1
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Draaisma F, Leenders EKSM, Erasmus CE, Braakman HMH, Burgers MCJ, Coppens CH, Rinne T, Zenker M, Tartaglia M, Reintjes W, Voermans NC, van Engelen BGM, van Alfen N, Draaisma JMT. Nerve enlargement in patients with Noonan syndrome: A retrospective cohort study. Am J Med Genet A 2024:e63810. [PMID: 38958480 DOI: 10.1002/ajmg.a.63810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 06/08/2024] [Accepted: 06/22/2024] [Indexed: 07/04/2024]
Abstract
Noonan syndrome (NS) is an autosomal dominant condition characterized by facial dysmorphism, congenital heart disease, development delay, growth retardation and lymphatic disease. It is caused by germline pathogenic variants in genes encoding proteins in the Ras/mitogen-activated protein kinase signaling pathway. Nerve enlargement is not generally considered as a feature of NS, although some cases have been reported. High-resolution nerve ultrasound enables detailed anatomical assessment of peripheral nerves and can show enlarged nerves. This retrospective cohort study aims to describe the sonographic findings of patients with NS performed during a 1-year time period. Data on the degree of enlargement, the relation to increasing age, pain in extremities, genotype on the gene level and clinical features were collected. Twenty-nine of 93 patients visiting the NS Center of Expertise of the Radboud University Medical Center Nijmegen underwent high-resolution ultrasound. In 24 patients (83%) nerve enlargement was found. Most of them experienced pain. We observed a weak correlation with increasing age and the degree of nerve enlargement but no association with pain, genotype at the gene level or clinical features. This study shows that patients with NS have a high predisposition for sonographic nerve enlargement and that the majority experience pain.
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Affiliation(s)
- Fieke Draaisma
- Department of Pediatrics, Radboud Institute for Health Sciences, Radboud University Medical Center, Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Erika K S M Leenders
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Corrie E Erasmus
- Department of Pediatric Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen Medical Center, Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Hilde M H Braakman
- Department of Pediatric Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen Medical Center, Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Melanie C J Burgers
- Department of Pediatrics, Radboud Institute for Health Sciences, Radboud University Medical Center, Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Catelijne H Coppens
- Department of Pediatrics, Radboud Institute for Health Sciences, Radboud University Medical Center, Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Tuula Rinne
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Martin Zenker
- Institute of Human Genetics, University Hospital Magdeburg, Magdeburg, Germany
| | - Marco Tartaglia
- Molecular Genetics and Functional Genomics, Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy
| | - Wesley Reintjes
- Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Nicol C Voermans
- Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Baziel G M van Engelen
- Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Nens van Alfen
- Department of Neurology, Clinical Neuromuscular Imaging Group, Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Jos M T Draaisma
- Department of Pediatrics, Radboud Institute for Health Sciences, Radboud University Medical Center, Amalia Children's Hospital, Nijmegen, The Netherlands
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2
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Pugliese A, Della Marina A, de Paula Estephan E, Zanoteli E, Roos A, Schara-Schmidt U, Hentschel A, Azuma Y, Töpf A, Thompson R, Polavarapu K, Lochmüller H. Mutations in PTPN11 could lead to a congenital myasthenic syndrome phenotype: a Noonan syndrome case series. J Neurol 2024; 271:1331-1341. [PMID: 37923938 DOI: 10.1007/s00415-023-12070-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 10/12/2023] [Accepted: 10/13/2023] [Indexed: 11/06/2023]
Abstract
The RASopathies are a group of genetic rare diseases caused by mutations affecting genes involved in the RAS/MAPK (RAS-mitogen activated protein kinase) pathway. Among them, PTPN11 pathogenic variants are responsible for approximately 50% of Noonan syndrome (NS) cases and, albeit to a lesser extent, of Leopard syndrome (LPRD1), which present a few overlapping clinical features, such as facial dysmorphism, developmental delay, cardiac defects, and skeletal deformities. Motor impairment and decreased muscle strength have been recently reported. The etiology of the muscle involvement in these disorders is still not clear but probably multifactorial, considering the role of the RAS/MAPK pathway in skeletal muscle development and Acetylcholine Receptors (AChR) clustering at the neuromuscular junction (NMJ). We report, herein, four unrelated children carrying three different heterozygous mutations in the PTPN11 gene. Intriguingly, their phenotypic features first led to a clinical suspicion of congenital myasthenic syndrome (CMS), due to exercise-induced fatigability with a variable degree of muscle weakness, and serum proteomic profiling compatible with a NMJ defect. Moreover, muscle fatigue improved after treatment with CMS-specific medication. Although the link between PTPN11 gene and neuromuscular transmission is unconfirmed, an increasing number of patients with RASopathies are affected by muscle weakness and fatigability. Hence, NS or LPDR1 should be considered in children with suspected CMS but negative genetic workup for known CMS genes or additional symptoms indicative of NS, such as facial dysmorphism or intellectual disability.
