Abstract
Spinal neurofibromas are found in up to 38% of NF1 patients. However, they cause clinical implications only in about 5% of the patients. In contrast, multiple symptomatic spinal neurofibromas are the main clinical finding in patients with familial spinal neurofibromatosis. Familial spinal neurofibromatosis has been considered to be a distinct clinical form of neurofibromatosis. Linkage analysis in two families and identification of a NF1 gene mutation in a third family strongly associate spinal neurofibromatosis with the NF1 gene. We describe a NF1 patient who satisfies the NIH diagnostic criteria and has severe spinal involvement with bilateral spinal root neurofibromas at every level. A recurrent splice site mutation (IVS19b-3C>G) was identified in the NF1 gene in the patient. We discuss the possibility that the clinical picture of this patient represents an additional example of spinal neurofibromatosis. By comparison of the clinical expression of NF1 in this patient and that in another patient with the identical mutation the hypothesis that spinal neurofibromatosis is associated with a particular mutation is highly unlikely. The involvement of other genes linked to the NF1 gene or modifying genes is currently the most likely explanation for the clinical phenotype of spinal neurofibromatosis.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Easton D, Ponder M, Huson S, Ponder B . An analysis of variation in expression of neurofibromatosis (NF) type 1 (NF1): evidence for modifying genes Am J Hum Genet 1993 53: 305–313
Tonsgard J, Yelavarthi K, Cushner S, Short M, Lindgren V . Do NF1 gene deletions result in a characteristic phenotype? Am J Med Genet 1997 73: 80–86
von Deimling A, Krone W, Menon A . Neurofibromatosis type 1: pathology, clinical features and molecular genetics Brain Pathol 1995 5: 153–162
Tonsgard JH, Kwak SM, Short MP, Dachman AH . CT imaging in adults with neurofibromatosis-1: frequent asymptomatic plexiform lesions Neurology 1998 50: 1755–1760
Huson S, Harper P, Compston D . Von Recklinghausen neurofibromatosis. A clinical and population study in south-east Wales Brain 1988 111: 1355–1381
Thakkar S, Feigen U, Mautner V . Spinal tumours in neurofibromatosis type 1: an MRI study of frequency multiplicity and variety Neuroradiology 1999 41: 625–629
Pöyhönen M, Leisti E, Kytola S, Leisti J . Hereditary spinal neurofibromatosis: a rare form of NF1? J Med Genet 1997 34: 184–187
Egelhoff J, Bates D, Ross J, Rothner A, Cohen B . Spinal MR findings in neurofibromatosis types 1 and 2 Am J Neuroradio 1992 13: 1071–1077
Carey J, Viskochil D . Neurofibromatosis type 1: A model condition for the study of the molecular basis of variable expressivity in human disorders Am J Med Genet 1999 26: 7–13
Viskochil D, Carey J . Alternate and related forms of the neurofibromatoses in Huson S, Hughes R (eds) The neurofibromatoses: a clinical and pathogenetic overview London 1994 pp 445–474
Riccardi V . Neurofibromatosis: phenotype, natural history, and pathogenesis 2nd. edition Baltimore: Johns Hopkins University Press 1992
Wimmer K, Eckart M, Rehder H, Fonatsch C . Illegitimate splicing of the NF1 gene in healthy individuals mimics mutation-induced splicing alterations in NF1 patients Hum Genet 2000 106: 311–313
Heim RA, Kam-Morgan LNW, Binnie CG, Corns DD, Cayouette MC, Farber RA, Aylsworth AS, Silverman LM, Luce MC . Distribution of 13 truncating mutations in the neurofibromatosis 1 gene Hum Mol Genet 1995 4: 975–981
Eisenbarth I, Beyer K, Krone W, Assum G . Toward a survey of somatic mutations of the NF1 gene in benign neurofibromas of patients with neurofibromatosis type 1 Am J Hum Genet 2000 66: 393–401
Fahsold R, Hoffmeyer S, Mischung C et al. Minor lesion mutational spectrum of the entire NF1 gene does not explain its high mutability but points to a functional domain upstream of the GAP-related domain Am J Hum Genet 2000 66: 790–818
Messiaen L, Callens T, Mortier G et al. Exhaustive mutation analysis of the NF1 gene allows identification of 95% of mutations and reveals a high frequency of unusual splicing defects Hum Mut 2000 15: 541–555
Ars E, Kruyer H, Gaona A et al. A clinical variant of neurofibromatosis type 1: familial spinal neurofibromatosis with a frameshift mutation in the NF1 gene Am J Hum Genet 1998 62: 834–841
Kaufmann D, Müller R, Bartelt B et al. Spinal neurofibromatosis without café-au-lait macules in two families with null mutations of the NF1 gene Am J Hum Genet 2001 69: 1395–1400
Pulst S, Riccardi V, Fain P, Korenberg J . Familial spinal neurofibromatosis: clinical and DNA linkage analysis Neurology 1991 41: 1923–1927
Hoffmeyer S, Assum G, Griesser J, Kaufmann D, Nurnberg P, Krone W . On unequal allelic expression of the neurofibromin gene in neurofibromatosis type 1 Hum Mol Genet 1995 4: 1267–1272
Buske A, Gewies A, Lehmann R et al. Recurrent NF1 gene mutation in a patient with oligosymptomatic neurofibromatosis type 1 (NF1) Am J Med Genet 1999 86: 328–330
Acknowledgements
We would like to thank the patients who participated in this study. In particular we wish to thank Ms Martina Vacik for her enthusiastic co-operation. This work was supported by the Jubiläumsfonds der Österreichischen Nationalbank grant no. 7519 and by Het Bijzonder Onderzoeksfonds UG No. 01107799 (L Messiaen).
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Wimmer, K., Mühlbauer, M., Eckart, M. et al. A patient severely affected by spinal neurofibromas carries a recurrent splice site mutation in the NF1 gene. Eur J Hum Genet 10, 334–338 (2002). https://doi.org/10.1038/sj.ejhg.5200807
Received:
Revised:
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.1038/sj.ejhg.5200807
Keywords
This article is cited by
-
Do non-pathogenic variants of DNA mismatch repair genes modify neurofibroma load in neurofibromatosis type 1?
Child's Nervous System (2022)
-
Familial spinal neurofibromatosis due to a multiexonic NF1 gene deletion
neurogenetics (2011)
-
The spectrum of somatic and germline NF1 mutations in NF1 patients with spinal neurofibromas
neurogenetics (2009)