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Basto DL, de Souza Vieira G, Andrade-Losso RM, Almeida PN, Riccardi VM, Rozza-de-Menezes RE, Cunha KS. Head circumference and anthropometric changes and their relation to plexiform and skin neurofibromas in sporadic and familial neurofibromatosis 1 Brazilian adults: a cross-sectional study. Orphanet J Rare Dis 2022; 17:341. [PMID: 36064430 PMCID: PMC9446792 DOI: 10.1186/s13023-022-02482-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 08/15/2022] [Indexed: 11/10/2022] Open
Abstract
Background Neurofibromatosis 1 (NF1) is a common autosomal dominant syndrome with complete penetrance and highly variable expressivity. The cutaneous neurofibroma (Cnf) and plexiform neurofibroma (Pnf), café-au-lait spots, and freckle-like lesions are common in NF1, but many other manifestations can occur. We aimed to evaluate head circumference, height, weight, body mass index (BMI), head circumference-to-height ratio (HCHR) and waist–hip ratio (WHR) in adult NF1 Brazilian individuals versus a paired control group and investigate their correlation with the presence of clinically visible Pnfs, and number of “skin neurofibromas” (Snf), which include both cutaneous and subcutaneous neurofibromas. Methods A case–control study was conducted with 168 individuals, 84 with NF1 and 84 without NF1, paired by sex and age. Head circumference and anthropometric measurements, Snf quantification, evaluation of clinically visible Pnf and familial inheritance were accessed. Results Prevalence of macrocephaly was significantly higher in NF1 women. Height and weight were significantly lower in both males and females with NF1. HCHR was higher in the NF1 group than in the control group for both sexes. BMI was significantly lower in men with NF1. Waist and hip circumferences were significantly reduced in NF compared with the controls, but the mean WHR was significantly lower only in NF1 women. No correlation was found between the Snf and head circumference and anthropometric measurements, sex or family history. The presence and larger size of clinically visible plexiform neurofibromas were associated with normal stature (p = 0.037 and p = 0.003, respectively). Conclusions NF1 individuals have increased prevalence of macrocephaly, short stature, low BMI, and reduced abdominal fat. There is no relation between head circumference and anthropometric data with family history, or neurofibromas.
Supplementary Information The online version contains supplementary material available at 10.1186/s13023-022-02482-8.
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Affiliation(s)
- Diogo Lisbôa Basto
- Graduate Program in Pathology, School of Medicine, Universidade Federal Fluminense, Niterói, RJ, Brazil.,Neurofibromatosis National Center, Rio de Janeiro, RJ, Brazil
| | - Gustavo de Souza Vieira
- Graduate Program in Pathology, School of Medicine, Universidade Federal Fluminense, Niterói, RJ, Brazil.,Neurofibromatosis National Center, Rio de Janeiro, RJ, Brazil
| | - Raquel M Andrade-Losso
- Graduate Program in Pathology, School of Medicine, Universidade Federal Fluminense, Niterói, RJ, Brazil.,Neurofibromatosis National Center, Rio de Janeiro, RJ, Brazil
| | - Paula Nascimento Almeida
- Graduate Program in Pathology, School of Medicine, Universidade Federal Fluminense, Niterói, RJ, Brazil.,Neurofibromatosis National Center, Rio de Janeiro, RJ, Brazil
| | | | - Rafaela Elvira Rozza-de-Menezes
- Graduate Program in Pathology, School of Medicine, Universidade Federal Fluminense, Niterói, RJ, Brazil.,Neurofibromatosis National Center, Rio de Janeiro, RJ, Brazil.,Department of Pathology, School of Medicine, Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Av. Marquês Do Paraná, 303, 4oandar, sala 01. Centro, Niterói, RJ, 24033-900, Brazil
| | - Karin Soares Cunha
- Graduate Program in Pathology, School of Medicine, Universidade Federal Fluminense, Niterói, RJ, Brazil. .,Neurofibromatosis National Center, Rio de Janeiro, RJ, Brazil. .,Department of Pathology, School of Medicine, Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Av. Marquês Do Paraná, 303, 4oandar, sala 01. Centro, Niterói, RJ, 24033-900, Brazil.
