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Palma-Milla C, Prat-Planas A, Soengas-Gonda E, Centeno-Pla M, Sánchez-Pozo J, Lazaro-Rodriguez I, Quesada-Espinosa JF, Arteche-Lopez A, Olival J, Pacio-Miguez M, Palomares-Bralo M, Santos-Simarro F, Cancho-Candela R, Vázquez-López M, Seidel V, Martinez-Monseny AF, Casas-Alba D, Grinberg D, Balcells S, Serrano M, Rabionet R, Martin MA, Urreizti R. Expanding the Phenotypic Spectrum of TRAF7-Related Cardiac, Facial, and Digital Anomalies With Developmental Delay: Report of 11 New Cases and Literature Review. Pediatr Neurol 2024; 155:8-17. [PMID: 38569228 DOI: 10.1016/j.pediatrneurol.2024.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 02/22/2024] [Accepted: 03/07/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND TRAF7-related cardiac, facial, and digital anomalies with developmental delay (CAFDADD), a multisystemic neurodevelopmental disorder caused by germline missense variants in the TRAF7 gene, exhibits heterogeneous clinical presentations. METHODS We present a detailed description of 11 new TRAF7-related CAFDADD cases, featuring eight distinct variants, including a novel one. RESULTS Phenotypic analysis and a comprehensive review of the 58 previously reported cases outline consistent clinical presentations, emphasizing dysmorphic features, developmental delay, endocrine manifestations, and cardiac defects. In this enlarged collection, novelties include a wider range of cognitive dysfunction, with some individuals exhibiting normal development despite early psychomotor delay. Communication challenges, particularly in expressive language, are prevalent, necessitating alternative communication methods. Autistic traits, notably rigidity, are observed in the cohort. Also, worth highlighting are hearing loss, sleep disturbances, and endocrine anomalies, including growth deficiency. Cardiac defects, frequently severe, pose early-life complications. Facial features, including arched eyebrows, contribute to the distinct gestalt. A novel missense variant, p.(Arg653Leu), further underscores the complex relationship between germline TRAF7 variants and somatic changes linked to meningiomas. CONCLUSIONS Our comprehensive analysis expands the phenotypic spectrum, emphasizing the need for oncological evaluations and proposing an evidence-based schedule for clinical management. This study contributes to a better understanding of TRAF7-related CAFDADD, offering insights for improved diagnosis, intervention, and patient care.
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Affiliation(s)
- Carmen Palma-Milla
- Unidad de Dismorfología y Genética (UDisGen), Hospital Universitario 12 de Octubre, Madrid, Spain; Department of Genetics, Hospital Universitario 12 de Octubre, Madrid, Spain.
| | - Aina Prat-Planas
- Faculty of Biology, Department of Genetics, Microbiology and Statistics, Institute of Biomedicine (IBUB), Universitat de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Institut de Recerca Sant Joan de Déu (IRSJD), Esplugues de Llobregat, Spain
| | - Emma Soengas-Gonda
- Unidad de Dismorfología y Genética (UDisGen), Hospital Universitario 12 de Octubre, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Mónica Centeno-Pla
- Faculty of Biology, Department of Genetics, Microbiology and Statistics, Institute of Biomedicine (IBUB), Universitat de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Institut de Recerca Sant Joan de Déu (IRSJD), Esplugues de Llobregat, Spain; Clinical Biochemistry Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Jaime Sánchez-Pozo
- Unidad de Dismorfología y Genética (UDisGen), Hospital Universitario 12 de Octubre, Madrid, Spain; Department of Pediatric Endocrinology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Irene Lazaro-Rodriguez
- Unidad de Dismorfología y Genética (UDisGen), Hospital Universitario 12 de Octubre, Madrid, Spain; Department of Pediatric Endocrinology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Juan F Quesada-Espinosa
- Unidad de Dismorfología y Genética (UDisGen), Hospital Universitario 12 de Octubre, Madrid, Spain; Department of Genetics, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Ana Arteche-Lopez
- Unidad de Dismorfología y Genética (UDisGen), Hospital Universitario 12 de Octubre, Madrid, Spain; Department of Genetics, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Jonathan Olival
- Genomic Unit, Molecular and Genetic Medicine Section, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Marta Pacio-Miguez
- INGEMM, Institute of Medical Genetics, Hospital Universitario La Paz, Madrid, Spain
| | - María Palomares-Bralo
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; INGEMM, Institute of Medical Genetics, Hospital Universitario La Paz, Madrid, Spain; ITHACA - European Reference Network, INGEMM, Institute of Medical Genetics, Hospital Universitario La Paz, Madrid, Spain
| | - Fernando Santos-Simarro
- Unidad de Diagnóstico Molecular y Genética Clínica, Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - Ramón Cancho-Candela
- Neuropediatrics, Faculty of Medicine, Hospital Universitario Río Hortega, Universidad de Valladolid, Valladolid, Spain
| | | | - Veronica Seidel