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Affiliation(s)
- Alessia Pugliese
- IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy
- Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Rd., Ottawa, ON, K1H 8L1, Canada
| | - Adela Della Marina
- Department of Pediatric Neurology, Centre for Neuromuscular Disorders, Centre for Translational Neuro- and Behavioral Sciences, University Duisburg-Essen, 45147, Essen, Germany
| | - Eduardo de Paula Estephan
- Department of Neurology, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
- Department of Neurological Sciences, Psychiatry, and Medical Psychology, Sao Jose do Rio Preto State Medical School, Sao Jose do Rio Preto, São Paulo, Brazil
| | - Edmar Zanoteli
- Department of Neurology, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
| | - Andreas Roos
- Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Rd., Ottawa, ON, K1H 8L1, Canada
- Department of Pediatric Neurology, Centre for Neuromuscular Disorders, Centre for Translational Neuro- and Behavioral Sciences, University Duisburg-Essen, 45147, Essen, Germany
- Department of Neurology, Heimer Institute for Muscle Research, University Hospital Bergmannsheil, Ruhr-University Bochum, 44789, Bochum, Germany
- Leibniz-Institut Für Analytische Wissenschaften-ISAS-e.V., 44227, Dortmund, Germany
| | - Ulrike Schara-Schmidt
- Department of Pediatric Neurology, Centre for Neuromuscular Disorders, Centre for Translational Neuro- and Behavioral Sciences, University Duisburg-Essen, 45147, Essen, Germany
| | - Andreas Hentschel
- Leibniz-Institut Für Analytische Wissenschaften-ISAS-e.V., 44227, Dortmund, Germany
| | - Yoshiteru Azuma
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Ana Töpf
- John Walton Muscular Dystrophy Research Centre, Translational and Clinical Research Institute, University of Newcastle, Newcastle Upon Tyne, UK
| | - Rachel Thompson
- Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Rd., Ottawa, ON, K1H 8L1, Canada
| | - Kiran Polavarapu
- Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Rd., Ottawa, ON, K1H 8L1, Canada
| | - Hanns Lochmüller
- Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Rd., Ottawa, ON, K1H 8L1, Canada.
- Division of Neurology, Department of Medicine, The Ottawa Hospital, Ottawa, Canada.
- Brain and Mind Research Institute, University of Ottawa, Ottawa, Canada.
- Department of Neuropediatrics and Muscle Disorders, Faculty of Medicine, Medical Center-University of Freiburg, Freiburg, Germany.
- Centro Nacional de Análisis Genómico (CNAG), Barcelona, Catalonia, Spain.
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3
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Leoni C, Viscogliosi G, Onesimo R, Verdolotti T, Biagini T, Mazza T, De Luca A, Perri L, Trevisan V, Flex E, Tartaglia M, Zampino G. Further case of enlarged spinal nerve roots in KRAS-related Noonan syndrome. Clin Genet 2023. [PMID: 36757675 DOI: 10.1111/cge.14308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/01/2023] [Accepted: 02/03/2023] [Indexed: 02/10/2023]
Abstract
Noonan syndrome (NS) belongs to RASopathies, a family of disorders caused by unregulated signaling through the RAS-MAPK pathway. Herein, we report on an individual with molecularly confirmed diagnosis of NS showing asymptomatic enlarged spinal nerve roots, which are distinctive features of neurofibromatosis type 1. To date, a total of 16 patients with neurogenic tumors resembling neurofibromas/schwannomas and a molecularly confirmed diagnosis of a non-NF1 RASopathy have been reported, adding this further feature shared among RASopathies.
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Affiliation(s)
- Chiara Leoni
- Department of Woman and Child Health and Public Health, Center for Rare Diseases and Birth Defects, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome (RM), Italy
| | - Germana Viscogliosi
- Department of Woman and Child Health and Public Health, Center for Rare Diseases and Birth Defects, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome (RM), Italy
| | - Roberta Onesimo
- Department of Woman and Child Health and Public Health, Center for Rare Diseases and Birth Defects, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome (RM), Italy
| | - Tommaso Verdolotti
- UOC Radiologia e Neuroradiologia, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome (RM), Italy
| | - Tommaso Biagini
- Laboratory of Bioinformatics, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy
| | - Tommaso Mazza
- Laboratory of Bioinformatics, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy
| | - Alessandro De Luca
- Medical Genetics Division, IRCCS Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy
| | - Lucrezia Perri
- Department of Woman and Child Health and Public Health, Center for Rare Diseases and Birth Defects, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome (RM), Italy
| | - Valentina Trevisan
- Department of Woman and Child Health and Public Health, Center for Rare Diseases and Birth Defects, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome (RM), Italy
| | - Elisabetta Flex
- Department of Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome (RM), Italy
| | - Marco Tartaglia
- Genetics and Rare Diseases Research Division, Ospedale Pediatrico Bambino Gesù, IRCCS, Rome (RM), Italy
| | - Giuseppe Zampino
- Department of Woman and Child Health and Public Health, Center for Rare Diseases and Birth Defects, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome (RM), Italy.,Università Cattolica del Sacro Cuore, Rome (RM), Italy
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4
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Leoni C, Giorgio V, Stella G, Onesimo R, Triumbari EKA, Podagrosi M, Kuczynska E, Vollono C, Lindley KJ, Zampino G. Prevalence of gastrointestinal disorders in individuals with RASopathies: May RAS/MAP/ERK pathway dysfunctions be a model of neuropathic pain and visceral hypersensitivity? Am J Med Genet A 2022; 188:3287-3293. [PMID: 35894438 DOI: 10.1002/ajmg.a.62917] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 05/18/2022] [Accepted: 07/10/2022] [Indexed: 01/31/2023]
Abstract
RASopathies are a group of neurodevelopmental syndromes caused by germline variants in genes of the Ras/MAP/ERK pathway. Growth failure, neurological involvement, and pain represent the main features of these conditions. ERK signaling cascade plays a crucial role in nociception and visceral pain and it is likely implicated in the genesis of neuropathic pain and maintenance of altered pain states. We studied the prevalence of abdominal pain and functional gastrointestinal (GI) disorders in a large sample of individuals with RASopathies. A brief pain inventory questionnaire and semi-structured dedicated interview were used to investigate presence and localization of pain. A Rome IV questionnaire was used to screen for functional GI disorders. Eighty patients with clinical and molecular diagnoses of RASopathy were recruited (42 with Noonan syndrome; 17 with Costello Syndrome and 21 with cardio-facio-cutaneous syndrome). Overall, the prevalence of abdominal pain was 44% and prevalence of functional GI disorders was 78% with constipation, abdominal pain, and aerophagia being the most frequently detected ones. A significant association was found between pain and irritable bowel syndrome, functional constipation and aerophagia. Children with RASopathies have a high prevalence of functional gastrointestinal disorders. These children could represent a good in vivo model to study neuropathic pain, visceral hypersensitivity and gut-brain axis disorders.
