusion: A novel ANK1 mutation (NM_000037.3, c.2960+2T>G, intron 26) that is potentially associated with HS was identified. To date, 80 ANK1 mutations have been reported to be associated with HS in humans.

1.
Eber SW, Gonzale JM, Lux ML, Scarpa AL, Tse WT, Dornwell M, et al: Ankyrin-1 mutations are a major cause of dominant and recessive hereditary spherocytosis. Nat Genet 1996; 13: 214–218.
2.
Morton NE, Mackinney AA, Kosower N, Schilling RF, Gray MP: Genetics of spherocytosis. Am J Hum Genet 1962; 14: 170–184.
3.
Delaunay J: Molecular basis of red cell membrane disorders. Acta Haematol 2002; 108: 210–218.
4.
Da Costa L, Galimand J, Fenneteau O, Mohandas N: Hereditary spherocytosis, elliptocytosis, and other red cell membrane disorders. Blood Rev 2013; 27: 167–178.
5.
Deng Z, Liao L, Yang W, Lin F: Misdiagnosis of two cases of hereditary spherocytosis in a family and review of published reports. Clin Chim Acta 2015; 441: 6–9.
6.
Christensen RD, Yaish HM, Gallagher PG: A pediatrician’s practical guide to diagnosing and treating hereditary spherocytosis in neonates. Pediatrics 2015; 135: 1107–1114.
7.
Peters LL, Lux SE: Ankyrins: structure and function in normal cells and hereditary spherocytes. Semin Hematol 1993; 211: 1–6.
8.
Iolascon A, Avvisati RA: Genotype/phenotype correlation in hereditary spherocytosis. Haematologica 2008; 93: 1283–1288.
9.
Gallagher PG: Hematologically important mutations: ankyrin variants in hereditary spherocytosis. Blood Cells Mol Dis 2005; 35: 345–347.
10.
Smith KR, Penzes P: Ankyrins: roles in synaptic biology and pathology. Mol Cell Neurosci 2018, E-pub ahead of print.
11.
Nakanishi H, Kanzaki A, Yawata A, Yamada O, Yawata Y: Ankyrin gene mutations in Japanese patients with hereditary spherocytosis. Int J Hematol 2001; 73: 54–63.
12.
Jarolim P, Rubin HL, Brabec V, Palek J: Comparison of the ankyrin (AC)n microsatellites in genomic DNA and mRNA reveals absence of one ankyrin mRNA allele in 20% of patients with hereditary spherocytosis. Blood 1995; 83: 3278–3282.
13.
Will A, Henderson CA, Jnah AJ, Newberry D: Hereditary spherocytosis in the neonatal period: a case report. Neonatal Netw 2017; 36: 280–288.
14.
Li H, Durbin R: Fast and accurate short read alignment with Burrows-Wheeler transform. Bioinformatics 2009; 25: 1754–1760.
15.
Richards S, Aziz N, Bick D, Das S, Gastier-Foster J, Grody WW, et al; ACMG Laboratory Quality Assurance Committee: Standards and guidelines for the interpretation of sequence variants: a joint consensus recommendation of the American College of Medical Genetics and Genomics and the Association for Molecular Pathology. Genet Med 2015; 17: 405–424.
16.
Leite RC, Basseres DS, Ferreira JS, Alberto FL, Costa FF, Saad ST: Low frequency of ankyrin mutations in hereditary spherocytosis: identification of three novel mutations. Hum Mutat 2000; 16: 529.
17.
Yawata Y, Kanzaki A, Yawata A, Doerfler W, Ozcan R, Eber SW: Characteristic features of the genotype and phenotype of hereditary spherocytosis in the Japanese population. Int J Hematol 2000; 71: 118–135.
18.
Morle L, Bozon M, Alloisio N, Vallier A, Ha-yette S, Pascal O, et al: Ankyrin Bugey: a de novo deletional frameshift variant in exon 6 of the ankyrin gene associated with spherocytosis. Am J Hematol 1997; 54: 242–248.
19.
Randon J, Miraglia del GE, Bozon M, Perrotta S, De VM, Iolascon A, Delaunay J, Morle L: Frequent de novo mutations of the ANK1 gene mimic a recessive mode of transmission in hereditary spherocytosis: three new ANK1 variants: ankyrins Bari, Napoli II and Anzio. Br J Haematol 1997; 96: 500–506.
20.
Gallagher PG, Ferreira JD, Costa FF, Saad ST, Forget BG: A recurrent frameshift mutation of the ankyrin gene associated with severe hereditary spherocytosis. Br J Haematol 2000; 111: 1190–1193.
21.
