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Almuhaidib SR, Aldulijan FA, Alkanaan NA, Almulhim AK, Alyami KS. An approach to café au lait macules in primary care setting. J Family Community Med 2021; 28:217-219. [PMID: 34703383 PMCID: PMC8496705 DOI: 10.4103/jfcm.jfcm_161_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 06/14/2021] [Accepted: 06/24/2021] [Indexed: 11/24/2022] Open
Abstract
Café au lait macules (CALMs), if solitary, are benign lesion with no clinical meaning, and are common in the general population. Multiple CALMs may be the hallmark of some disorders and need to be assessed by an interprofessional team. The diagnosis and evaluation of a patient with a suspected condition may include a team of pediatric neurologists, dermatologists, ophthalmologists, geneticists, and orthopedic surgeons. To evaluate the progression of the disease, an annual follow-up is required.
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Affiliation(s)
- Seereen R Almuhaidib
- College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Fajar A Aldulijan
- College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Najlaa A Alkanaan
- College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Abdulmohsin K Almulhim
- Department of Family and Community Medicine, King Fahad University Hospital, Al Khobar, Saudi Arabia
| | - Khalid S Alyami
- Department of Family and Community Medicine, King Fahad University Hospital, Al Khobar, Saudi Arabia
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de Castro IJ, da Silva EBS, Dos Santos TR, de Freitas AB, de Castro IJ, Portela AS, de Magalhães MC, Pires KL, da Silva GAR, de Azevedo MCVM. T-Cell Lymphoma in a Patient with Neurofibromatosis Type 1 and AIDS. Case Rep Oncol 2017; 10:161-168. [PMID: 28413392 PMCID: PMC5346920 DOI: 10.1159/000456029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 01/12/2017] [Indexed: 11/19/2022] Open
Abstract
Neurofibromatosis type 1 (NF1) and AIDS are risk factors for the development of malignant neoplasms, including hematological malignancies, such as non-Hodgkin lymphoma. NF1 is an autosomal dominant disease that primarily manifests as café-au-lait spots, dermal neurofibromas, axillary and/or inguinal ephelides or freckles, plexiform neurofibromas, Lisch nodules, and bone deformities. In this report, we present a 38-year-old female patient with NF1 from childhood and AIDS who developed peripheral T-cell lymphoma with good response to chemotherapeutic treatment.
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Affiliation(s)
| | | | | | | | | | | | | | - Karina Lebeis Pires
- Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
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Legendre CM, Charpentier-Côté C, Drouin R, Bouffard C. Neurofibromatosis type 1 and the "elephant man's" disease: the confusion persists: an ethnographic study. PLoS One 2011; 6:e16409. [PMID: 21347399 PMCID: PMC3036577 DOI: 10.1371/journal.pone.0016409] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2010] [Accepted: 12/22/2010] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In 1986, two Canadian geneticists had demonstrated that Joseph Merrick, better known as the Elephant Man, suffered from the Proteus syndrome and not from neurofibromatosis type 1 (NF1), as was alleged by dermatologist Parkes in 1909. Despite this and although the two diseases differ at several levels: prevalence, diagnostic criteria, clinical manifestations and transmission, the confusion between NF1 and the "elephant man's" disease continues in medical and social representations by current linguistic usage, and in some media reports. With this article, we want to 1) document the persistence and extent of this fallacy, 2) identify certain critical factors that contribute to its persistence, and 3) evaluate its impact on the health and well being of patients with NF1 and their family members. METHODOLOGY Participant observation in the course of an ethnographic study on intergenerational dialogue between individuals with neurofibromatosis and their parents - Analysis of the scientific literature and of pinpoint articles in the print and online news media. FINDINGS Our findings show that because physicians have little knowledge about NF1, several print and online news media and a lot of physicians continue to make the confusion between NF1 and the disease the "elephant man". This misconception contributes to misinformation about the disease, feeding prejudices against affected patients, exacerbating the negative impacts of the disease on their quality of life, their cognitive development, their reproductive choices, as well as depriving them of proper care and appropriate genetic counseling. CONCLUSION If family physicians and pediatricians were properly informed about the disease, they could refer their patients with NF1 to NF clinics and to specialists. Thus, patients and their family members would benefit from better-tailored clinical management of their cases, perhaps even optimal management. [corrected]
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Affiliation(s)
- Claire-Marie Legendre
- Division of Genetics, Department of Pediatrics, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada.