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Affiliation(s)
- Chiara Leoni
- Center for Rare Diseases and Birth Defects, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Valentina Giorgio
- Center for Rare Diseases and Birth Defects, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Giuseppe Stella
- Center for Rare Diseases and Birth Defects, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Roberta Onesimo
- Center for Rare Diseases and Birth Defects, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Elizabeth K A Triumbari
- Center for Rare Diseases and Birth Defects, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Maria Podagrosi
- Center for Rare Diseases and Birth Defects, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Eliza Kuczynska
- Center for Rare Diseases and Birth Defects, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Catello Vollono
- Department of Geriatrics, Unit of Neurophysiopathology and Sleep Medicine, Neurosciences and Orthopedics, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| | - Keith J Lindley
- Department of Pediatric Gastroenterology, Great Ormond Street Hospital for Children, London, UK
| | - Giuseppe Zampino
- Center for Rare Diseases and Birth Defects, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
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5
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De Ridder W, Engelen B, Alfen N. Neurological features of Noonan syndrome and related
RASopathies
: Pain and nerve enlargement characterized by nerve ultrasound. Am J Med Genet A 2022; 188:1801-1807. [DOI: 10.1002/ajmg.a.62714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 01/23/2022] [Accepted: 02/18/2022] [Indexed: 01/09/2023]
Affiliation(s)
- Willem De Ridder
- Department of Neurology, Neuromuscular Reference Centre University Hospital of Antwerp Antwerp Belgium
| | - Baziel Engelen
- Institute Born‐Bunge University of Antwerp Antwerp Belgium
| | - Nens Alfen
- Department of Neurology and Clinical Neurophysiology Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center Nijmegen The Netherlands
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6
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Miao Y, Chen J, Guo X, Wei Y, Wu X, Sang Y, Wu D. Case report: Clinical manifestations and genotype analysis of a child with PTPN11 and SEC24D mutations. Front Pediatr 2022; 10:973920. [PMID: 36186652 PMCID: PMC9524269 DOI: 10.3389/fped.2022.973920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 08/22/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The PTPN11 gene, located at 12q24. 13, encodes protein tyrosine phosphatase 2C. Mutations in the PTPN11 gene can lead to various phenotypes, including Noonan syndrome and LEOPARD syndrome. The SEC24D gene is located at 4q26 and encodes a component of the COPII complex, and is closely related to endoplasmic reticulum protein transport. Mutations in SEC24D can lead to Cole-Carpenter syndrome-2. To date, dual mutations in these two genes have not been reported in the literature. METHODS We report a patient with short stature and osteogenesis imperfecta as the primary clinical manifestation. Other clinical features were peculiar facial features, deafness, and a history of recurrent fractures. Whole exome sequencing was performed on this patient. RESULTS After whole-exome sequencing, three mutations in two genes were identified that induced protein alterations associated with the patient's phenotype. One was a de novo variant c.1403C>T (p.Thr468Met) on exon 12 of the PTPN11 gene, and the other was a compound heterozygous mutation in the SEC24D gene, a novel variant c.2609_2610delGA (p.Arg870Thrfs*10) on exon 20 and a reported variant c.938G>A (p.Arg313His) on exon 8. CONCLUSIONS Concurrent mutations in PTPN11 and SEC24D induced a phenotype that was significantly different from individual mutations in either PTPN11 or SEC24D gene. Personalized genetic analysis and interpretation could help us understand the patient's etiology and hence develop treatments and improve the prognosis of these patients.
