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Noonan and cardio-facio-cutaneous syndromes: Two clinically and genetically overlapping disorders
Department of Genetics and Pathology, Uppsala University, SE-751 85 Uppsala, Sweden.
Department of Genetics and Pathology, Uppsala University, SE-751 85 Uppsala, Sweden.
Department of Paediatrics, Central Hospital, Skellefteå, Sweden.
Department of Paediatrics, University Hospital, Örebro, Sweden.
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2008 (English)In: Journal of Medical Genetics, ISSN 0022-2593, E-ISSN 1468-6244, Vol. 45, no 8, 500-506 p.Article in journal (Refereed) Published
Abstract [en]

Background: Noonan syndrome (NS) and cardio-faciocutaneous syndrome (CFC) are related disorders associated with disrupted RAS/RAF/MEK/ERK signalling. NS, characterised by facial dysmorphism, congenital heart defects and short stature, is caused by mutations in the genes PTPN11, SOS1, KRAS and RAF1. CFC is distinguished from NS by the presence of ectodermal abnormalities and more severe mental retardation in addition to the NS phenotype. The genetic aetiology of CFC was recently assigned to four genes: BRAF KRAS, MEK1 and MEK2. Methods: A comprehensive mutation analysis of BRAF, KRAS, MEK1, MEK2 and SOS1 in 31 unrelated patients without mutations in PTPN11 is presented. Results: Mutations were identified in seven patients with CFC (two in BRAF, one in KRAS, one in MEK1, two in MEK2 and one in SOS1). Two mutations were novel: MEK1 E203Q and MEK2 F57L. The SOS1 E433K mutation, identified in a patient diagnosed with CFC, has previously been reported in patients with NS. In one patient with NS, we also identified a mutation, BRAF K499E, that has previously been reported in patients with CFC. We thus suggest involvement of BRAF in the pathogenesis of NS also. Conclusions: Taken together, our results indicate that the molecular and clinical overlap between CFC and NS is more complex than previously suggested and that the syndromes might even represent allelic disorders. Furthermore, we suggest that the diagnosis should be refined to, for example, NS-PTPN11-associated or CFC-BRAF-associated syndromes after the genetic defect has been established, as this may affect the prognosis and treatment of the patients.

Place, publisher, year, edition, pages
2008. Vol. 45, no 8, 500-506 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-45667DOI: 10.1136/jmg.2008.057653OAI: diva2:266563
Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2010-05-24

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Duchen, Karin
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Pediatrics Faculty of Health SciencesDepartment of Paediatrics in Linköping
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