Genetics - Multi-system Disease Flashcards
Multi-system disorders are caused by what?
Germ-line genetic variations
What modes of inheritance cause Multi-system disorders?
Chromosomal
Single gene disorders
Multifactorial
What are the common problems seen in multi-system disease?
Variable expression within as well as between families
Present to a large variety of specialists
Easy to miss FH
What type of inheritance causes Neurofibromatosis Type 1?
Autosomal dominant
How common is Neurofibromatosis Type 1?
1/2500-3500
How is Neurofibromatosis Type 1 diagnosed?
2+ of: Cafe au lait spots (6+) Neurofibromas (2+) Axillary freckling Lisch nodules Optic glioma Thinning of long bone cortex Family history
What are the other symptoms of Neurofibromatosis Type 1?
Macrocephaly Short stature Noonan-look Learning difficulties Epilepsy Scoliosis Pseudoarthritis of tibia HTN Neoplasia
How is Neurofibromatosis Type 1 managed?
Annual review of children at risk and individuals with diagnosis of: Blood pressure Spine (scoliosis) Tibia (angulation) Educational assessment Visual acuity/fields
What gene causes Neurofibromatosis Type 1?
Variable expression of tumour suppressor gene 17q (usually paternal)
How does Neurofibromatosis Type 2 present?
Acoustic (bilateral) neuromas
CNS/spinal tumours
Few CAL spots
Where is the NF2 gene located?
Chromosome 22
What is Tuberous Sclerosis?
Triad of Epilepsy, Skin lesions and Learning difficulty
Autosomal dominant
Hamartomas in different organs
What are the genetics of tuberous sclerosis?
Autosomal dominant with full penetrance
TSC1+2 genes
What are the clinical features of Tuberous Sclerosis?
Variable expression Learning difficulty (autism) Seizures (infantile, myoclonic) Skin lesions Kidney cysts Phakomas in eye Rhabdomyomas in heart
What skin lesions are seen in Tuberous sclerosis?
Angiofibromas Depigmented macules Fibrous plaques on forehead Shagreen patches Subungual fibromas