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Affiliation(s)
- Yuqi Miao
- Department of Endocrinology, Genetics and Metabolism, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China
| | - Jiahui Chen
- Department of Endocrinology, Genetics and Metabolism, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China
| | - Xiaoya Guo
- Department of Endocrinology, Genetics and Metabolism, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China
| | - Yu Wei
- Department of Endocrinology, Genetics and Metabolism, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China
| | - Xiaozhi Wu
- Beijing Haidian Hospital, Haidian Section of Peking University Third Hospital, Beijing, China
| | - Yanmei Sang
- Department of Endocrinology, Genetics and Metabolism, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China
| | - Di Wu
- Department of Endocrinology, Genetics and Metabolism, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China
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7
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Chiara L, Marta T, Dario T, Tommaso V, Roberta O, Cesare C, Elisabetta F, Alessandro DL, Marco T, Donato R, Giuseppe Z. Enlarged spinal nerve roots in RASopathies: Report of two cases. Eur J Med Genet 2021; 64:104187. [PMID: 33676063 DOI: 10.1016/j.ejmg.2021.104187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 01/26/2021] [Accepted: 02/27/2021] [Indexed: 11/15/2022]
Abstract
RASopathies are a group of genetic conditions caused by germline variants in genes encoding signal transducers and modulators of the RAS-MAPK cascade. These disorders are multisystem diseases with considerable clinical overlap, even though distinct hallmarks are recognizable for each specific syndrome. Here we report on the presence of enlarged spinal nerve roots resembling neurofibromas, a typical neuroradiological finding of neurofibromatosis type 1, in two patients with a molecularly confirmed diagnosis of Noonan syndrome and cardio-facio-cutaneous syndrome, respectively. This evidence add enlarged spinal nerve roots as features shared among RASopathies. Future studies aiming to a better understanding of the molecular mechanisms leading to neurogenic tumor development in these patients are necessary to define their biological nature, evolution, prognosis and possible treatments.
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Affiliation(s)
- Leoni Chiara
- Center for Rare Diseases and Birth Defects, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy.
| | - Tedesco Marta
- Center for Rare Diseases and Birth Defects, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Talloa Dario
- Center for Rare Diseases and Birth Defects, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Verdolotti Tommaso
- UOC Radiologia e Neuroradiologia, Dipartimento di diagnostica per immagini, Oncologica ed ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Onesimo Roberta
- Center for Rare Diseases and Birth Defects, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Colosimo Cesare
- UOC Radiologia e Neuroradiologia, Dipartimento di diagnostica per immagini, Oncologica ed ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy
| | - Flex Elisabetta
- Department of Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy
| | - De Luca Alessandro
- Medical Genetics Division, IRCCS Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Tartaglia Marco
- Genetics and Rare Diseases Research Division, Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy
| | - Rigante Donato
- Center for Rare Diseases and Birth Defects, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy
| | - Zampino Giuseppe
- Center for Rare Diseases and Birth Defects, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy
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8
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Ando Y, Sawada M, Kawakami T, Morita M, Aoki Y. A Patient with Noonan Syndrome with a KRAS Mutation Who Presented Severe Nerve Root Hypertrophy. Case Rep Neurol 2021; 13:108-118. [PMID: 33790768 PMCID: PMC7989852 DOI: 10.1159/000512265] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 10/04/2020] [Indexed: 11/19/2022] Open
Abstract
We report a 45-year-old female with clinical features resembling Noonan syndrome (NS) who presented with significant nerve root hypertrophy. She was initially diagnosed with Charcot-Marie-Tooth disease because her gait disturbance gradually deteriorated and nerve conduction velocity was reduced. However, she did not carry a PMP22 gene mutation. RASopathies are a group of phenotypically overlapping developmental syndromes caused by germline mutations that encode components of the Ras/MAPK signaling pathway. These disorders include NS, cardiofaciocutaneous (CFC) syndrome, and Costello syndrome and are associated with molecular abnormalities in the Ras/MAPK pathway. The patient was suspected to have NS and related disorders because of pulmonary artery stenosis, lymphedema, distinctive facial appearance, and intellectual disability. Genetic analysis identified a heterozygous de novo mutation in KRAS (c.211T>G, p.Tyr71Asp), which is usually observed in patients with NS or CFC syndrome. Although our patient was diagnosed with NS, she revealed clinical manifestations that were typical to CFC syndrome, including intellectual disability. It has been reported that some patients diagnosed with RASopathies with mutations in PTPN11, SOS1, or KRAS developed nerve root hypertrophy. These results suggest that nerve root hypertrophy may be associated with RASopathy, although the onset mechanisms of nerve root hypertrophy are unknown.
