Neurofibromatosis laríngea: a propósito de un caso / Laryngeal neurofibromatosis: a case report

Resumen El neurofibroma laríngeo es poco frecuente, representa menos del 0,1% de las neoplasias benignas de la laringe. Puede presentarse aislado, o más comúnmente asociado a neurofibromatosis tipo I. Se presenta el caso de un paciente varón de 40 años, ya diagnosticado de neurofibromatosis tipo I, que presenta masa supraglótica submucosa asintomática, diagnosticada como hallazgo casual en una intubación por una cirugía previa programada.

Abstract Laryngeal neurofibroma is rare, representing less than 0.1% of benign tumors of the larynx. It can occur in isolation or more commonly associated with type I neurofibromatosis. The case of a 40-year-old male patient, already diagnosed with type I neurofibromatosis, is presented with an asymptomatic submucosal supraglottic mass, diagnosed as a chance finding in intubation due to a previous scheduled surgery.

Targeted genetic and molecular therapies in neurofibromatosis – A review of present therapeutic options and a glimpse into the future

Neurofibromatosis type 1, the most common phakomatoses, can present with a host of signs and symptoms, usually involving the skin and the peripheral nervous system. It is characterized by a mutation in the neurofibromatosis type 1 gene on chromosome 17q11.2 that codes for the protein neurofibromin. Neurofibromin acts as a tumor suppressor gene by inhibiting rat sarcoma (Ras) activity and its deficiency leads to increased Ras activity, cellular proliferation and tumor formation. This review was conducted to analyze the various targeted therapies at the genetic and molecular level employed to manage the tumors and other clinical presentations associated with neurofibromatosis type 1. Twenty-eight studies of treatment modalities for the conditions associated with neurofibromatosis and which involved either targeted gene therapy or molecular level therapies, including the latest advances, were included in this review. Mitogen-activated protein kinase kinase inhibition, mammalian target of Rapamycin inhibition and Tyrosine kinase inhibition, represent some of the newer treatment options in this category. Although there are a number of trials for providing therapeutic options at the genetic and molecular level for the various physical and psychological morbidities associated with neurofibromatosis type 1, most of them are in the preclinical stage. Increased clinical trials of the molecules and gene therapies could significantly help in managing the various chronic and sometimes, life-threatening conditions associated with neurofibromatosis 1 and these will probably represent the preferred treatment direction of the future.

Preimplantation genetic testing and prenatal diagnosis in a family with type Ⅰ neurofibromatosis / 中华围产医学杂志

We report the implantation genetic testing and prenatal diagnosis of a family with neurofibromatosis type I (NF1). High-throughput sequencing combined with multiplex ligation-dependent probe amplification was performed to identify the pathogenic mutation sites, then verified by Sanger sequencing. The pathogenic mutation of c.4172G>C in the NF1 gene was found in the proband and his mother. After sequencing and single nucleotide polymorphism (SNP) haplotyping of the mutation sites in the embryos by establishing the SNP-linked haplotype, a well-developed blastocyst, without pathogenic mutations, was transplanted, and 28 d later, the ultrasound confirmed that the patient was pregnant. Amniotic fluid samples of the fetus were obtained at 19 +3 weeks for karyotyping and detection of the gene mutation site, which found the fetus did not carry the maternal c.4172G>C mutation of NF1 gene or any copy number variants of clear clinical significance. The patient delivered a healthy term girl by cesarean section, and no significant abnormalities were found during the follow-up to 10 months of age.

