Clinical and genetic analysis of a rare fetus with Protein C deficiency due to compound heterozygous variants of PROC gene

Objective: To explore the genetic etiology for a fetus with hydrocephalus and intraventricular hemorrhage.

Methods: Trio whole exome sequencing was carried out. Candidate variants were verified by Sanger sequencing of the fetus and its parents.

Results: The fetus was found to harbor c.818G>A (p.W273X) and c.833T>C (p.L278P) compound heterozygous variants of the PROC gene, which were respectively inherited from its mother and father. Based on the guidelines of the American College of Medical Genetics and Genomics (ACMG), both variants were predicted to be likely pathogenic (PVS1_Strong+PM2_Supporting+PP4; PM2_Supporting+PM3+PP1+PP3+PP4).

Conclusions: The fetus was diagnosed with Protein C deficiency due to the c.818G>A (p.W273X) and c.833T>C (p.L278P) compound heterozygous variants of the PROC gene. Above finding has enriched the spectrum of PROC gene variants and enabled genetic counseling and prenatal diagnosis for the family.