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Affiliation(s)
- Yoshihito Ando
- Department of Internal Medicine, Josai Hospital, Yuki, Japan.,Division of Neurology, Department of Internal Medicine, Jichi Medical University Hospital, Shimotsuke, Japan.,Department of Neurology, Haga Red Cross Hospital, Moka, Japan
| | - Mikio Sawada
- Division of Neurology, Department of Internal Medicine, Jichi Medical University Hospital, Shimotsuke, Japan.,Department of Neurology, Haga Red Cross Hospital, Moka, Japan
| | - Tadataka Kawakami
- Division of Neurology, Department of Internal Medicine, Jichi Medical University Hospital, Shimotsuke, Japan.,Department of Neurology, Shin Oyama City Hospital, Oyama, Japan
| | - Mitsuya Morita
- Division of Neurology, Department of Internal Medicine, Jichi Medical University Hospital, Shimotsuke, Japan.,Division of Rehabilitation, Jichi Medical University Hospital, Shimotsuke, Japan
| | - Yoko Aoki
- Department of Medical Genetics, Tohoku University School of Medicine, Sendai, Japan
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9
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Vizcaino MA, Belzberg A, Ahlawat S, Belakhoua S, Chen L, Staedtke V, Rodriguez FJ. Localized Hypertrophic Neuropathy as a Neoplastic Manifestation of KRAS-Mediated RASopathy. J Neuropathol Exp Neurol 2020; 79:647-651. [PMID: 32388560 DOI: 10.1093/jnen/nlaa034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Indexed: 12/12/2022] Open
Abstract
Localized hypertrophic neuropathy is a rare Schwann cell proliferation that usually affects single nerves from the extremities, and it is of unclear etiology in its pure form. RASopathies are a defined group of genetic diseases with overlapping clinical features, usually secondary to germline mutations in genes encoding either components or regulators of the RAS/MAPK pathway. Herein, we report an 11-year-old boy presenting with café au lait spots and right leg length discrepancy. A fascicular nerve biopsy of the tibial nerve demonstrated a Schwann cell proliferation with prominent onion-bulb formation, satisfying criteria for localized hypertrophic neuropathy. Molecular genetic analysis demonstrated identical KRAS mutations (c38_40dupGCG) in the peripheral nerve lesion and melanocytes from café au lait spots, but not in blood, supporting a diagnosis of a KRAS-mediated rasopathy with mosaicism. Immunohistochemical staining in the peripheral nerve lesion demonstrated strong pERK staining consistent with downstream MAPK pathway activation. This report suggests that at least a subset of localized hypertrophic neuropathies are bonafide, well-differentiated Schwann cell neoplasms developing through oncogenic RAS signaling, which provides new insights into the controversial entity historically known as localized hypertrophic neuropathy.
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Affiliation(s)
- M Adelita Vizcaino
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Allan Belzberg
- Department of Neurosurgery, Baltimore, Maryland.,Sydney Kimmel Cancer Center, Baltimore, Maryland
| | | | - Sarra Belakhoua
- Department of Pathology, Baltimore, Maryland.,Johns Hopkins University School of Medicine, Baltimore, Maryland.,University of Tunis el Manar School of Medicine, Tunis, Tunisia
| | - Liam Chen
- Department of Pathology, Baltimore, Maryland
| | - Verena Staedtke
- Department of Neurology, Baltimore, Maryland.,Sydney Kimmel Cancer Center, Baltimore, Maryland
| | - Fausto J Rodriguez
- Department of Pathology, Baltimore, Maryland.,Department of Ophthalmology, Baltimore, Maryland.,Sydney Kimmel Cancer Center, Baltimore, Maryland
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10
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Liu WS, Wang RR, Li WY, Rong M, Liu CL, Ma Y, Wang RL. Investigating the reason for loss-of-function of Src homology 2 domain-containing protein tyrosine phosphatase 2 (SHP2) caused by Y279C mutation through molecular dynamics simulation. J Biomol Struct Dyn 2019; 38:2509-2520. [DOI: 10.1080/07391102.2019.1634641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Wen-Shan Liu
- School of Pharmacy, Tianjin Key Laboratory on Technologies Enabling Development of Clinical Therapeutics and Diagnostics (Theranostics), Tianjin Medical University, Tianjin, China
| | - Rui-Rui Wang
- School of Pharmacy, Tianjin Key Laboratory on Technologies Enabling Development of Clinical Therapeutics and Diagnostics (Theranostics), Tianjin Medical University, Tianjin, China
| | - Wei-Ya Li
- School of Pharmacy, Tianjin Key Laboratory on Technologies Enabling Development of Clinical Therapeutics and Diagnostics (Theranostics), Tianjin Medical University, Tianjin, China
| | - Mei Rong
- School of Pharmacy, Tianjin Key Laboratory on Technologies Enabling Development of Clinical Therapeutics and Diagnostics (Theranostics), Tianjin Medical University, Tianjin, China
| | - Chi-Lu Liu
- School of Pharmacy, Tianjin Key Laboratory on Technologies Enabling Development of Clinical Therapeutics and Diagnostics (Theranostics), Tianjin Medical University, Tianjin, China
| | - Ying Ma
- School of Pharmacy, Tianjin Key Laboratory on Technologies Enabling Development of Clinical Therapeutics and Diagnostics (Theranostics), Tianjin Medical University, Tianjin, China
| | - Run-Ling Wang
- School of Pharmacy, Tianjin Key Laboratory on Technologies Enabling Development of Clinical Therapeutics and Diagnostics (Theranostics), Tianjin Medical University, Tianjin, China
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11
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Leoni C, Triumbari EKA, Vollono C, Onesimo R, Podagrosi M, Giorgio V, Kuczynska E, Veltri S, Tartaglia M, Zampino G. Pain in individuals with RASopathies: Prevalence and clinical characterization in a sample of 80 affected patients. Am J Med Genet A 2019; 179:940-947. [DOI: 10.1002/ajmg.a.61111] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 01/08/2019] [Accepted: 02/19/2019] [Indexed: 12/14/2022]
Affiliation(s)
- Chiara Leoni
- Department of Woman and Child Health, Center for Rare Diseases and Birth Defects, Institute of PediatricsFondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore Rome Italy
