Abstract
A clinical study of patients on the North West Regional Genetic Register with neurofibromatosis type 1 (NF1) identified 523 affected cases from 304 families. In those for whom relevant information was available, 86.7% (383 of 442) had more than six café au lait patches, 83.8% (310 of 370) had axillary freckling, 42.3% (151 of 357) had inguinal freckling, and 63% (157 of 249) had Lisch nodules. Cutaneous neurofibromas were present in 59.4% (217 of 365) and 45.5% (150 of 330) were noted to have subcutaneous tumours. Plexiform neurofibromas were present in 15.3% (80 of 523). A positive family history of NF1 was found in 71.2% (327 of 459) and 28.8% (132 of 459) of affected patients were considered to be the result of a new mutation. Learning difficulties of varying severity occurred in 62% (186 of 300). CNS tumours associated with NF1 were reported in 9.4% (49) of patients, optic gliomas occurring in 25 of these, 4.8% of patients. Some degree of scoliosis was reported for 11.7% (61), 1.9% (10) had pseudoarthrosis, 4.3% (23) had epilepsy, and 2.1% (11) had spinal neurofibromas. Actuarial analyses were carried out for both optic glioma and malignant nerve sheath tumours and the data are presented. Keywords: neurofibromatosis type 1; optic glioma; malignancy; Lisch nodules
Full Text
The Full Text of this article is available as a PDF (116.0 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- BORBERG A. Clinical and genetic investigations into tuberous sclerosis and Recklinghausen's neurofibromatosis; contribution to elucidation of interrelationship and eugenics of the syndromes. Acta Psychiatr Neurol Scand Suppl. 1951;71:1–239. [PubMed] [Google Scholar]
- Benjamin C. M., Colley A., Donnai D., Kingston H., Harris R., Kerzin-Storrar L. Neurofibromatosis type 1 (NF1): knowledge, experience, and reproductive decisions of affected patients and families. J Med Genet. 1993 Jul;30(7):567–574. doi: 10.1136/jmg.30.7.567. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Carey J. C., Laub J. M., Hall B. D. Penetrance and variability in neurofibromatosis: a genetic study of 60 families. Birth Defects Orig Artic Ser. 1979;15(5B):271–281. [PubMed] [Google Scholar]
- Cawthon R. M., Weiss R., Xu G. F., Viskochil D., Culver M., Stevens J., Robertson M., Dunn D., Gesteland R., O'Connell P. A major segment of the neurofibromatosis type 1 gene: cDNA sequence, genomic structure, and point mutations. Cell. 1990 Jul 13;62(1):193–201. doi: 10.1016/0092-8674(90)90253-b. [DOI] [PubMed] [Google Scholar]
- Duffner P. K., Cohen M. E. Isolated optic nerve gliomas in children with and without neurofibromatosis. Neurofibromatosis. 1988;1(4):201–211. [PubMed] [Google Scholar]
- Easton D. F., Ponder M. A., Huson S. M., Ponder B. A. An analysis of variation in expression of neurofibromatosis (NF) type 1 (NF1): evidence for modifying genes. Am J Hum Genet. 1993 Aug;53(2):305–313. [PMC free article] [PubMed] [Google Scholar]
- Friedman J. M., Birch P. H. Type 1 neurofibromatosis: a descriptive analysis of the disorder in 1,728 patients. Am J Med Genet. 1997 May 16;70(2):138–143. doi: 10.1002/(sici)1096-8628(19970516)70:2<138::aid-ajmg7>3.0.co;2-u. [DOI] [PubMed] [Google Scholar]
- Goldgar D. E., Green P., Parry D. M., Mulvihill J. J. Multipoint linkage analysis in neurofibromatosis type I: an international collaboration. Am J Hum Genet. 1989 Jan;44(1):6–12. [PMC free article] [PubMed] [Google Scholar]
- Hoyt W. F., Baghdassarian S. A. Optic glioma of childhood. Natural history and rationale for conservative management. Br J Ophthalmol. 1969 Dec;53(12):793–798. doi: 10.1136/bjo.53.12.793. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Huson S. M., Compston D. A., Clark P., Harper P. S. A genetic study of von Recklinghausen neurofibromatosis in south east Wales. I. Prevalence, fitness, mutation rate, and effect of parental transmission on severity. J Med Genet. 1989 Nov;26(11):704–711. doi: 10.1136/jmg.26.11.704. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Huson S. M., Compston D. A., Harper P. S. A genetic study of von Recklinghausen neurofibromatosis in south east Wales. II. Guidelines for genetic counselling. J Med Genet. 1989 Nov;26(11):712–721. doi: 10.1136/jmg.26.11.712. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Huson S. M., Harper P. S., Compston D. A. Von Recklinghausen neurofibromatosis. A clinical and population study in south-east Wales. Brain. 1988 Dec;111(Pt 6):1355–1381. doi: 10.1093/brain/111.6.1355. [DOI] [PubMed] [Google Scholar]