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Onesti MG, Carella S, Spinelli G, Scuderi N. The megasession technique for excision of multiple neurofibromas. Dermatol Surg 2010; 36:1488-90. [PMID: 20636383 DOI: 10.1111/j.1524-4725.2010.01666.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Maria Giuseppina Onesti
- Department of Dermatology and Plastic Reconstructive Surgery, University of Rome Sapienza, Rome, Italy
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A 38-year review of oral schwannomas and neurofibromas in a Brazilian population: clinical, histopathological and immunohistochemical study. Clin Oral Investig 2010; 15:329-35. [PMID: 20217161 DOI: 10.1007/s00784-010-0389-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2009] [Accepted: 02/09/2010] [Indexed: 10/19/2022]
Abstract
The benign peripheral nerve sheath tumours are rare lesions mainly represented by schwannoma and neurofibroma. The present work evaluated the clinical and histopathological features of schwannomas and neurofibromas of the oral cavity diagnosed in a Brazilian population. Among 9.000 cases of oral lesions archived from 1970 to 2008, four schwannomas and 12 neurofibromas were identified, microscopically revised and immunohistochemically certified through a panel including monoclonal antibodies (anti-S100, vimentin, HHF-35 and desmin). From biopsy and histological sections records, clinical and histopathological data were retrieved, reviewed and statistically analysed. Predominantly, schwannomas affected non-white males (3:1), with an age and size averages of 34.7 years and 2.8 cm, respectively. Neurofibromas preferentially occurred on the gingival/alveolar ridge of white females (5:1), with 35.7-year mean age, peak of incidence between 3rd and 5th decade, and size average of 1.7 cm. (12 cases, 75%). The studied tumours exhibited more frequently as a painless, sessile and slow growth very similar to other oral lesions, but their microscopic features differed significantly. Schwannomas and neurofibromas are extremely uncommon in the oral cavity, exhibiting clinical features very similar but specific and peculiar microscopic findings that are useful in the establishment of the diagnosis, which in some particular cases must be confirmed by immunohistochemistry.
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Darrigo Junior LG, Bonalumi Filho A, D'Alessandro DSM, Geller M. Neurofibromatose tipo 1 na infância: revisão dos aspectos clínicos. REVISTA PAULISTA DE PEDIATRIA 2008. [DOI: 10.1590/s0103-05822008000200014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJETIVO: Realizar uma revisão da literatura sobre neurofibromatose tipo 1 (NF1) em crianças e adolescentes, enfatizando as manifestações clínicas. FONTES DE DADOS: Artigos publicados, indexados na base de dados Medline e publicados entre 1998 a 2007, buscados pelos seguintes termos: "neurofibromatosis type 1", "neurofibroma", "von Recklinghausen" e "optic pathway gliomas". SÍNTESE DOS DADOS: A NF1 é uma doença genética autossômica dominante, crônica e progressiva, com incidência de 1/2.000 a 1/7.800 nascidos vivos. Tem sido observada em diferentes partes do mundo, em todas as raças e nos dois sexos. Metade dos casos representa mutações novas. A taxa de mutação para o gene NF1 é de 1/10.000, a qual se deve ao fato do gene ser grande e possuir estrutura interna atípica, que predispõe a deleções e mutações. O diagnóstico presuntivo da NF1 é feito por critérios clínicos. As três principais manifestações - neurofibromas, manchas café-com-leite e nódulos de Lisch - ocorrem em mais de 90% dos pacientes até a puberdade. CONCLUSÕES: Os cuidados com os pacientes com NF1 devem antecipar as principais complicações e oferecer um tratamento precoce. No aconselhamento genético, é importante informar pais e familiares a respeito do panorama geral da doença e suas possíveis complicações, enfatizando que a maioria dos pacientes apresenta vida saudável e produtiva.
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Affiliation(s)
| | | | | | - Mauro Geller
- Fundação Educacional Serra dos Órgãos; International Neurofibromatosis Association, Brasil
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7
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Schena D, Germi L, Zamperetti MR, Darra F, Giacopuzzi S, Girolomoni G. Uncombable hair syndrome, mental retardation, single palmar crease and arched palate in a patient with neurofibromatosis type I. Pediatr Dermatol 2007; 24:E73-5. [PMID: 17958786 DOI: 10.1111/j.1525-1470.2007.00446.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
A 2-year-old girl presented with hair that naturally stood out from her scalp. Her mother reported that the girl's hair had been impossible to comb since the first month of life. The child's eyebrows and lashes were normal. Scanning electron microscopy confirmed the presence of grooving on the hair shaft. Moreover, eight cafè-au-lait macules larger than 5 mm on the trunk and the limbs, and freckles in the axillary regions were observed. Neurologic examination showed some difficulties in motor organization and dyslalia. Magnetic resonance imaging illustrated multiple cerebral hamartomas. Molecular analysis disclosed microdeletion of gene 17q.11.2. Additional features included arched palate, a single palmar crease on one hand and low-set ears, which, together with bone abnormalities, have been previously associated with uncombable hair. This is the first report, to the best of our knowledge, of uncombable hair syndrome in a patient with neurofibromatosis type I.