- Clinical Genetics, Pediatrics Department, Hospital Gregorio Marañón, Madrid, Spain
| | - Antonio F Martinez-Monseny
- Institut de Recerca Sant Joan de Déu (IRSJD), Esplugues de Llobregat, Spain; Department of Genetic Medicine, Pediatric Institute of Rare Diseases (IPER), Hospital Sant Joan de Déu, Barcelona, Spain
| | - Didac Casas-Alba
- Institut de Recerca Sant Joan de Déu (IRSJD), Esplugues de Llobregat, Spain; Department of Genetic Medicine, Pediatric Institute of Rare Diseases (IPER), Hospital Sant Joan de Déu, Barcelona, Spain
| | - Daniel Grinberg
- Faculty of Biology, Department of Genetics, Microbiology and Statistics, Institute of Biomedicine (IBUB), Universitat de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Institut de Recerca Sant Joan de Déu (IRSJD), Esplugues de Llobregat, Spain
| | - Susanna Balcells
- Faculty of Biology, Department of Genetics, Microbiology and Statistics, Institute of Biomedicine (IBUB), Universitat de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Institut de Recerca Sant Joan de Déu (IRSJD), Esplugues de Llobregat, Spain
| | - Mercedes Serrano
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Institut de Recerca Sant Joan de Déu (IRSJD), Esplugues de Llobregat, Spain; Pediatric Neurology Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Raquel Rabionet
- Faculty of Biology, Department of Genetics, Microbiology and Statistics, Institute of Biomedicine (IBUB), Universitat de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Institut de Recerca Sant Joan de Déu (IRSJD), Esplugues de Llobregat, Spain
| | - Miguel A Martin
- Unidad de Dismorfología y Genética (UDisGen), Hospital Universitario 12 de Octubre, Madrid, Spain; Department of Genetics, Hospital Universitario 12 de Octubre, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Grupo de Enfermedades Mitocondriales y Neurometabólicas, Instituto de Investigación Hospital 12 de Octubre (imas12), Madrid, Spain
| | - Roser Urreizti
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Institut de Recerca Sant Joan de Déu (IRSJD), Esplugues de Llobregat, Spain; Clinical Biochemistry Department, Hospital Sant Joan de Déu, Barcelona, Spain
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Carcavilla A, Santomé JL, Pinto I, Sánchez-Pozo J, Guillén-Navarro E, Martín-Frías M, Lapunzina P, Ezquieta B. LEOPARD syndrome: a variant of Noonan syndrome strongly associated with hypertrophic cardiomyopathy. ACTA ACUST UNITED AC 2013; 66:350-6. [PMID: 24775816 DOI: 10.1016/j.rec.2012.09.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Accepted: 09/22/2012] [Indexed: 10/27/2022]
Abstract
INTRODUCTION AND OBJECTIVES LEOPARD syndrome is an autosomal dominant condition related to Noonan syndrome, although it occurs less frequently. The aim of this study was to characterize the clinical and molecular features of a large series of LEOPARD syndrome patients. METHODS We collected clinical data from 19 patients in 10 hospitals. Bidirectional sequencing analysis of PTPN11, RAF1, and BRAF focused on exons carrying recurrent mutations. RESULTS After facial dysmorphism, structural heart defects (88%) were the most common feature described. Hypertrophic cardiomyopathy (71%) was diagnosed more often than pulmonary valve stenosis (35%). Multiple lentigines or café au lait spots were found in 84% of the series, and deafness was diagnosed in 3 patients. Mutations in PTPN11 were identified in 16 (84%) patients (10 patients had the recurrent LEOPARD syndrome mutation, p.Thr468Met) (NP_002825.3T468M). Two other patients had a mutation in RAF, and 1 patient had a mutation in BRAF. When compared with other neurocardiofaciocutaneous syndromes, LEOPARD syndrome patients showed a higher prevalence of hypertrophic cardiomyopathy and cutaneous abnormalities, and a lower prevalence of pulmonary valve stenosis and short stature. CONCLUSIONS LEOPARD syndrome patients display distinctive features apart from multiple lentigines, such as a higher prevalence of hypertrophic cardiomyopathy and lower prevalence of short stature. Given its clinical implications, active search for hypertrophic cardiomyopathy is warranted in Noonan syndrome spectrum patients, especially in LEOPARD syndrome patients.
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Affiliation(s)
- Atilano Carcavilla
- Servicio de Pediatría, Hospital Virgen de la Salud, Toledo, Spain; Laboratorio de Genética Molecular, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
| | - José L Santomé
- Laboratorio de Genética Molecular, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Isabel Pinto
- Servicio de Pediatría, Hospital Severo Ochoa, Leganés, Madrid, Spain
| | - Jaime Sánchez-Pozo
- Servicio de Pediatría, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Encarna Guillén-Navarro
- Unidad de Genética Médica, Servicio de Pediatría, Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain
| | - María Martín-Frías
- Servicio de Pediatría, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Pablo Lapunzina
- Instituto de Genética Médica y Molecular, Hospital Universitario La Paz, Madrid, Spain
| | - Begoña Ezquieta
- Laboratorio de Genética Molecular, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
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