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Instructions to fill in the LDLR Database report sheet
* Spaces that must be filled in to include this mutation in the database.
** Frame the correct information(s) and line the other(s) .
SEND THE REPORT SHEET FILLED IN TO Dr Mathilde VARRET :
Address : INSERM U 698
CHU Xavier Bichat Secteur Claude Bernard
46, rue Henri Huchard
75018 Paris
FRANCE
Fax +33 1 40 25 86 02
e-mail : mathilde.varret@inserm.fr
LDLR DATABASE MUTATION REPORT SHEET
For point mutations and small deletions or insertions (<99bp) only.
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NAME* (According to the recommendations of the Human Genome Variation Society at www.hgvs.org/mutnomen/) : |
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File (Do not fill in this space) : |
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MOLECULAR INFORMATIONS |
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Nucleotide* : |
Event : |
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Codon* : |
CpG : |
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Exon* : |
Type : |
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WT codon* : |
Mutant codon* : |
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Inserted sequence (In case of insertions *) : |
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Genotype of the mutation* : Wa aa ab Wa/b ** |
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Name of the second mutation (in case of compound heterozygote* ) : |
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Restriction site created : |
Restriction site abolished : |
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PROTEIN INFORMATIONS |
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WT amino acid* : |
Mutant amino acid * : |
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Affected domain* : |
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Mutation class : |
LDLR activity (%) : |
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Others : |
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PERSONAL INFORMATIONS |
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Ethnic Origin* : |
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Clinical status * : Heterozygote Homozygote ** |
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Sex : M F ** |
Cosanguinity : Yes No ** |
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Age (At lipid mesurement) : |
BMI (At lipid mesurement) : |
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Familial history : FH CAD xanthomas arcus cornean Don’t know ** |
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Others : |
For point mutations and small deletions or insertions (<99bp) only.
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NAME* (According to the recommendations of the Human Genome Variation Society at www.hgvs.org/mutnomen/) : |
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File (Do not fill in this space) : |
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CLINICAL INFORMATIONS (Without treatment or diet) |
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Total cholesterol (mmol/l) : |
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HDL cholesterol (mmol/l) : |
Xanthomas : Yes No Don’t know ** |
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Triglycerides (mmol/l) : |
CAD : Yes No Don’t know ** |
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LDL cholesterol(mmol/l) : |
arcus corneae : Yes No Don’t know ** |
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Others : |
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RECURRENCE OF THE MUTATION |
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F P DN R ** |
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F : founder effect. Indicate the ratio of mutations found in the tested population :
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P : private mutation, today. |
DN : de novo mutation. |
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R : recurrent mutation. Indicate the other(s) population(s) were the mutation was found: |
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METHOD* |
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Detection method** : Sequencing SSCP DGGE ASO
Other : |
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All the LDLR gene was screened** :
Yes
No, Indicate exons sreened : |
For point mutations and small deletions or insertions (<99bp) only.
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NAME* (According to the recommendations of the Human Genome Variation Society at www.hgvs.org/mutnomen/) : |
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File (Do not fill in this space) : |
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EVIDENCE FOR EXISTENCE AND EFFECT OF MUTATION* |
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Base change found on repeat PCR sample** : Yes No Don’t know |
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Base change segregates or appears with trait** : Yes No Don’t know |
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Base change affects conserved residues** : Yes No Don’t know |
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Expression analysis supports hypothesis for causation** : Yes No Don’t know |
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Normals tested (50 required)** : Yes No Don’t know |
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REFERENCE (if the mutation is published)* |
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YOUR NAME AND ADRESSE * |
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Name : |
e-mail : |
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Address : |
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Postal Code : |
City : |
Country : |
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Phone : |
Fax : |
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Do you allowd us to add these informations in the TEAMS’ page of the LSDB-UMD-LDLR web site:
Yes No ** |
For point mutations and small deletions or insertions (<99bp) only.
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NAME* (According to the recommendations of the Human Genome Variation Society at www.hgvs.org/mutnomen/) : |
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File (Do not fill in this space) : |
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