Mechanism study of neurofibromin 1 in gallbladder cancer / 中华消化外科杂志

Objective:To investigate the mechanism of neurofibromin 1 (NF1) in gallbla-dder cancer.Methods:The experimental study was conducted. Human gallbladder cancer cell lines, including GBC-SD, NOZ, SGC996, EH-GB1, ZJU0428, human embryonic kidneys cell line 293T and human cervical cancer cell line HELA, were cultured. The recombinant plasmids (mRFP-YAP1 FL-FLAG and eGFP-MYC-NF1 2650?2750-HA) were constructed for co-immunoprecipitation experiment. The truncated Yes associated protein 1(YAP1) and NF1 recombinant proteins were purified in vitro. The interaction between NF1 and YAP1 in vitro or in vivo were verified by isothermal titration calori-metry (ITC) assay, GST pull-down experiment, co-immunoprecipitation, immunofluorescence, laser confocal microscopy, and the expression of NF1 protein in different gallbladder cancer cell lines was verified by Western blot experiments. Observation indicators: (1) interaction between NF1 and YAP1 in vitro; (2) interaction between NF1 and YAP1 in cells; (3) expression of NF1 protein in different human gallbladder cancer cell lines. The dissociation constants were exported from ITC 200 software and represented as Mean± SD. Count data were represented as absolute numbers. Results:(1) Interaction between NF1 and YAP1 in vitro. ① Results of ITC assay showed that there was interac-tion between PPQY and YAP1-WW1, between PPQY and YAP1 (Amino acid residues 162?275), and the dissociation constants between PPQY and YAP1-WW1, between PPQY and YAP1(Amino acid residues 162?275) were (0.42±0.06)mmol/L, (0.69±0.14)mmol/L, respectively. ② GST pull-down results indicated that the target protein His-Sumo-YAP1 WW1 was obviouly observed in protein lane of reaction system between GST-PPQY recombinant protein and His-Sumo-YAP1 WW1, relative to the reaction system between GST protein and His-Sumo-YAP1 WW1. The target protein His-Sumo-YAP1 WW2 was obviouly observed in protein lane of reaction system between GST-PPQY recombinant protein and His-Sumo-YAP1 WW2, relative to the reaction system between GST protein and His-Sumo-YAP1 WW2. (2) Interaction between NF1 and YAP1 in cells. ① Co-immunoprecipitation results indica-ted that NF1 protein was observed in cell lysis solution which was incubated by FLAG gel beads and cotransfected with mRFP-YAP1 FL-FLAG and eGFP-MYC-NF1 2650?2750-HA. ② Immuno-fluorescence and laser confocal microscopy results indicated that YAP1 and NF1 with obvious fluorescence were co-localized in the cytoplasm of human gallbladder cancer NOZ cells. However, YAP1 with obvious fluorescence was localized in the nucleus of human gallbladder SGC996 cells and NF1 showed weak fluorescence. (3) Expression of NF1 protein in different human gallbladder cancer cell lines. Western blot results showed that with the expression level of NF1 protein in HELA cell line as the standard, the relative expression levels of NF1 protein in EH-GB1, GBC-SD, NOZ, SGC996, ZJU0428 cell lines were 1.28, 0, 1.01, 0, 0, respectively. Conclusion:NF1 affects the gallbladder cancer by directly acting on YAP1 protein.

Neurofibromatosis tipo 1: seudoaneurisma de arteria temporal / Neurofibromatosis type 1: temporal artery pseudoaneurysm

Neurofibromatosis is a disease caused by a mutation on chromosome 17, and was described by Friedrich Daniel von Recklinghausen in 1882. It is characterized by the appearance of benign tumors in different organs that can occasionally turn malignant. Four types of neurofibromatosis are described; being type 1 the most frequent, produced by mutations in NF1 gene inhibiting neurofibromin, and in a small percentage of cases by 17q11 microdeletion. In 50% of cases, it is autosomal dominant and the penetrance is 100%. Its prevalence is 1/3000 births and affects both sexes equally. The diagnosis is done by the presence of characteristic signs and can be corroborated through genetic studies. It usually manifests in childhood and involves skin issues, formation of multiple neurofibromas, gliomas of the optic pathway, hamartomas of the iris, bone malformations, arterial hypertension, vascular alterations, intracranial and peripheral nerve sheath tumors, seizures, hydrocephalus, cognitive deficits and learning difficulties. Vascular disease is a rare complication that is usually asymptomatic and can affect the vessels that go from the proximal aorta to small arterioles, including arterial stenosis, aneurysms and arteriovenous malformations. The prognosis is usually good, with neoplasms and vascular diseases being the cause of early mortality. We present the case of a patient with a diagnosis of neurofibromatosis type 1 who presents a rupture of a pseudoaneurysm dependent on the left temporal artery with a fistula with drainage to the superficial facial vein that resulved favorably by endovascular treatment.