| | - Elizabeth Katherine Anna Triumbari
- Department of Woman and Child Health, Center for Rare Diseases and Birth Defects, Institute of PediatricsFondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore Rome Italy
| | - Catello Vollono
- Department of Geriatrics, Unit of Neurophysiopathology and Sleep Medicine, Neurosciences and OrthopedicsFondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore Rome Italy
| | - Roberta Onesimo
- Department of Woman and Child Health, Center for Rare Diseases and Birth Defects, Institute of PediatricsFondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore Rome Italy
| | - Maria Podagrosi
- Department of Woman and Child Health, Center for Rare Diseases and Birth Defects, Institute of PediatricsFondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore Rome Italy
| | - Valentina Giorgio
- Department of Woman and Child Health, Center for Rare Diseases and Birth Defects, Institute of PediatricsFondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore Rome Italy
| | - Eliza Kuczynska
- Department of Woman and Child Health, Center for Rare Diseases and Birth Defects, Institute of PediatricsFondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore Rome Italy
| | - Stefania Veltri
- Department of Woman and Child Health, Center for Rare Diseases and Birth Defects, Institute of PediatricsFondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore Rome Italy
- Department of Neuroscience, Unit of NeuropsychiatryOspedale Pediatrico Bambino Gesù Rome Italy
| | - Marco Tartaglia
- Genetics and Rare Diseases Research DivisionOspedale Pediatrico Bambino Gesù Rome Italy
| | - Giuseppe Zampino
- Department of Woman and Child Health, Center for Rare Diseases and Birth Defects, Institute of PediatricsFondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore Rome Italy
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12
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Ding X, Yang W, Liu XD, Yang X, Wang HM, Tai J. Spinal SHP2 Contributes to Exaggerated Incisional Pain in Adult Rats Subjected to Neonatal and Adult Incisions via PI3K. Neuroscience 2018; 385:102-120. [PMID: 29909075 DOI: 10.1016/j.neuroscience.2018.06.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 05/23/2018] [Accepted: 06/07/2018] [Indexed: 12/24/2022]
Abstract
Neonatal injury-induced exaggeration of pain hypersensitivity after adult trauma is a significant clinical challenge. However, the underlying mechanisms remain poorly understood. Growing evidence shows that spinal Src homology-2 domain-containing protein tyrosine phosphatase-2 (SHP2) contributes to chronic pain in adult rodents. Here we demonstrated that the phosphorylation and expression of SHP2 in synaptosomal fraction of the spinal dorsal horn are elevated in adult rats subjected to neonatal and adult incisions (nIN-IN), and the upregulation of SHP2 is highly correlated with pain hypersensitivity. Intrathecal blockade of SHP2 phosphorylation using a SHP2 protein tyrosine phosphatase inhibitor NSC-87877, or knockdown of SHP2 by intrathecal delivery of small interfering RNA (siRNA), ameliorates mechanical allodynia and heat hyperalgesia in nIN-IN rats. Moreover, the expression of phosphatidylinositol 3-kinase (PI3K) in the spinal dorsal horn is significantly increased in nIN-IN rats. Intrathecal application of PI3K inhibitor, LY294002 or wortmannin, alleviates pain hypersensitivity in nIN-IN rats. Additionally, intrathecal administration of NSC-87877 or SHP2 siRNA attenuates the upregulation of PI3K. Finally, no alternation of SHP2 phosphorylation in the dorsal root ganglion and dorsal root of nIN-IN rats as well as PI3K expression in the dorsal root of nIN-IN rats intrathecally treated with NSC-87877 or SHP2 siRNA is observed. These results suggest that the phosphorylation and expression of SHP2 in the spinal dorsal horn play vital roles in neonatal incision-induced exaggeration of adult incisional pain via PI3K. Thus, SHP2 and PI3K may serve as potential therapeutic targets for exaggerated incisional pain induced by neonatal and adult injuries.
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Affiliation(s)
- Xu Ding
- Nutrition Research Unit, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Wei Yang
- Department of Surgical Oncology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Xiao-Dan Liu
- Department of Pathology, Peking University, Beijing, China
| | - Xi Yang
- Department of Laboratory Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Huan-Min Wang
- Department of Surgical Oncology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Jun Tai
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery; Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
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13
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Patel M, Patel S, Mangukia N, Patel S, Mankad A, Pandya H, Rawal R. Ocimum basilicum miRNOME revisited: A cross kingdom approach. Genomics 2018; 111:772-785. [PMID: 29775783 DOI: 10.1016/j.ygeno.2018.04.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 03/29/2018] [Accepted: 04/27/2018] [Indexed: 02/06/2023]
Abstract
O. basilicum is medicinally important herb having inevitable role in human health. However, the mechanism of action is largely unknown. Present study aims to understand the mechanism of regulation of key human target genes that could plausibly modulated by O. basilicum miRNAs in cross kingdom manner using computational and system biology approach. O. basilicum miRNA sequences were retrieved and their corresponding human target genes were identified using psRNA target and interaction analysis of hub nodes. Six O. basilicum derived miRNAs were found to modulate 26 human target genes which were associated `with PI3K-AKTand MAPK signaling pathways with PTPN11, EIF2S2, NOS1, IRS1 and USO1 as top 5 Hub nodes. O. basilicum miRNAs not only regulate key human target genes having a significance in various diseases but also paves the path for future studies that might explore potential of miRNA mediated cross-kingdom regulation, prevention and treatment of various human diseases including cancer.
