Stuttgart, Germany
Stuttgart, Germany

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Kratz C.P.,Hannover Medical School | Franke L.,University Hospital Magdeburg | Peters H.,Institute of Medical and Human Genetics | Kohlschmidt N.,Institute For Klinische Genetik | And 28 more authors.
British Journal of Cancer | Year: 2015

Background:Somatic mutations affecting components of the Ras-MAPK pathway are a common feature of cancer, whereas germline Ras pathway mutations cause developmental disorders including Noonan, Costello, and cardio-facio-cutaneous syndromes. These 'RASopathies' also represent cancer-prone syndromes, but the quantitative cancer risks remain unknown.Methods:We investigated the occurrence of childhood cancer including benign and malignant tumours of the central nervous system in a group of 735 individuals with germline mutations in Ras signalling pathway genes by matching their information with the German Childhood Cancer Registry.Results:We observed 12 cases of cancer in the entire RASopathy cohort vs 1.12 expected (based on German population-based incidence rates). This corresponds to a 10.5-fold increased risk of all childhood cancers combined (standardised incidence ratio (SIR)=10.5, 95% confidence interval=5.4-18.3). The specific cancers included juvenile myelomonocytic leukaemia=4; brain tumour=3; acute lymphoblastic leukaemia=2; rhabdomyosarcoma=2; and neuroblastoma=1. The childhood cancer SIR in Noonan syndrome patients was 8.1, whereas that for Costello syndrome patients was 42.4.Conclusions:These data comprise the first quantitative evidence documenting that the germline mutations in Ras signalling pathway genes are associated with increased risks of both childhood leukaemia and solid tumours. © 2015 Cancer Research UK. All rights reserved.


PubMed | Zentrum fur Humangenetik, MVZ genteQ, U.S. National Cancer Institute, Mitteldeutscher Praxisverbund Humangenetik and 23 more.
Type: Journal Article | Journal: British journal of cancer | Year: 2015

Somatic mutations affecting components of the Ras-MAPK pathway are a common feature of cancer, whereas germline Ras pathway mutations cause developmental disorders including Noonan, Costello, and cardio-facio-cutaneous syndromes. These RASopathies also represent cancer-prone syndromes, but the quantitative cancer risks remain unknown.We investigated the occurrence of childhood cancer including benign and malignant tumours of the central nervous system in a group of 735 individuals with germline mutations in Ras signalling pathway genes by matching their information with the German Childhood Cancer Registry.We observed 12 cases of cancer in the entire RASopathy cohort vs 1.12 expected (based on German population-based incidence rates). This corresponds to a 10.5-fold increased risk of all childhood cancers combined (standardised incidence ratio (SIR)=10.5, 95% confidence interval=5.4-18.3). The specific cancers included juvenile myelomonocytic leukaemia=4; brain tumour=3; acute lymphoblastic leukaemia=2; rhabdomyosarcoma=2; and neuroblastoma=1. The childhood cancer SIR in Noonan syndrome patients was 8.1, whereas that for Costello syndrome patients was 42.4.These data comprise the first quantitative evidence documenting that the germline mutations in Ras signalling pathway genes are associated with increased risks of both childhood leukaemia and solid tumours.


Amrhein P.,Klinik fur Hals Nasen Ohrenkrankheiten | Sittel C.,Klinik fur Hals Nasen Ohrenkrankheiten | Spaich C.,Institute For Klinische Genetik | Kohlhase J.,Praxis fur Humangenetik | And 3 more authors.
HNO | Year: 2014

Branchio-oto-renal (BOR) syndrome is characterized by ear malformations associated with sensorineural or mixed hearing loss. In addition, preauricular tags, preauricular pits, branchial cleft fistulas and cysts, as well as renal dysplasia are seen. A genetic mutation on chromosome 8, either autosomal dominantly inherited or occuring as a spontaneous mutation, is the cause in the majority of cases. Using array-based comparative genomic hybridization (CGH), it is possible to detect even the smallest genetic changes. Salivary gland choristoma in the middle ear is very rare. Surgical removal and histological clarification are required. © 2013 Springer-Verlag Berlin Heidelberg.