La neurofibromatosis es una enfermedad producida por una mutación en el cromosoma 17; fue descrita por Friedrich Daniel von Recklinghausen en 1882. Se caracteriza por la aparición de tumores benignos en distintos órganos que, ocasionalmente, pueden malignizarse. Se describen cuatro tipos de neurofibromatosis; la más frecuente es la de tipo 1, que se produce por mutaciones en el gen NF1, inhibiendo la neurofibromina, y en un pequeño porcentaje de casos por microdeleción 17q11. En el 50% de los casos es autosómica dominante y la penetrancia es del 100%. Su prevalencia es de 1/3000 nacidos vivos y afecta por igual a ambos sexos. El diagnóstico se efectúa por la presencia de signos característicos y puede corroborarse por medio de estudios genéticos. Suele manifestarse en la infancia y comprometer la piel, con formación de múltiples neurofibromas, gliomas de la vía óptica, hamartomas del iris, malformaciones óseas, hipertensión arterial, alteraciones vasculares, tumores intracraneales y de las vainas de nervios periféricos, convulsiones, hidrocefalia, déficit cognitivo y dificultades del aprendizaje. La enfermedad vascular es una complicación rara que suele ser asintomática, puede afectar los vasos que van desde la aorta proximal hasta las arteriolas pequeñas, incluyendo estenosis arteriales, aneurismas y malformaciones arteriovenosas. El pronóstico suele ser bueno; las causas de mortalidad temprana son las neoplasias y las vasculopatías. Presentamos el caso de un paciente con diagnóstico de neurofibromatosis tipo 1 que presentó ruptura de seudoaneurisma dependiente de la arteria temporal izquierda, con fístula con drenaje a la vena facial superficial, que se resolvió favorablemente mediante tratamiento endovascular

Neurofibromatosis tipos 1 y 2 / Neurofibromatosis type 1 and 2

La neurofibromatosis (NF) comprende un grupo de enfermedades genéticas de herencia autosómica dominante, que se clasifican de la siguiente manera: neurofibromatosis tipo 1 (NF1), neurofibromatosis tipo 2 (NF2) y schwannomatosis (también conocida como neurofibromatosis tipo 3). Esta última es una enfermedad muy infrecuente, con una prevalencia aproximada de 1/126 000 personas, por lo que solo profundizaremos las dos primeras. La NF1, también conocida como la enfermedad de Von Recklinghausen, es la más frecuente de las tres y afecta principalmente la piel y el sistema nervioso periférico. Se caracteriza por la presencia de máculas "café con leche", pecas axilares o inguinales, nódulos de Lisch (hamartomas en el iris) y neurofibromas (tumores de la vaina de nervios periféricos). Otras manifestaciones menos frecuentes, aunque de mayor gravedad, incluyen gliomas del nervio óptico, meningiomas, neurofibromas malignos, escoliosis y displasia de la tibia. Su diagnóstico se suele realizar al nacimiento o durante los primeros años de vida, y se estima que un 50% de quienes la padecen presenta dificultades cognitivas. No hay datos concluyentes sobre la mortalidad en los pacientes con NF1, aunque se sabe que la expectativa de vida es menor que en la población general. La NF2 tiene una prevalencia considerablemente menor que la NF1 y su inicio es más tardío, afectando principalmente a adultos jóvenes. La presentación clínica típica se caracteriza por acúfenos, hipoacusia y ataxia en contexto de la presencia de schwannomas vestibulares bilaterales. Otros hallazgos menos frecuentes incluyen schwannomas de nervios periféricos, meningiomas, ependimomas o astrocitomas. La esperanza de vida es de unos 36 años, con una supervivencia media desde el momento del diagnóstico de 15 años. (AU)

Neurofibromatosis (NF) includes a group of genetic diseases with an autosomal-dominant inheritance pattern, and they are classified as follows: Neurofibromatosis type 1 (NF1), neurofibromatosis type 2 (NF2) and Schwannomatosis (also known as neurofibromatosis type 3). This last one is a very rare disease, with an approximate prevalence of 1/126000, so we will only deepen in the first two. NF1, also known as von Recklinghausen disease, is the most frequent, and mainly affects the skin and peripheral nervous system. Its typical manifestations are the presence of café-au-lait macules, axillary or inguinal freckles, Lisch nodules (hamartomas in the iris) and neurofibromas (peripheral nerve sheath tumors). Less frequent manifestations, although more serious, include optic nerve gliomas, meningiomas, malignant neurofibromas, scoliosis and tibial dysplasia. The diagnosis is usually made at birth or during the first years of life, and approximately 50% of patients present cognitive difficulties. There is no conclusive data on mortality in patients with NF1, although it is known that life expectancy is lower than in general population. NF2 has a considerably lower prevalence than NF1, and its onset is later in life, mainly affecting young adults. Its typical clinical presentation is characterized by tinnitus, hearing loss and ataxia in the context in the presence of bilateral vestibular schwannomas. Less frequent findings include peripheral nerve schwannomas, meningiomas, ependymomas or astrocytomas. Life expectancy is about 36 years old, with a median survival from the moment of diagnosis of 15 years. (AU)

A Novel c.6766_6767insAA Mutation in the Neurofibromin Gene in a Patient with Neurofibromatosis Type 1-Associated Glioblastoma / 대한소아신경학회지

Neurofibromatosis type 1 (NF-1) is an autosomal dominant neurocutaneous syndrome caused by mutations in the neurofibromin gene. NF-1 patients have a high risk of tumors, and optic glioma is the most commonly observed central nervous system tumor in these patients. However, glioblastoma is extremely rare in pediatric NF-1 patients. Here we report the discovery of a novel heterozygous c.6766_6767insAA (p.Ser2256Lysfs*4), pathogenic mutation in the neurofibromin gene in a 17-year-old boy with NF-1-associated glioblastoma.