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Affiliation(s)
- Donatella Schena
- Department of Biomedical and Surgical Sciences, Section of Dermatology and Venereology, University of Verona, Verona, Italy.
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López-Cepeda LD, Dorina LCL, Domínguez-Gómez MA, Antonieta DGM, Novales-Santa CJ, Josefa NSC, Guarneros-Campos A, Arturo GC. Segmental neurofibromatosis of facial localization. Int J Dermatol 2005; 44:583-6. [PMID: 15985029 DOI: 10.1111/j.1365-4632.2004.02093.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Pinson S, Wolkenstein P. La neurofibromatose 1 (NF1) ou maladie de Von Recklinghausen. Rev Med Interne 2005; 26:196-215. [PMID: 15777582 DOI: 10.1016/j.revmed.2004.06.011] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2003] [Accepted: 06/20/2004] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Neurofibromatosis 1(NF1) is one of the most common genetic diseases. NF1 is an autosomal dominant genetic disorder and half of affected individuals have NF1 as the result of a new gene NF1 mutation. The offspring of an affected individual have a 50% risk of inheriting the altered NF1 gene. The disease manifestations are extremely variable, even within a family. NF1 is characterized by multiple cafe au lait spots, axillary and inguinal freckling, multiple discrete dermal neurofibromas, and iris Lisch nodules. Learning disabilities are frequent. Less common but potentially more serious manifestations include plexiform neurofibromas, optic and other central nervous system gliomas, malignant peripheral nerve sheath tumors, vasculopathy, and osseous lesions. CURRENT KNOWLEDGES AND KEY POINTS Since the original National Institutes of Health consensus Development Conference in 1987, there have been significant progress toward a more complete understanding of the molecular-bases for neurofibromatosis 1 and the routine follow-up for the care of the NF1 patients. The authors review the present data on the clinical and molecular aspects of the neurofibromatosis 1. FUTURE PROSPECTS AND PROJECTS NF1 requires life-long management adapted to age and multidisciplinary structures are particularly well adapted to the diversity of the manifestations of this pathology. The French NF-France Network has been created in 2001 to federate the French multidisciplinary structures for neurofibromatosis and harmonize the follow-up of NF1 patients in France.
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Affiliation(s)
- S Pinson
- Laboratoire de génétique moléculaire, bâtiment E, hôpital Edouard-Hérriot, 5, place d'Arsonval, 69437 Lyon, France.
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Reis C, Carneiro E, Fonseca J, Pereira P, Vaz R, Pinto R, Capelinha AF, Lopes JM, Salgado A. Epithelioid hemangioendothelioma and multiple thoraco-lumbar lateral meningoceles: two rare pathological entities in a patient with NF-1. Neuroradiology 2005; 47:165-9. [PMID: 15688204 DOI: 10.1007/s00234-004-1321-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2004] [Accepted: 11/19/2004] [Indexed: 10/25/2022]
Abstract
Epithelioid hemangioendothelioma (EHE) is a rare vascular soft-tissue tumour of intermediate malignancy. Neurofibromatosis type I (NF-1) is a genetic syndrome associated with soft tissue sarcoma and higher risk of developing neoplasia. Lateral meningoceles are uncommon entities, being mostly associated with NF-1. We report a case of a 31-year-old woman, with NF-1 and past history of right thalamic/peduncular astrocytoma WHO grade II, admitted to the Neurosurgery Department in December 2003 due to severe low back pain, irradiating to the left leg without a radicular pattern. Thoraco-lumbar magnetic resonance imaging (MRI) showed a large left posterior paravertebral expansive lesion, bilateral and multiple thoraco-lumbar lateral meningoceles and dural ectasias with scalloping of the vertebral bodies. Biopsy of the paravertebral mass lesion disclosed EHE. We present this case because of the novel association between NF-1 and EHE, and the unusual aggressiveness of the neoplasia. Additionally, we highlight the co-existence of bilateral and multiple lateral meningoceles.
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Affiliation(s)
- C Reis
- Departments of Neuroradiology, Hospital S. João, Alameda Prof. Hernâni Monteiro, 4202-451 Porto, Portugal.
