PT  - JOURNAL ARTICLE
AU  - Barbara Girerd
AU  - David Montani
AU  - Xavier Jaïs
AU  - Mélanie Eyries
AU  - Azzedine Yaici
AU  - Benjamin Sztrymf
AU  - Laurent Savale
AU  - Florence Parent
AU  - Florence Coulet
AU  - Laurent Godinas
AU  - Edmund M. Lau
AU  - Yuichi Tamura
AU  - Olivier Sitbon
AU  - Florent Soubrier
AU  - Gérald Simonneau
AU  - Marc Humbert
TI  - Genetic counselling in a national referral centre for pulmonary hypertension
AID  - 10.1183/13993003.00717-2015
DP  - 2016 Feb 01
TA  - European Respiratory Journal
PG  - 541--552
VI  - 47
IP  - 2
4099  - http://erj.ersjournals.com/content/47/2/541.short
4100  - http://erj.ersjournals.com/content/47/2/541.full
SO  - Eur Respir J2016 Feb 01; 47
AB  - Genetic causes of pulmonary arterial hypertension (PAH) and pulmonary veno-occlusive disease (PVOD) have been identified, leading to a growing need for genetic counselling.Between 2003 and 2014, genetic counselling was offered to 529 PAH and 100 PVOD patients at the French Referral Centre for Pulmonary Hypertension.Mutations in PAH-predisposing genes were identified in 72 patients presenting as sporadic PAH (17% of cases; 62 mutations in BMPR2, nine in ACVRL1 (ALK1) and one in ENG) and in 94 patients with a PAH family history (89% of cases; 89 mutations in BMPR2, three in ACVRL1 (ALK1) and two in KCNK3). Bi-allelic mutations in EIF2AK4 were identified in all patients with a family history of PVOD (n=19) and in seven patients (8.6%) presenting as sporadic PVOD. Pre-symptomatic genetic diagnosis was offered to 272 relatives of heritable PAH patients, identifying mutations in 36.4% of them. A screening programme is now offered to asymptomatic mutation carriers to detect PAH in an early phase and to identify predictors of outcomes in asymptomatic BMPR2 mutation carriers. BMPR2 screening allowed us to offer pre-implantation diagnosis to two couples with a BMPR2 mutation.Genetic counselling can be implemented in pulmonary hypertension centres.Genetic causes of PAH and PVOD have been identified; genetic counselling can be implemented in PH centres http://ow.ly/TLbee