Genetic counseling of high-risk isolated populations: A worldwide challenge

Lena Sagi-Dain, Irith Weissman, Nehama Cohen-Kfir, Limor Kalfon, Nurit Edri, Hadas Shasha Lavski, Amir Peleg, Tzipora C. Falik-Zaccai

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Background: Isolated populations with high rates of consanguinity and genetic disorders can be found in most parts of the world. The aim of our paper was to highlight the unique challenges faced in genetic counseling for such patients and to discuss the ways to facilitate the difficulties, with an emphasis on the crucial role of electronic medical records (EMR). Case: We report a couple presenting with elevated maternal alpha-fetoprotein in three pregnancies, in which an erroneous diagnosis of epidermolysis bullosa was established in the past and carried along through several years. The live born proband had no evidence of skin disease; however, soon after birth she was diagnosed with congenital nephrotic syndrome. Sequencing of NPHS1 gene yielded a homozygous likely pathogenic genetic variant c.2104G > A (p.Gly702Arg). Population screening performed in the village of residence revealed a carrier frequency of 1–47. This high frequency justified including testing for the founder genetic variant in the national program for population screening. Conclusions: Our report highlights the caution, suspicion and time investment which should be practiced and addressed in genetic counseling of high-risk isolated populations. Using EMR may facilitate reaching the correct diagnosis, enable accurate genetic counseling and provide information for decision-making to the couples, as well as “save” a large community from devastating diseases.

Original languageEnglish
Pages (from-to)316-320
Number of pages5
JournalBirth Defects Research
Issue number4
StatePublished - 1 Mar 2020

Bibliographical note

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© 2019 Wiley Periodicals, Inc.


  • consanguinity
  • electronic medical records
  • erroneous diagnosis
  • genetic counseling
  • isolated populations


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