Whole-exome sequencing was performed on DNA extracted from whole blood using a previously described method with the following alterations: the Agilent SureSelectXT Human All Exon V4 kit (Agilent Technologies) was used27 (link), and sequencing was performed on the HiSeq2500 instrument (Illumina) with 100-bp paired-end sequencing. Sequence was aligned to the human reference genome (Hg19) using Burrow–Wheeler Aligner (0.5.11)28 (link); variants were called with Samtools29 (link) and Genome Analysis Toolkit (v.1.6)30 (link) and annotated with Annovar31 (link). Variants with a quality score <10 were excluded from analysis. Variant filtering and segregation was performed with in-house developed software (https://github.com/brendanofallon/VarViewer). All genes previously associated with congenital lymphoedema (CCBE1, FOXC2, FLT4, KIF11, GATA2, GJC2, SOX18, FAT4 and PTPN14) were specifically analysed and no rare or pathogenic variants were found in any family member despite full sequencing coverage. The reported PIEZO1 variants were confirmed by Sanger sequencing using standard methods. Primer sequences are available upon request.
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