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Tumor sacrococcígeo en un paciente con enfermedad de von Recklinghausen. ACTAS DERMO-SIFILIOGRAFICAS 2004. [DOI: 10.1016/s0001-7310(04)76875-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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12
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Drappier JC, Khosrotehrani K, Zeller J, Revuz J, Wolkenstein P. Medical management of neurofibromatosis 1: a cross-sectional study of 383 patients. J Am Acad Dermatol 2003; 49:440-4. [PMID: 12963907 DOI: 10.1067/s0190-9622(03)01481-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND The morbidity and mortality caused by neurofibromatosis 1 are a result of complications that may involve any of the body systems. Two models of management have been proposed for the detection of various complications in specialized neurofibromatosis clinics: investigation protocols (including extensive imaging and analysis of 24-hour urinary catecholamine levels); or clinical follow-up without imaging. OBJECTIVE Our purpose was to validate the strategy of clinical follow-up (without routine imaging and 24-hour urinary catecholamine levels). METHODS We retrospectively compared the number of treated complications during 2 successive periods from our database: screening investigations from November 1988 to June 1995 and clinical examination from July 1995 to June 2000. RESULTS The number of treated complications during the 2 periods was not statistically different (27/166 vs 28/217; Fisher's exact test, P =.39). CONCLUSION Screening investigations added little to clinical follow-up. Indeed, routine clinical examination can easily identify complications that require treatment in adult patients with neurofibromatosis 1.
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Pinson S, Créange A, Barbarot S, Stalder JF, Chaix Y, Rodriguez D, Sanson M, Bernheim A, d'Incan M, Doz F, Stoll C, Combemale P, Kalifa C, Zeller J, Teillac-Hamel D, Lyonnet S, Zerah M, Lacour JP, Guillot B, Wolkenstein P. [Neurofibromatosis 1: recommendations for management]. Arch Pediatr 2002; 9:49-60. [PMID: 11865551 DOI: 10.1016/s0929-693x(01)00695-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Twenty experts, members of a French medical network devoted to neurofibromatosis 1 have elaborated recommendations for the management of the disease. Bibliography was obtained through a Medline of articles from 1966 to 1999 for the terms neurofibromatosis, NF1, neurofibroma and from textbooks. A consensual document was written taking into account extracted data. An annual careful clinical examination is recommended except in cases with complications. Screening investigations are not recommended due to the rarity of complications, generally symptomatic and easily detected during the clinical follow-up. The only controversial exception might be magnetic resonance imaging for early detection of optic pathway gliomas in young children. A co-ordinated follow-up in specialised multidisciplinary centres, providing patients with a rational management, is recommended.
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Affiliation(s)
- S Pinson
- Hôpital Edouard-Herriot, Lyon, France.
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Wolkenstein P, Durand-Zaleski I, Moreno JC, Zeller J, Hemery F, Revuz J. Cost evaluation of the medical management of neurofibromatosis 1: a prospective study on 201 patients. Br J Dermatol 2000; 142:1166-70. [PMID: 10848741 DOI: 10.1046/j.1365-2133.2000.03543.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Neurofibromatosis 1 (NF1) is associated with many internal complications as well as skin manifestations, and patients may require a variety of medical and surgical interventions. We aimed to assess the medical needs of NF1 patients, and to evaluate the financial cost of the resources used for them in relation to the severity of the disease. We conducted a prospective analysis on a cohort of 201 patients in our referral centre for adults. Severity of the disease was assessed. Therapeutic management was considered as multidisciplinary if it required more than three different specialists. Plastic and dermatological surgery procedures performed were recorded. Hospital costs were computed over a 3-year period and included all hospitalization days, clinic visits and procedures performed in all departments where the patients were admitted. One hundred and thirty-seven patients had at least one out-patient procedure or one hospitalization during the follow-up period. The mean cost per patient per year was pound810 (median 240; range 0-13, 860). Multidisciplinary procedures were more frequent in moderately and severely affected NF1 patients than in milder cases (P < 0. 0001); hence, the costs for moderate and severe cases were higher than for less severe groups (P = 0.005). Plastic and/or dermatological surgery was performed with the same frequency in the different severity groups (71%). Regardless of the presence of serious intractable complications, the patients' priority is for treatment of the disfigurement due to the disease. The management of these patients can be considered relatively inexpensive from the viewpoint of the healthcare system.
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Affiliation(s)
- P Wolkenstein
- Departments of Dermatology and Public Health, and Réseau NF-Mondor, Henri-Mondor Hospital, 94010 Créteil cedex, France.
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