Del GE, Hayette S, Bozon M, Perrotta S, Alloisio N, Vallier A, et al: Ankyrin Napoli: a de novo deletional frameshift mutation in exon 16 of ankyrin gene (ANK1) associated with spherocytosis. Br J Haematol 1996; 93: 828–834.
22.
Ozcan R, Jarolim P, Lux SE, Ungewickell E, Eber SW: Simultaneous (AC)n microsatellite polymorphism analysis and single-stranded conformation polymorphism screening is an efficient strategy for detecting ankyrin-1 mutations in dominant hereditary spherocytosis. Br J Haematol 2003; 122: 669–677.
23.
Hayette S, Garre G, Bozon M, Alloisio N, Maillet P, Wilmotte R, et al: Two distinct truncated variants of ankyrin associated with hereditary spherocytosis. Am J Hematol 1998; 58: 36–41.
24.
Jarolim P, Rubin HL, Brabec V, Palek J: A nonsense mutation 1669Glu–>Ter within the regulatory domain of human erythroid ankyrin leads to a selective deficiency of the major ankyrin isoform (band 2.1) and a phenotype of autosomal dominant hereditary spherocytosis. J Clin Invest 1995; 95: 941–947.
25.
Sangerman J, Maksimova Y, Edelman EJ, Morrow JS, Forget BG, Gallagher PG: Ankyrin-linked hereditary spherocytosis in African-American kindred. Am J Hematol 2008; 83: 789–794.
26.
Liu S, Jiang H, Huang LY, Li DZ: A de novo ankyrin mutation (ANK1 Q109X) causing severe hereditary spherocytosis from preterm neonatal period. Ann Hematol 2017; 96: 1067–1068.
27.
Boguslawska DM, Heger E, Listowski M, Wasinski D, Kuliczkowski K, Machnicka B, Sikorski AF: A novel L1340P mutation in the ANK1 gene is associated with hereditary spherocytosis? Br J Haematol 2014; 167: 269–271.
28.
Han JH, Kim S, Jang H, Kim SW, Lee MG, Koh H: Identification of a novel p.Q1772X ANK1 mutation in a Korean family with hereditary spherocytosis. PLoS One 2015; 10:e0131251.
29.
Jiang M, Lu J, Zhong Y, Wang Y, Yang C: Identification of a novel ANK1 gene mutation in a newborn with hereditary spherocytosis. Zhonghua Yi Xue Yi Chuan Xue Za Zhi 2016; 33: 44–47.
30.
Park J, Jeong DC, Yoo J, Jang W, Chae H, Kim J: Mutational characteristics of ANK1 and SPTB genes in hereditary spherocytosis. Clin Genet 2016; 90: 69–78.
31.
Del Orbe Barreto R, Arrizabalaga B, De la Hoz AB, García-Orad Á, Tejada MI, Garcia-Ruiz JC, et al: Detection of new pathogenic mutations in patients with congenital haemolytic anaemia using next-generation sequencing. Int J Lab Hematol 2016; 38: 629–638.
32.
Gundel F, Eber S, Heep A: A new ankyrin mutation (ANK1 EXON E9X) causing severe hereditary spherocytosis in the neonatal period. Ann Hematol 2011; 90: 231–232.
33.
He Y, Jia S, Dewan RK, Liao N: Novel mutations in patients with hereditary red blood cell membrane disorders using next-generation sequencing. Gene 2017; 627: 556–562.
34.
Guan H, Liang X, Zhang R, Wang H, Liu W, Zhang R, Yang J, Liu S: Identification of a de novo ANK1 mutation in a Chinese family with hereditary spherocytosis. Hematology 2017; 3: 1–5.
35.
Wang X, Yi B, Mu K, Shen N, Zhu Y, Hu Q, Lu Y: Identification of a novel de novo ANK1 R1426* nonsense mutation in a Chinese family with hereditary spherocytosis by NGS. Oncotarget 2017; 8: 96791–96797.
36.
Agarwal AM, Nussenzveig RH, Reading NS, Patel JL, Sangle N, Salama ME, et al: Clinical utility of next-generation sequencing in the diagnosis of hereditary haemolytic anaemias. Br J Haematol 2016; 174: 806–814.
37.
Delhommeau F, Cynober T, Schischmanoff PO, Rhrlich P, Delaunay J, Mohandas N, Tchernia G: Natural history of hereditary spherocytosis during the first year of life. Blood 2000; 95: 393–397.
38.
Bhutani VK, Johnson LH: Urgent clinical need for accurate and precise bilirubin measurements in the United States to prevent kernicterus. Clin Chem 2004; 50: 477–480.
39.
Bolton-Maggs PH, Langer JC, Iolascon A, Tittensor P, King MJ: Guidelines for the diagnosis and management of hereditary spherocytosis – 2011 update. Br J Haematol 2012; 156: 37–49.
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