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SENDRASOA FA, RASOARISATA A, RAMAROZATOVO LS, RAPELANORO RABENJA F. [Clinical aspects of Neurofibromatosis type 1 seen in the Department of Dermatology at University Hospital Antananarivo, Madagascar]. MEDECINE TROPICALE ET SANTE INTERNATIONALE 2022; 2:mtsi.v2i2.2022.247. [PMID: 35919256 PMCID: PMC9326780 DOI: 10.48327/mtsi.v2i2.2022.247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 05/24/2022] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Neurofibromatosis 1 (NF1) is an inherited disease, in an autosomal dominant manner, with complex multi-system involvements. Prevalence varies from one country to another. However, little is known about neurofibromatosis in African countries, particularly in Madagascar. METHODOLOGY A descriptive retrospective study from 2014 to 2019 was conducted at the service of dermatology at University Hospital Joseph Raseta Befelatanana in Antananarivo, including all patients with neurofibromatosis according to National Institutes of Health Consensus Conference criteria for whom genealogical investigation could be made. RESULTS Among 32 cases of NF1 seen during 6 years, 28 cases were included with a sex ratio M/F of 0.87. The mean age was 24 years ranging from 11 to 54 years. Seventeen patients presented sporadic forms. All patients had "café au lait" spots and cutaneous neurofibromatosis. Three cases presented plexiform neurofibromas which cause significant cosmetic and functional problems by their size and their displayed topography. Fifteen patients had Lisch nodules but no case of optic glioma was identified. Neurological symptoms such as learning difficulties, epilepsy and headache were frequent in our case series. However, access to medical imaging was very limited. Scoliosis was the most common orthopedic complication. CONCLUSION The clinical manifestations of NF1 are extremely variable. Although the possibility of systemic complications seems to be low, patients must be followed up.
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Tettamanti G, Mogensen H, Kampitsi CE, Nordgren A, Feychting M. Birth Characteristics Among Children Diagnosed with Neurofibromatosis Type 1 and Tuberous Sclerosis. J Pediatr 2021; 239:200-205.e2. [PMID: 34390698 DOI: 10.1016/j.jpeds.2021.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 08/03/2021] [Accepted: 08/06/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate whether children with neurofibromatosis type 1 (NF1) and tuberous sclerosis have different birth characteristics compared with the general population. STUDY DESIGN We identified all individuals born in Sweden between 1973 and 2014 from the nationwide Medical Birth Register for whom information on both biological parents was available (n = 4 242 122). Individuals with NF1 and individuals with tuberous sclerosis were identified using data from Swedish population-based health data registers. Using logistic regression models, we assessed the associations between these 2 neurocutaneous syndromes and birth characteristics in a cohort that included 1804 subjects with NF1 and 450 with tuberous sclerosis. RESULTS Children with NF1 and tuberous sclerosis were significantly more likely to be born preterm and via cesarean delivery. In addition, children with NF1 were also more likely to be born with other birth characteristics, such as short length, a large head circumference, and a low Apgar score. Moreover, children with NF1 had an increased odds of being born with a high birth weight or large for gestational age (OR, 1.61; 95% CI, 1.42-1.82 and OR, 1.82; 95% CI, 1.60-2.06, respectively). CONCLUSION Children with NF1 and tuberous sclerosis differ from the general population in terms of several birth characteristics, with the strongest associations observed for high birth weight and large for gestational age in individuals with NF1.
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Affiliation(s)
- Giorgio Tettamanti
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Hanna Mogensen
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Ann Nordgren
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| | - Maria Feychting
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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Kallionpää RA, Peltonen S, Leppävirta J, Pöyhönen M, Auranen K, Järveläinen H, Peltonen J. Haploinsufficiency of the NF1 gene is associated with protection against diabetes. J Med Genet 2020; 58:378-384. [PMID: 32571896 PMCID: PMC8142421 DOI: 10.1136/jmedgenet-2020-107062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 05/08/2020] [Accepted: 05/11/2020] [Indexed: 12/15/2022]
Abstract
Background The hereditary predisposition to diabetes is only partially explained by genes identified so far. Neurofibromatosis type 1 (NF1) is a rare monogenic dominant syndrome caused by aberrations of the NF1 gene. Here, we used a cohort of 1410 patients with NF1 to study the association of the NF1 gene with type 1 (T1D) and type 2 diabetes (T2D). Methods A total of 1410 patients were confirmed to fulfil the National Institutes of Health diagnostic criteria for NF1 by individually reviewing their medical records. The patients with NF1 were compared with 14 017 controls matched for age, sex and area of residence as well as 1881 non-NF1 siblings of the patients with NF1. Register-based information on purchases of antidiabetic medication and hospital encounters related to diabetes were retrieved. The Cox proportional hazards model was used to calculate the relative risk for diabetes in NF1. Results Patients with NF1 showed a lower rate of T2D when compared with a 10-fold control cohort (HR 0.27, 95% CI 0.17 to 0.43) or with their siblings without NF1 (HR 0.28, 95% CI 0.16 to 0.47). The estimates remained practically unchanged after adjusting the analyses for history of obesity and dyslipidaemias. The rate of T1D in NF1 was decreased although statistically non-significantly (HR 0.58, 95% CI 0.27 to 1.25). Conclusion Haploinsufficiency of the NF1 gene may protect against T2D and probably T1D. Since NF1 negatively regulates the Ras signalling pathway, the results suggest that the Ras pathway may be involved in the pathogenesis of diabetes.
