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Genotype-Phenotype Correlation in NF1: Evidence for a More Severe Phenotype Associated with Missense Mutations Affecting NF1 Codons 844-848.

Magdalena Koczkowska | Yunjia Chen | Tom Callens | Alicia Gomes | Angela Sharp | Sherrell Johnson | Meng-Chang Hsiao | Zhenbin Chen | Meena Balasubramanian | Christopher P Barnett | Troy A Becker | Shay Ben-Shachar | Debora R Bertola | Jaishri O Blakeley | Emma M M Burkitt-Wright | Alison Callaway | Melissa Crenshaw | Karin S Cunha | Mitch Cunningham | Maria D D'Agostino | Karin Dahan | Alessandro De Luca | Anne Destrée | Radhika Dhamija | Marica Eoli | D Gareth R Evans | Patricia Galvin-Parton | Jaya K George-Abraham | Karen W Gripp | Jose Guevara-Campos | Neil A Hanchard | Concepcion Hernández-Chico | LaDonna Immken | Sandra Janssens | Kristi J Jones | Beth A Keena | Aaina Kochhar | Jan Liebelt | Arelis Martir-Negron | Maurice J Mahoney | Isabelle Maystadt | Carey McDougall | Meriel McEntagart | Nancy Mendelsohn | David T Miller | Geert Mortier | Jenny Morton | John Pappas | Scott R Plotkin | Dinel Pond | Kenneth Rosenbaum | Karol Rubin | Laura Russell | Lane S Rutledge | Veronica Saletti | Rhonda Schonberg | Allison Schreiber | Meredith Seidel | Elizabeth Siqveland | David W Stockton | Eva Trevisson | Nicole J Ullrich | Meena Upadhyaya | Rick van Minkelen | Helene Verhelst | Margaret R Wallace | Yoon-Sim Yap | Elaine Zackai | Jonathan Zonana | Vickie Zurcher | Kathleen Claes | Yolanda Martin | Bruce R Korf | Eric Legius | Ludwine M Messiaen
American journal of human genetics | 2018

Neurofibromatosis type 1 (NF1), a common genetic disorder with a birth incidence of 1:2,000-3,000, is characterized by a highly variable clinical presentation. To date, only two clinically relevant intragenic genotype-phenotype correlations have been reported for NF1 missense mutations affecting p.Arg1809 and a single amino acid deletion p.Met922del. Both variants predispose to a distinct mild NF1 phenotype with neither externally visible cutaneous/plexiform neurofibromas nor other tumors. Here, we report 162 individuals (129 unrelated probands and 33 affected relatives) heterozygous for a constitutional missense mutation affecting one of five neighboring NF1 codons-Leu844, Cys845, Ala846, Leu847, and Gly848-located in the cysteine-serine-rich domain (CSRD). Collectively, these recurrent missense mutations affect ∼0.8% of unrelated NF1 mutation-positive probands in the University of Alabama at Birmingham (UAB) cohort. Major superficial plexiform neurofibromas and symptomatic spinal neurofibromas were more prevalent in these individuals compared with classic NF1-affected cohorts (both p < 0.0001). Nearly half of the individuals had symptomatic or asymptomatic optic pathway gliomas and/or skeletal abnormalities. Additionally, variants in this region seem to confer a high predisposition to develop malignancies compared with the general NF1-affected population (p = 0.0061). Our results demonstrate that these NF1 missense mutations, although located outside the GAP-related domain, may be an important risk factor for a severe presentation. A genotype-phenotype correlation at the NF1 region 844-848 exists and will be valuable in the management and genetic counseling of a significant number of individuals.

Pubmed ID: 29290338 RIS Download

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