Neurofibromatosis tipo 1 (NF1) y su diagnóstico molecular como estrategia del diagnóstico diferencial y a edades tempranas / Molecular diagnosis as a strategy for differential diagnosis and at early ages of neurofibromatosis type 1 (NF1)

Neurofibromatosis type 1 (NF1), is a haploinsufficient and multisystemic disease, caused by inherited or sporadic mutations in the NF1 gene. Its incidence is one in 2,500 to 3,000 individuals, it has an autosomal dominant pattern of inheritance, high clinical variability, complete penetrance and age-dependent complications. Neurofibromin is the product of the NF1 gene and is believed to act as a tumor suppressor since the loss of its function has been associated with benign and malignant tumors in neural crest-derived tissues. Only two correlations between clinical phenotype and mutant alleles in the NF1 gene have been observed. The established criteria for disease diagnosis are very efficient in adults and children older than 3 years of age, but not for children under this age. Mutational analysis is therefore recommended to confirm the disease in young children with a negative family history. A pathogenic mutation in the NF1 should be added to the list of diagnostic criteria. Mutational analysis is also recommended for differential diagnosis and for prenatal or pre-implantation genetic diagnosis, taking into consideration the family history and the type of method to be applied. Molecular studies of this disease using different complimentary molecular techniques and bioinformatics tools have characterized NF1 gene mutations at both the DNA and mRNA levels, increasing the mutational spectrum. Consequently, about 1,289 defects have been reported to date, mainly nonsense/missense mutations, deletions and splice site defects.

Unusual coexistence between lupus nephritis and neurofibromatosis 1: a case report and review of previous cases.

The association of Neurofibromatosis 1 (NF 1), an autosomal dominant genetic disease with autoimmune diseases like systemic lupus erythematosus is rare, five case reports are there in medical literature showing such association. Here we have documented a case of Lupus nephritis associated with Neurofibromatosis 1 diagnosed in the same setting, in a 24 years old female patient presented with oliguria, hypertension, anasarca, cafe-au-lait spots, palmer freckling, subcutaneous nodules, alopecia areata and positive family history for NF 1.

Neurofibromatosis Type I Associated with Malaria: A Case Report and Review of Literature.

Neurofibromatosis (von Recklinghausen disease) is a genetic disorder which is now not been considered to be most common due to a gradual increase in its number of cases worldwide. Its prevalence found is around 1 in 4000-5000 individuals with the incidence been found equally in all regions and reported in almost all ethnic groups. Two-three million cases are reported all over world so far with this disorder. It is an autosomal dominant trait with varied age range of the cases reported from 6 years to late adulthood. Disease occurs by a genetic mutation in the neurofibromatosis Type 1 (NF1) gene (tumor suppressor gene) which is located on chromosome no. 17 at 17q11.2, responsible for coding of neurofibromin, a cytoplasmic protein. The effect of this mutation is elicited in almost all systems of the body with mild to severe complications. About half of the cases reported are present with new mutations in the NF1 genes. A patient afflicted with NF1 has around 50-60% of chances of transmitting the disease to each of his/her offspring. Presenting here a case of the female patient diagnosed malaria associated with NF1.

A Case of Vitiligo Coexistent with Neurofibromatosis Type 1 / 대한피부과학회지

No abstract available.

Spinal Cord Ependymoma Associated with Neurofibromatosis 1 : Case Report and Review of the Literature

Patients with neurofibromatosis 1 (NF1) are predisposed to develop central nervous system tumors, due to the loss of neurofibromin, an inactivator of proto-oncogene Ras. However, to our knowledge, only three cases of ependymomas with NF1 have been reported in the literature. The authors present a case of NF1 patient with a spinal cord ependymoma. She was referred for about half a year history of increasing numbness that progressed from her fingers to her entire body above the bellybutton. Magnetic resonance imaging revealed a relative-demarcated, heterogeneously enhanced mass lesion accompanied by perifocal edema in C5-7 level, a left-sided T11 spinous process heterogeneously enhanced mass in soft tissue, intervertebral disk hernia in L2-5 level, and widespread punctum enhancing lesion in her scalp and in T11-L5 level. The patient underwent C5-7 laminectomies and total excision of the tumor under operative microscope, and intraoperative ultrasonography and physiological monitoring were used during the surgery. Histopathologically, her tumor was found to be a ependymoma without malignant features (grade II in the World Health Organization classification). Therefore, no adjuvant therapy was applied. Following the operation, the patient showed an uneventful clinical recovery with no evidence of tumor recurrence after one year of follow-up.

