Nörofibromatozis tip 1’li hastada sağ amelia

Yıl 2020, , 240 - 242, 01.03.2020

Hilal Aydın

https://doi.org/10.28982/josam.630597

Öz

Nörofibromatozis tip 1 (NF1); deri, periferal ve santral sinir sistemi (SSS) yanında kemik, endokrin, gastrointestinal sistem gibi bir çok değişik sistemi etkiler. Otozomal dominant geçişli olup görülme sıklığı 1/3000-1/4000 olarak saptanmıştır. NF-1 geni 17. kromozom 11p12 bölgesindedir, bu gen nörofibromin olarak adlandırılan tümor supresor bir proteini kodlamaktadır. NF1 geni, nörofibromin proteini kodlar, çok çeşitli hücre ve doku tiplerinde eksprese edilir. Nörofibromin, bir GTPaz aktive edici protein (Ras-GAP) olarak işlev görerek hücre içi bir sinyal molekülü p21ras’ın (Ras) aktivitesini negatif olarak düzenler. Nörofibrominin Ras-GAP fonksiyonu, NF1 ile ilişkili çeşitli klinik semptomlarla ilişkilendirilmiştir. Bu yazıda Nörofibramatozis tip 1 klinik ve genetik olarak tanısı konulan ve sağ elde gelişimsel anomalisi (sağ el amelia) olan bir vakayı sunmayı hedefledik. Bu iki durum birlikteliğinin koinsidental mi olduğu yada nörofibramatozis sonucu mu olduğu konusunda bilgilerimiz yetersiz kalmaktadır. Amelia ve nörofibramatozis birlikteliği bir ilk olduğu için bu vakayı sunmak istedik.

Anahtar Kelimeler

Nörofibromatozis Tip 1, Amelia, Nörofibromin

Right amelia in a patient with neurofibromatosis type 1

Öz

Neurofibromatosis type 1 (NF1) affects many different systems such as the skeletal, endocrine, gas-trointestinal systems, as well as the skin, peripheral and central nervous systems (CNS). The NF-1 gene, located in the 11p12 region of chromosome 17, encodes a tumor suppressor protein, called neurofibromin, and is expressed in a diverse range of cell and tissue types. Neurofibromin negatively regulates the activity of an intracellular signaling molecule, p21ras (Ras), acting as a GTPase-activating protein (Ras-GAP). The Ras-GAP function of neurofibromin has been associated with various NF1-related clinical symptoms. We aimed to present a case of clinically and genetically diagnosed neurofibromatosis type 1 with a developmental anomaly in the right hand (right hand amelia). Our knowledge about whether the coexistence of these two conditions is coincidental or a result of neurofibromatosis is limited. We wanted to present this case since the coexistence of amelia and neurofibromatosis is a first.

Anahtar Kelimeler

Neurofibromatosis type 1, Amelia, Neurofibromin

Kaynakça

• 1. Neurofibromatosis. Conference statement. National Institutes of Health Consensus Development Conference. Arch Neurol. 1988;45:575–8.
• 2. Viskochil D. Genetics of neurofibromatosis 1 and the NF1 gene. J Child Neurol. 2002;17:562–70.
• 3. Elefteriou F, Kolanczyk M, Schindeler A, Viskochil DH, Hock JM, Schorry EK. Skeletal abnormalities in neurofibromatosis type 1: approaches to therapeutic options. Am J Med Genet. 2009;149a:2327-38.
• 4. Georgescu EF, Stanescu L, Georgescu AC, Dumitrescu D, Foarfa C, Calin G. Bone abnormalities occurring in the follow-up of the patients with neurofibromatosis type 1. Romanian Journal of Morphology and Embryology. 2007;48(3):249–56.
• 5. Kristiansen LP, Steen H, Terjesen T. Residual challenges after healing of congenital pseudarthrosis in the tibia. Clin Orthop. 2003;414:228-37.
• 6. Schindeler A, Little DG. Recent insights into bone development, homeostasis, and repair in type 1 neurofibromatosis (NF1). Bone. 2008;42:616–22.
• 7. Yang FC, Chen S, Robling AG, Yu X, Nebesio TD, Yan J, et al. Hyperactivation of p21 and PI3K cooperate to alter murine and human neurofibromatosis type 1-haploinsufficient osteoclast functions. J Clin Invest. 2006;116:2880–91.
• 8. Kimes KL, Han MJ, Brown PJ. Polydactyly in neurofibromatosis type I: a potential clue to diagnosis. Dermatol Online J. 2016;22(11):7–11.
• 9. Chaudhary R, Singh K. A Rare Fetal Congenital Anomaly: Meromelia. Journal of Gynecology. 2018;1(13):1-5.
• 10. Yesender M, Anjum A, Saritha S, Rao SB, Ramani TV, Ericson P. Limb defects: a spectrum of correlated study. International Journal of Anatomy and Research. 2016;4(1):1810-8.