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Douzgou S, Rawson M, Baselga E, Danielpour M, Faivre L, Kashanian A, Keppler-Noreuil KM, Kuentz P, Mancini GMS, Maniere MC, Martinez-Glez V, Parker VE, Semple RK, Srivastava S, Vabres P, de Wit MCY, Graham JM, Clayton-Smith J, Mirzaa GM, Biesecker LG. A standard of care for individuals with PIK3CA-related disorders: An international expert consensus statement. Clin Genet 2022; 101:32-47. [PMID: 34240408 PMCID: PMC8664971 DOI: 10.1111/cge.14027] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/10/2021] [Accepted: 06/15/2021] [Indexed: 01/19/2023]
Abstract
Growth promoting variants in PIK3CA cause a spectrum of developmental disorders, depending on the developmental timing of the mutation and tissues involved. These phenotypically heterogeneous entities have been grouped as PIK3CA-Related Overgrowth Spectrum disorders (PROS). Deep sequencing technologies have facilitated detection of low-level mosaic, often necessitating testing of tissues other than blood. Since clinical management practices vary considerably among healthcare professionals and services across different countries, a consensus on management guidelines is needed. Clinical heterogeneity within this spectrum leads to challenges in establishing management recommendations, which must be based on patient-specific considerations. Moreover, as most of these conditions are rare, affected families may lack access to the medical expertise that is needed to help address the multi-system and often complex medical issues seen with PROS. In March 2019, macrocephaly-capillary malformation (M-CM) patient organizations hosted an expert meeting in Manchester, United Kingdom, to help address these challenges with regards to M-CM syndrome. We have expanded the scope of this project to cover PROS and developed this consensus statement on the preferred approach for managing affected individuals based on our current knowledge.
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Affiliation(s)
- Sofia Douzgou
- Department of Medical Genetics, Haukeland University Hospital, Bergen, Norway
- Manchester Centre for Genomic Medicine, St Mary’s Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Sciences Centre, M13 9WL, United Kingdom
- Division of Evolution and Genomic Sciences, School of Biological Sciences, University of Manchester, Oxford Road, M13 9PL, United Kingdom
| | - Myfanwy Rawson
- Manchester Centre for Genomic Medicine, St Mary’s Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Sciences Centre, M13 9WL, United Kingdom
| | - Eulalia Baselga
- Department of Dermatology, Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Barcelona, Spain
| | - Moise Danielpour
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Centre, Los Angeles, CA 90048, USA; Department of Neurosurgery, Cedars-Sinai Medical Centre, Los Angeles, CA 90048, USA
| | - Laurence Faivre
- Department of Medical Genetics and Centre of Reference for Developmental Anomalies and Malformative syndromes, CHU de Dijon, 14 Rue Paul Gaffarel, 21000 Dijon, France
| | - Alon Kashanian
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Centre, Los Angeles, CA 90048, USA; Department of Neurosurgery, Cedars-Sinai Medical Centre, Los Angeles, CA 90048, USA
| | - Kim M Keppler-Noreuil
- Division of Genetics & Metabolism, Department of Paediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Paul Kuentz
- Oncobiologie Génétique Bioinformatique, PCBio, CHU Besançon, France
| | - Grazia MS Mancini
- Department of Clinical Genetics, Erasmus MC University Medical Centre, 3015, GD, Rotterdam, the Netherlands
| | - Marie-Cecile Maniere
- Centre de Référence, Maladies orales et dentaires rares, Pôle de Médecine et Chirurgie Bucco-dentaires, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Victor Martinez-Glez
- IdiPAZ Research Institute, Madrid, Spain
- Centre for Biomedical Network Research on Rare Diseases (CIBERER), CIBER, Institute of Health Carlos III, Madrid, Spain
- Institute of Medical and Molecular Genetics (INGEMM), La Paz University Hospital, Madrid, Spain
| | - Victoria E Parker
- The National Institute for Health Research Cambridge Biomedical Research Centre, Cambridge, United Kingdom
| | - Robert K Semple
- Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ, United Kingdom
| | - Siddharth Srivastava
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Pierre Vabres
- Department of Medical Genetics and Centre of Reference for Developmental Anomalies and Malformative syndromes, CHU de Dijon, 14 Rue Paul Gaffarel, 21000 Dijon, France
| | - Marie-Claire Y de Wit
- Department of Child Neurology, Sophia Children's hospital, Erasmus MC University Medical Centre Rotterdam, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
| | - John M Graham
- Department of Paediatrics, Division of Medical Genetics, Cedars Sinai Medical Centre, David Geffen School of Medicine at UCLA, Los Angeles, CA 90048, USA
| | - Jill Clayton-Smith
- Manchester Centre for Genomic Medicine, St Mary’s Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Sciences Centre, M13 9WL, United Kingdom
- Division of Evolution and Genomic Sciences, School of Biological Sciences, University of Manchester, Oxford Road, M13 9PL, United Kingdom
| | - Ghayda M Mirzaa
- Genetic Medicine, Department of Paediatrics, University of Washington, Seattle, USA
| | - Leslie G Biesecker
- Centre for Precision Health Research, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA
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