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Affiliation(s)
| | - Sirkku Peltonen
- Department of Dermatology and Venereology, University of Turku, Turku, Finland.,Department of Dermatology, Turku University Hospital, Turku, Finland
| | - Jussi Leppävirta
- Department of Clinical Genetics, HUSLAB, Helsinki University Hospital (HUS) Diagnostic Center, Helsinki, Finland.,Department of Medical and Clinical Genetics, University of Helsinki, Helsinki, Finland
| | - Minna Pöyhönen
- Department of Clinical Genetics, HUSLAB, Helsinki University Hospital (HUS) Diagnostic Center, Helsinki, Finland.,Department of Medical and Clinical Genetics, University of Helsinki, Helsinki, Finland
| | - Kari Auranen
- Department of Mathematics and Statistics and Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Hannu Järveläinen
- Institute of Biomedicine, University of Turku, Turku, Finland.,Department of Internal Medicine, Satakunta Central Hospital, Pori, Finland
| | - Juha Peltonen
- Institute of Biomedicine, University of Turku, Turku, Finland
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Leppävirta J, Kallionpää RA, Uusitalo E, Vahlberg T, Pöyhönen M, Peltonen J, Peltonen S. Neurofibromatosis type 1 of the child increases birth weight. Am J Med Genet A 2019; 179:1173-1183. [PMID: 31016862 PMCID: PMC6618292 DOI: 10.1002/ajmg.a.61161] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 03/18/2019] [Accepted: 03/29/2019] [Indexed: 12/30/2022]
Abstract
Neurofibromatosis type 1 (NF1) is associated with reduced adult height, but there are no cohort studies on birth size. This retrospective study includes a cohort of 1,410 persons with NF1 and a matched comparison cohort from the general population. Figures for birth size were retrieved from the administrative registers of Finland, and the data were converted to standard deviation scores (SDS), defined as standard deviation difference to the reference population. The birth weight among infants with NF1 was higher than among infants without the disorder (adjusted mean difference [95% confidence interval]: 0.53 SDS [0.19–0.87]), as was the head circumference at birth (0.58 SDS [0.26–0.90]). The birth length of the NF1 infants did not differ significantly from the comparison cohort. The birth weight in the group consisting of NF1 and non‐NF1 infants of NF1 mothers was lower than among infants of mothers in the comparison cohort (−0.28 SDS [−0.51 to −0.06]), as was the birth length (−0.22 SDS [−0.45 to 0.00]). In conclusion, the birth weight and head circumference of persons with NF1 are significantly higher than those of persons without the disorder. NF1 of the mother reduces birth weight and birth length of the infant.
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Affiliation(s)
- Jussi Leppävirta
- Department of Dermatology and VenereologyUniversity of TurkuTurkuFinland
- Department of DermatologyTurku University HospitalTurkuFinland
| | - Roope A. Kallionpää
- Department of Cell Biology and AnatomyInstitute of Biomedicine, University of TurkuTurkuFinland
| | - Elina Uusitalo
- Department of Cell Biology and AnatomyInstitute of Biomedicine, University of TurkuTurkuFinland
| | - Tero Vahlberg
- Department of Clinical MedicineUniversity of TurkuTurkuFinland
| | - Minna Pöyhönen
- Department of Medical and Clinical GeneticsUniversity of HelsinkiHelsinkiFinland
- Department of Clinical GeneticsHUSLAB and Helsinki University Central HospitalHelsinkiFinland
| | - Juha Peltonen
- Department of Cell Biology and AnatomyInstitute of Biomedicine, University of TurkuTurkuFinland
| | - Sirkku Peltonen
- Department of Dermatology and VenereologyUniversity of TurkuTurkuFinland
- Department of DermatologyTurku University HospitalTurkuFinland
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