Genome-wide scan of granular corneal dystrophy, type II: confirmation of chromosome 5q31 and identification of new co-segregated loci on chromosome 3q26.3

Granular corneal dystrophy, type II (CGD2; Avellino corneal dystrophy) is the most common corneal dystrophy among Koreans, but its pathophysiology is still poorly understood. Many reports showed that even though the causative mutation is the same TGFBI R124H mutation, there are severe and mild phenotypes of the corneal dystrophy. We also observed the phenotype differences in our samples. For this reason, we focused our effort on the identification of unknown genetic factor related to phenotype variation. A total 551 individuals from 59 families were genotyped with SNP chip and used in genome-wide linkage analysis. From single-point linkage analyses, we confirmed the known 5q31 region for TGFBI gene, and selected novel nine candidate loci for CGD2. In simulation analysis, the only 3q26.3 region including neuroligin 1 gene (NLGN1) was supported by empirical statistic significance. To investigate the effect of genetic heterogeneity in linkage analysis, we classified CGD2 families into two subgroups. Although we could not find a significant evidence for correlation between the 3q26.3 region and CGD2 phenotypes, this first genome-wide analysis with CGD2 families in Korea has a very important value for offering insights in genetics of CGD2. In addition, the co-segregating loci with CGD2 including 3q26.3 would be a good target for further study to understand the pathophysiology of CGD2.

Biological features of osteoblasts isolated from patients with type Ⅰ neurofibromatosis / 中华骨科杂志

Objective To detect the neurofibromin expression and observe the biological features of the osteoblasts of patients with type 1 neurofibromatosis and scoliosis. Methods 10 cases of congenital scoliosis and 8 cases of NF1 scoliosis were chosen. The two groups were with the similar age(with the average of 11.7 years and 12.5 years) and Cobb angle(with the average of 85? and 94?). Cancellous bone was harvested from the ilia and the bone explants culture system was used. Proliferation of the osteoblasts, and also the specific differentiation index including alkaline phosphatase, type Ⅰ collagen and osteocalcin was assayed in sewnd generation osteoblasts. Neurofibromin expression in the two kinds of osteoblasts was detected with immunoprecipitation followed by Western blot. Results Compared to the osteoblasts of patients with congenital scoliosis, lower level of neurofibromin was expressed in osteoblasts of patients with NF1 scoliosis, (the OD value was 1.05?0.06 and 2.59?1.40 respectively, P=0.002). The level of alkaline phosphatase, type Ⅰ collagen and osteocalcin were significant lower in osteoblasts of patients with NF1 scoliosis than those of CS patients (44.69 IU/mg vs 51.38 IU/mg, P=0.019; 226.34 ng/mg vs 249.93 ng/mg, P=0.014; 7.41 ng/mg vs 8.87 ng/mg, P=0.049). But the proliferation rate of the NF1 osteoblasts was significant higher than that of the CS osteoblasts (3.34 and 2.70 respectively, P=0.049). Conclusion With the decrease of neurofibromin expression, the NF1 osteoblasts show some defects in their function, these function defects may contribute to varieties of skeletal abnormalities as dystrophic change and decreased bone density.

Identification of two novel frame shift mutations of the NF1 gene in Korean patients with neurofibromatosis type 1

Neurofibromatos is type 1 (NF1) is one of the most common inherited disorders and is characterized by abnormalities in multiple tissues derived from the neural crest. The NF-1 gene has been cloned and mapped to human chromosome 17q11.2. The NF-1 gene has an open reading frame that predicts a protein consisting of 2,818 amino acids, known as neurofibromin. Here, we report two kinds of novel frame shift mutations of the NF1 gene from 2 out of 56 unrelated Korean NF1 patients. These mutations were detected using polymerase chain reaction and single strand conformational polymorphism analysis. Sequencing analysis revealed four base pair insertion at codon 1270 of exon 22, and a base pair deletion at codon 1398 of exon 24. These mutations resulted in premature termination of the mutant alleles and may encode truncated forms of neurofibromin.