Ending diagnostic odyssey by reanalysis of whole exome sequencing data

Initial Whole Exome Sequencing frequently fails to resolve rare disease cases. Bioinformatic reanalysis of existing genomic data utilizes advancing knowledge to enhance diagnosis without additional testing. This study investigated six patients with clinical features consistent with Fanconi Anemia bu...

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Detalles Bibliográficos
Autores: Tejero Laguna, Eudald|||0000-0002-7536-4322, Pujol Calvet, Maria Roser|||0000-0003-1840-5455, Bogliolo, Massimo|||0000-0001-8240-7784, Rodriguez Santiago, Benjamin|||0000-0003-1167-3852, Surralles, Jordi|||0000-0002-4041-7519, Ramírez de Haro, Ma. José|||0000-0003-1417-7731
Tipo de recurso: artículo
Fecha de publicación:2025
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:dnet:uabarcelona_::f1e627e60326b973206b2ff7946989f7
Acceso en línea:https://ddd.uab.cat/record/327747
https://dx.doi.org/urn:doi:10.1186/s13023-025-03928-5
Access Level:acceso abierto
Palabra clave:WES Reanalysis
Rare Genetic Diseases
Fanconi Anemia
Diamond-Blackfan Anemia
Dyskeratosis Congenita
RPL5
TERT
Descripción
Sumario:Initial Whole Exome Sequencing frequently fails to resolve rare disease cases. Bioinformatic reanalysis of existing genomic data utilizes advancing knowledge to enhance diagnosis without additional testing. This study investigated six patients with clinical features consistent with Fanconi Anemia but negative chromosomal breakage tests, whose initial genetic analyses were inconclusive. Whole Exome Sequencing data from these patients (collected 2005-2009) underwent comprehensive reanalysis, including single nucleotide variants, insertions/deletions, and copy number variants across genes beyond those typically associated with Fanconi Anemia. Telomere length was assessed via monochrome multiplex quantitative PCR. Reanalysis identified clinically significant variants in two patients (33.3% yield): one harboured a heterozygous pathogenic loss-of-function variant in the Diamond-Blackfan anemia gene RPL5, while the second exhibited compound heterozygous variants in the TERT gene, indicative of dyskeratosis congenita. This study underscores the clinical value of reanalyzing existing genomic data in unresolved suspected genetic disorders, even when phenotype-specific assays are negative. The 33.3% diagnostic yield aligns with gains from larger reanalysis studies (10-25%). Systematic reassessment after sufficient time (24 + months) for genomic advancements offers a cost-effective diagnostic approach for long-undiagnosed cases, highlighting the dynamic nature of genomic interpretation as gene-disease understanding evolves. The online version contains supplementary material available at 10.1186/s13023-025-03928-5.