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Affiliation(s)
- Maulikkumar Patel
- Department of Botany, Bioinformatics and Climate change impacts management, School of Sciences, Gujarat University, Ahmedabad, Gujarat, India
| | - Shanaya Patel
- Department of Botany, Bioinformatics and Climate change impacts management, School of Sciences, Gujarat University, Ahmedabad, Gujarat, India
| | - Naman Mangukia
- Department of Botany, Bioinformatics and Climate change impacts management, School of Sciences, Gujarat University, Ahmedabad, Gujarat, India
| | - Saumya Patel
- Department of Botany, Bioinformatics and Climate change impacts management, School of Sciences, Gujarat University, Ahmedabad, Gujarat, India
| | - Archana Mankad
- Department of Botany, Bioinformatics and Climate change impacts management, School of Sciences, Gujarat University, Ahmedabad, Gujarat, India
| | - Himanshu Pandya
- Department of Botany, Bioinformatics and Climate change impacts management, School of Sciences, Gujarat University, Ahmedabad, Gujarat, India
| | - Rakesh Rawal
- Department of Life Sciences, Food Science and Nutrition, School of Sciences, Gujarat University, Ahmedabad, Gujarat, India.
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14
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Paludan-Müller C, Ahlberg G, Ghouse J, Svendsen JH, Haunsø S, Olesen MS. Analysis of 60 706 Exomes Questions the Role of De Novo Variants Previously Implicated in Cardiac Disease. ACTA ACUST UNITED AC 2017; 10:CIRCGENETICS.117.001878. [DOI: 10.1161/circgenetics.117.001878] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 10/20/2017] [Indexed: 11/16/2022]
Affiliation(s)
- Christian Paludan-Müller
- From the Laboratory for Molecular Cardiology, Institute for Biomedical Sciences, University of Copenhagen, Denmark (C.P.-M., G.A., J.G., J.H.S., S.H., M.S.O.); Laboratory for Molecular Cardiology, Department of Cardiology, Heart Centre at Rigshospitalet, Copenhagen University Hospital, Denmark (C.P.-M., G.A., J.G., J.H.S., S.H., M.S.O.); Danish National Research Foundation Centre for Cardiac Arrhythmia, Copenhagen, Denmark (C.P.-M., G.A., J.G., J.H.S., S.H., M.S.O.); and Department of Clinical
| | - Gustav Ahlberg
- From the Laboratory for Molecular Cardiology, Institute for Biomedical Sciences, University of Copenhagen, Denmark (C.P.-M., G.A., J.G., J.H.S., S.H., M.S.O.); Laboratory for Molecular Cardiology, Department of Cardiology, Heart Centre at Rigshospitalet, Copenhagen University Hospital, Denmark (C.P.-M., G.A., J.G., J.H.S., S.H., M.S.O.); Danish National Research Foundation Centre for Cardiac Arrhythmia, Copenhagen, Denmark (C.P.-M., G.A., J.G., J.H.S., S.H., M.S.O.); and Department of Clinical
| | - Jonas Ghouse
- From the Laboratory for Molecular Cardiology, Institute for Biomedical Sciences, University of Copenhagen, Denmark (C.P.-M., G.A., J.G., J.H.S., S.H., M.S.O.); Laboratory for Molecular Cardiology, Department of Cardiology, Heart Centre at Rigshospitalet, Copenhagen University Hospital, Denmark (C.P.-M., G.A., J.G., J.H.S., S.H., M.S.O.); Danish National Research Foundation Centre for Cardiac Arrhythmia, Copenhagen, Denmark (C.P.-M., G.A., J.G., J.H.S., S.H., M.S.O.); and Department of Clinical
| | - Jesper H. Svendsen
- From the Laboratory for Molecular Cardiology, Institute for Biomedical Sciences, University of Copenhagen, Denmark (C.P.-M., G.A., J.G., J.H.S., S.H., M.S.O.); Laboratory for Molecular Cardiology, Department of Cardiology, Heart Centre at Rigshospitalet, Copenhagen University Hospital, Denmark (C.P.-M., G.A., J.G., J.H.S., S.H., M.S.O.); Danish National Research Foundation Centre for Cardiac Arrhythmia, Copenhagen, Denmark (C.P.-M., G.A., J.G., J.H.S., S.H., M.S.O.); and Department of Clinical
| | - Stig Haunsø
- From the Laboratory for Molecular Cardiology, Institute for Biomedical Sciences, University of Copenhagen, Denmark (C.P.-M., G.A., J.G., J.H.S., S.H., M.S.O.); Laboratory for Molecular Cardiology, Department of Cardiology, Heart Centre at Rigshospitalet, Copenhagen University Hospital, Denmark (C.P.-M., G.A., J.G., J.H.S., S.H., M.S.O.); Danish National Research Foundation Centre for Cardiac Arrhythmia, Copenhagen, Denmark (C.P.-M., G.A., J.G., J.H.S., S.H., M.S.O.); and Department of Clinical
| | - Morten S. Olesen
- From the Laboratory for Molecular Cardiology, Institute for Biomedical Sciences, University of Copenhagen, Denmark (C.P.-M., G.A., J.G., J.H.S., S.H., M.S.O.); Laboratory for Molecular Cardiology, Department of Cardiology, Heart Centre at Rigshospitalet, Copenhagen University Hospital, Denmark (C.P.-M., G.A., J.G., J.H.S., S.H., M.S.O.); Danish National Research Foundation Centre for Cardiac Arrhythmia, Copenhagen, Denmark (C.P.-M., G.A., J.G., J.H.S., S.H., M.S.O.); and Department of Clinical
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15
