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The clinical spectrum of complete FBN1 allele deletions

  作者 Hilhorst-Hofstee, Y; Hamel, BC; Verheij, JBGM; Rijlaarsdam, MEB; Mancini, GMS; Cobben, JM; Giroth, C; Ruivenkamp, CAL; Hansson, KBM; Timmermans, J; Moll, HA; Breuning, MH; Pals, G  
  选自 期刊  European Journal of Human Genetics;  卷期  2011年19-3;  页码  247-252  
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[摘要]The most common mutations found in FBN1 are missense mutations (56%), mainly substituting or creating a cysteine in a cbEGF domain. Other mutations are frameshift, splice and nonsense mutations. There are only a few reports of patients with marfanoid features and a molecularly proven complete deletion of a FBN1 allele. We describe the clinical features of 10 patients with a complete FBN1 gene deletion. Seven patients fulfilled the Ghent criteria for Marfan syndrome (MFS). The other three patients were examined at a young age and did not (yet) present the full clinical picture of MFS yet. Ectopia lentis was present in at least two patients. Aortic root dilatation was present in 6 of the 10 patients. In three patients, the aortic root diameter was on the 95th percentile and in one patient, the diameter of the aortic root was normal, the cross-section, however, had a cloverleaf appearance. Two patients underwent aortic root surgery at a relatively young age (27 and 34 years). Mitral valve prolapse was present in 4 of the 10 patients, and billowing of the mitral valve in 1. All patients had facial and skeletal features of MFS. Two patients with a large deletion extending beyond the FBN1 gene had an extended phenotype. We conclude that complete loss of one FBN1 allele does not predict a mild phenotype, and these findings support the hypothesis that true haploinsufficiency can lead to the classical phenotype of Marfan syndrome. European Journal of Human Genetics (2011) 19, 247-252; doi:10.1038/ejhg.2010.174; published online 10 November 2010

 
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