[Cardiofaciocutaneous syndrome, a Noonan syndrome related disorder: clinical and molecular findings in 11 patients]

Med Clin (Barc). 2015 Jan 20;144(2):67-72. doi: 10.1016/j.medcli.2014.06.009. Epub 2014 Sep 4.
[Article in Spanish]

Abstract

Objectives: To describe 11 patients with cardiofaciocutaneous syndrome (CFC) and compare them with 130 patients with other RAS-MAPK syndromes (111 Noonan syndrome patients [NS] and 19 patients with LEOPARD syndrome).

Patients and methods: Clinical data from patients submitted for genetic analysis were collected. Bidirectional sequencing analysis of PTPN11, SOS1, RAF1, BRAF, and MAP2K1 focused on exons carrying recurrent mutations, and of all KRAS exons were performed.

Results: Six different mutations in BRAF were identified in 9 patients, as well as 2 MAP2K1 mutations. Short stature, developmental delay, language difficulties and ectodermal anomalies were more frequent in CFC patients when compared with other neuro-cardio-faciocutaneous syndromes (P<.05). In at least 2 cases molecular testing helped reconsider the diagnosis.

Discussion: CFC patients showed a rather severe phenotype but at least one patient with BRAF mutation showed no developmental delay, which illustrates the variability of the phenotypic spectrum caused by BRAF mutations. Molecular genetic testing is a valuable tool for differential diagnosis of CFC and NS related disorders.

Keywords: BRAF; Cardiofaciocutaneous syndrome; Correlación genotipo-fenotipo; Estenosis pulmonar valvular; Genotype-phenotype correlation; Hypertrophic cardiomyopathy; LEOPARD syndrome; MAP2K1; Miocardiopatía hipertrófica; Noonan syndrome; PTPN11; Pulmonary valve stenosis; RAS-MAPK pathway; Rasopathy; Rasopatía; Síndrome LEOPARD; Síndrome cardiofaciocutáneo; Síndrome de Noonan; Vía RAS-MAPK.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Amino Acid Substitution
  • Child
  • Child, Preschool
  • Cryptorchidism / genetics
  • DNA Mutational Analysis
  • Dwarfism / genetics
  • Ectodermal Dysplasia / genetics*
  • Ectodermal Dysplasia / pathology
  • Facies
  • Failure to Thrive / genetics*
  • Failure to Thrive / pathology
  • Female
  • Genetic Heterogeneity
  • Hair / pathology
  • Heart Defects, Congenital / genetics*
  • Heart Defects, Congenital / pathology
  • Humans
  • Infant
  • Intellectual Disability / genetics
  • LEOPARD Syndrome / pathology
  • Language Development Disorders / genetics
  • MAP Kinase Kinase 1 / genetics*
  • MAP Kinase Signaling System / physiology
  • Male
  • Mutation, Missense*
  • Noonan Syndrome / pathology
  • Point Mutation*
  • Proto-Oncogene Proteins / genetics
  • Proto-Oncogene Proteins / physiology
  • Proto-Oncogene Proteins B-raf / genetics*
  • Proto-Oncogene Proteins p21(ras)
  • Skin / pathology
  • ras Proteins / genetics
  • ras Proteins / physiology

Substances

  • KRAS protein, human
  • Proto-Oncogene Proteins
  • BRAF protein, human
  • Proto-Oncogene Proteins B-raf
  • MAP Kinase Kinase 1
  • MAP2K1 protein, human
  • Proto-Oncogene Proteins p21(ras)
  • ras Proteins

Supplementary concepts

  • Cardiofaciocutaneous syndrome