- Huson S. M. Recent developments in the diagnosis and management of neurofibromatosis. Arch Dis Child. 1989 May;64(5):745–749. doi: 10.1136/adc.64.5.745. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lewis R. A., Gerson L. P., Axelson K. A., Riccardi V. M., Whitford R. P. von Recklinghausen neurofibromatosis. II. Incidence of optic gliomata. Ophthalmology. 1984 Aug;91(8):929–935. doi: 10.1016/s0161-6420(84)34217-8. [DOI] [PubMed] [Google Scholar]
- Lewis R. A., Riccardi V. M. Von Recklinghausen neurofibromatosis. Incidence of iris hamartomata. Ophthalmology. 1981 Apr;88(4):348–354. doi: 10.1016/s0161-6420(81)35034-9. [DOI] [PubMed] [Google Scholar]
- Listernick R., Charrow J., Greenwald M. J., Esterly N. B. Optic gliomas in children with neurofibromatosis type 1. J Pediatr. 1989 May;114(5):788–792. doi: 10.1016/s0022-3476(89)80137-4. [DOI] [PubMed] [Google Scholar]
- Listernick R., Charrow J., Greenwald M., Mets M. Natural history of optic pathway tumors in children with neurofibromatosis type 1: a longitudinal study. J Pediatr. 1994 Jul;125(1):63–66. doi: 10.1016/s0022-3476(94)70122-9. [DOI] [PubMed] [Google Scholar]
- Lubs M. L., Bauer M. S., Formas M. E., Djokic B. Lisch nodules in neurofibromatosis type 1. N Engl J Med. 1991 May 2;324(18):1264–1266. doi: 10.1056/NEJM199105023241807. [DOI] [PubMed] [Google Scholar]
- North K., Joy P., Yuille D., Cocks N., Mobbs E., Hutchins P., McHugh K., de Silva M. Specific learning disability in children with neurofibromatosis type 1: significance of MRI abnormalities. Neurology. 1994 May;44(5):878–883. doi: 10.1212/wnl.44.5.878. [DOI] [PubMed] [Google Scholar]
- Pierce S. M., Barnes P. D., Loeffler J. S., McGinn C., Tarbell N. J. Definitive radiation therapy in the management of symptomatic patients with optic glioma. Survival and long-term effects. Cancer. 1990 Jan 1;65(1):45–52. doi: 10.1002/1097-0142(19900101)65:1<45::aid-cncr2820650111>3.0.co;2-z. [DOI] [PubMed] [Google Scholar]
- Riccardi V. M., Lewis R. A. Penetrance of von Recklinghausen neurofibromatosis: a distinction between predecessors and descendants. Am J Hum Genet. 1988 Feb;42(2):284–289. [PMC free article] [PubMed] [Google Scholar]
- Riccardi V. M., Powell P. P. Neurofibrosarcoma as a complication of von Recklinghausen neurofibromatosis. Neurofibromatosis. 1989;2(3):152–165. [PubMed] [Google Scholar]
- Samuelsson B., Axelsson R. Neurofibromatosis. A clinical and genetic study of 96 cases in Gothenburg, Sweden. Acta Derm Venereol Suppl (Stockh) 1981;95:67–71. [PubMed] [Google Scholar]
- Seizinger B. R., Rouleau G. A., Ozelius L. J., Lane A. H., Faryniarz A. G., Chao M. V., Huson S., Korf B. R., Parry D. M., Pericak-Vance M. A. Genetic linkage of von Recklinghausen neurofibromatosis to the nerve growth factor receptor gene. Cell. 1987 Jun 5;49(5):589–594. doi: 10.1016/0092-8674(87)90534-4. [DOI] [PubMed] [Google Scholar]
- Shen M. H., Harper P. S., Upadhyaya M. Molecular genetics of neurofibromatosis type 1 (NF1). J Med Genet. 1996 Jan;33(1):2–17. doi: 10.1136/jmg.33.1.2. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Spence M. A., Sparkes R. S., Parry D. M., Bale S. J., Cortessis V., Mulvihill J. J. Genetic linkage studies with neurofibromatosis: the question of heterogeneity. J Med Genet. 1987 Sep;24(9):527–529. doi: 10.1136/jmg.24.9.527. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Upadhyaya M., Osborn M., Maynard J., Harper P. Characterization of six mutations in exon 37 of neurofibromatosis type 1 gene. Am J Med Genet. 1996 Jul 26;67(4):421–423. doi: 10.1002/(SICI)1096-8628(19960726)67:4<421::AID-AJMG20>3.0.CO;2-K. [DOI] [PubMed] [Google Scholar]
- Viskochil D., Buchberg A. M., Xu G., Cawthon R. M., Stevens J., Wolff R. K., Culver M., Carey J. C., Copeland N. G., Jenkins N. A. Deletions and a translocation interrupt a cloned gene at the neurofibromatosis type 1 locus. Cell. 1990 Jul 13;62(1):187–192. doi: 10.1016/0092-8674(90)90252-a. [DOI] [PubMed] [Google Scholar]
- Wallace M. R., Marchuk D. A., Andersen L. B., Letcher R., Odeh H. M., Saulino A. M., Fountain J. W., Brereton A., Nicholson J., Mitchell A. L. Type 1 neurofibromatosis gene: identification of a large transcript disrupted in three NF1 patients. Science. 1990 Jul 13;249(4965):181–186. doi: 10.1126/science.2134734. [DOI] [PubMed] [Google Scholar]
- Zehavi C., Romano A., Goodman R. M. Iris (Lisch) nodules in neurofibromatosis. Clin Genet. 1986 Jan;29(1):51–55. doi: 10.1111/j.1399-0004.1986.tb00770.x. [DOI] [PubMed] [Google Scholar]