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Santoro C, Giugliano T, Melone MAB, Cirillo M, Schettino C, Bernardo P, Cirillo G, Perrotta S, Piluso G. Multiple spinal nerve enlargement and SOS1 mutation: Further evidence of overlap between neurofibromatosis type 1 and Noonan phenotype. Clin Genet 2017; 93:138-143. [PMID: 28456002 DOI: 10.1111/cge.13047] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 04/24/2017] [Accepted: 04/25/2017] [Indexed: 12/13/2022]
Abstract
Neurofibromatosis type 1 (NF1) has long been considered a well-defined, recognizable monogenic disorder, with neurofibromas constituting a pathognomonic sign. This dogma has been challenged by recent descriptions of patients with enlarged nerves or paraspinal tumors, suggesting that neurogenic tumors and hypertrophic neuropathy may be a complication of Noonan syndrome with multiple lentigines (NSML) or RASopathy phenotype. We describe a 15-year-old boy, whose mother previously received clinical diagnosis of NF1 due to presence of bilateral cervical and lumbar spinal lesions resembling plexiform neurofibromas and features suggestive of NS. NF1 molecular analysis was negative in the mother. The boy presented with Noonan features, multiple lentigines and pectus excavatum. Next-generation sequencing analysis of all RASopathy genes identified p.Ser548Arg missense mutation in SOS1 in the boy, confirmed in his mother. Brain and spinal magnetic resonance imaging scans were negative in the boy. No heart involvement or deafness was observed in proband or mother. This is the first report of a SOS1 mutation associated with hypertrophic neuropathy resembling plexiform neurofibromas, a rare complication in Noonan phenotypes with mutations in RASopathy genes. Our results highlight the overlap between RASopathies, suggesting that NF1 diagnostic criteria need rethinking. Genetic analysis of RASopathy genes should be considered when diagnosis is uncertain.
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Affiliation(s)
- C Santoro
- Dipartimento della Donna, del Bambino e della Chirurgia generale e specialistica, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - T Giugliano
- Dipartimento di Biochimica, Biofisica e Patologia Generale, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - M A B Melone
- Divisione di Neurologia, Dipartimento Medico-Chirurgico di Internistica Clinica e Sperimentale "F. Magrassi e A. Lanzara", Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy.,Centro Interuniversitario di Ricerca in Neuroscienze (CIRN), Naples, Italy
| | - M Cirillo
- Prima Divisione di Neurologia, Dipartimento di Scienze Mediche, Chirurgiche, Neurologiche, Metaboliche e dell'Invecchiamento, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - C Schettino
- Divisione di Neurologia, Dipartimento Medico-Chirurgico di Internistica Clinica e Sperimentale "F. Magrassi e A. Lanzara", Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - P Bernardo
- Dipartimento di Salute Mentale, Fisica e Medicina Preventiva, Clinica di Neuropsichiatria Infantile, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - G Cirillo
- Prima Divisione di Neurologia, Dipartimento di Scienze Mediche, Chirurgiche, Neurologiche, Metaboliche e dell'Invecchiamento, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - S Perrotta
- Dipartimento della Donna, del Bambino e della Chirurgia generale e specialistica, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - G Piluso
- Dipartimento di Biochimica, Biofisica e Patologia Generale, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
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16
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Maridet C, Sole G, Morice-Picard F, Taieb A. Hypertrophic neuropathy in Noonan syndrome with multiple lentigines. Am J Med Genet A 2016; 170:1570-2. [DOI: 10.1002/ajmg.a.37601] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 02/01/2016] [Indexed: 12/31/2022]
Affiliation(s)
- Claire Maridet
- Department of Dermatology and Pediatric Dermatology; National Reference Centre for Rare Disorders; Hôpital Saint-André; CHU Bordeaux France
| | - Guilhem Sole
- Department of Neurology; Hôpital Pellegrin; CHU Bordeaux France
| | - Fanny Morice-Picard
- Department of Dermatology and Pediatric Dermatology; National Reference Centre for Rare Disorders; Hôpital Saint-André; CHU Bordeaux France
| | - Alain Taieb
- Department of Dermatology and Pediatric Dermatology; National Reference Centre for Rare Disorders; Hôpital Saint-André; CHU Bordeaux France
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17
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Phenotypical diversity of patients with LEOPARD syndrome carrying the worldwide recurrent p.Tyr279Cys PTPN11 mutation. Arch Dermatol Res 2015; 307:891-5. [DOI: 10.1007/s00403-015-1597-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 08/31/2015] [Accepted: 09/04/2015] [Indexed: 01/17/2023]
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