학술논문

Expanding the clinical phenotype of individuals with a 3-bp in-frame deletion of the NF1 gene (c.2970_2972del): an update of genotype–phenotype correlation
Document Type
article
Source
Genetics in Medicine. 21(4)
Subject
Biological Sciences
Genetics
Pediatric
Rare Diseases
Neurofibromatosis
Clinical Research
Neurosciences
Brain Disorders
Adolescent
Adult
Child
Child
Preschool
Female
Genetic Association Studies
Genetic Predisposition to Disease
Heterozygote
Humans
Infant
Learning Disabilities
Male
Mutation
Missense
Neurofibroma
Plexiform
Neurofibromatosis 1
Neurofibromin 1
Sequence Deletion
Young Adult
NF1
p.Met992del
genotype-phenotype correlation
neurofibroma
learning difficulties
genotype–phenotype correlation
Clinical Sciences
Genetics & Heredity
Language
Abstract
PurposeNeurofibromatosis type 1 (NF1) is characterized by a highly variable clinical presentation, but almost all NF1-affected adults present with cutaneous and/or subcutaneous neurofibromas. Exceptions are individuals heterozygous for the NF1 in-frame deletion, c.2970_2972del (p.Met992del), associated with a mild phenotype without any externally visible tumors.MethodsA total of 135 individuals from 103 unrelated families, all carrying the constitutional NF1 p.Met992del pathogenic variant and clinically assessed using the same standardized phenotypic checklist form, were included in this study.ResultsNone of the individuals had externally visible plexiform or histopathologically confirmed cutaneous or subcutaneous neurofibromas. We did not identify any complications, such as symptomatic optic pathway gliomas (OPGs) or symptomatic spinal neurofibromas; however, 4.8% of individuals had nonoptic brain tumors, mostly low-grade and asymptomatic, and 38.8% had cognitive impairment/learning disabilities. In an individual with the NF1 constitutional c.2970_2972del and three astrocytomas, we provided proof that all were NF1-associated tumors given loss of heterozygosity at three intragenic NF1 microsatellite markers and c.2970_2972del.ConclusionWe demonstrate that individuals with the NF1 p.Met992del pathogenic variant have a mild NF1 phenotype lacking clinically suspected plexiform, cutaneous, or subcutaneous neurofibromas. However, learning difficulties are clearly part of the phenotypic presentation in these individuals and will require specialized care.