Radvanszky J.,Slovak Academy of Sciences | Hyblova M.,R.Ø.S.A. | Durovcikova D.,Slovak Medical University | Hikkelova M.,R.Ø.S.A. | And 5 more authors.
Clinical Genetics | Year: 2016

Say-Barber-Biesecker-Young-Simpson syndrome (SBBYSS) and genitopatellar syndrome (GTPTS) are clinically similar disorders with some overlapping features. Although they are currently considered to be distinct clinical entities, both were found to be caused by de novo truncating sequence variants in the KAT6B (lysine acetyltransferase 6B) gene, strongly suggesting that they are allelic disorders. Herein, we report the clinical and genetic findings in a girl presenting with a serious multiple congenital anomaly syndrome with phenotypic features overlapping both SBBYSS and GTPTS; pointing out that the clinical distinction between these disorders is not exact and there do exist patients, in whom conventional clinical classification is problematic. Genetic analyses revealed a truncating c.4592delA (p.Asn1531Thrfs*18) variant in the last KAT6B exon. Our findings support that phenotypes associated with typical KAT6B disease-causing variants should be referred to as 'KAT6B spectrum disorders' or 'KAT6B related disorders', rather than their current SBBYSS and GTPTS classification. © 2016 John Wiley & Sons A/S..


Spengler S.,RWTH Aachen | Begemann M.,RWTH Aachen | Ortiz Bruchle N.,RWTH Aachen | Baudis M.,University of Zürich | And 11 more authors.
Journal of Pediatrics | Year: 2012

Objective: To determine the contribution of submicroscopic chromosomal imbalances to the etiology of Silver-Russell syndrome (SRS) and SRS-like phenotypes. Study design: We performed molecular karyotyping in 41 patients with SRS or SRS-like features without known chromosome 7 and 11 defects using the Affymetrix SNP Array 6.0 system (Affymetrix, High Wycombe, United Kingdom). Results: In 8 patients, pathogenic copy number variations with sizes ranging from 672 kb to 9.158 Mb were identified. The deletions in 1q21, 15q26, 17p13, and 22q11 were associated with known microdeletion syndromes with overlapping features with SRS. The duplications in 22q13 and Xq25q27 represent unique novel copy number variations but have an obvious influence on the phenotype. In 5 additional patients, the pathogenetic relevance of the detected variants remained unclear. Conclusion: Pathogenic submicroscopic imbalances were detectable in a significant proportion of patients with short stature and features reminiscent of SRS. Therefore, molecular karyotyping should be implemented in routine diagnostics for growth-retarded patients with even slight dysmorphisms suggestive for SRS. Copyright © 2012 Mosby Inc.


Molecular karyotyping of array-based genomic hybridization (microarrays) not only detects copy number variations, genomic gains and losses but also provides the assessment of specific mosaicism. This article gives an overview on parameters influencing the detection of mosaicism and different cases with mosaicism detected by comparative genomic hybridization (CGH) arrays and by single nucleotide polymorphism (SNP) arrays. Furthermore, a possibility is provided to calculate the percentage of a given mosaicism. © 2014, Springer-Verlag Berlin Heidelberg.


Bartholdi D.,Institute For Klinische Genetik | Miny P.,University of Basel
Therapeutische Umschau | Year: 2013

New key technologies such as arraybased molecular karyotyping and high throughput sequencing are currently introduced in pre- and postnatal diagnostic testing. These greatly improved genomic testing approaches are beginning to fundamentally change diagnostic strategies in the clinical setting. Molecular karyotyping in the fetus is now routinely performed in high risk situations or on parental request. It will replace the conventional microscopic approach in the near future. Non-invasive prenatal testing to exclude common trisomies is probably the most significant recent achievement and has the potential to dramatically reduce invasive testing. Multiple congenital malformations and intellectual disability (ID) occur in up to 3 % of the general population. A correct diagnosis at an early age is important for clinical management of the patients and for counselling the families with regard to recurrence risk. Conventional karyotyping has been replaced by molecular karyotyping (microarray analysis, Array-CGH), increasing the diagnostic yield up to 15 - 20 % in this population. This approach can be challenging with regard to interpretation of copy number variants of uncertain significance or variants with reduced penetrance. If the clinical assessment leads to the suspicion of a specific syndrome or a leading symptom like epilepsy or microcephaly is present, genetic testing might be directed towards single-gene analysis. However, increasing knowledge indicates that many of these conditions are genetically heterogeneous. The availability of next-generation sequencing techniques has led to the implementation of testing panels in the diagnostic setting, by which multiple genes are analyzed in parallel. This approach allows for increased diagnostic yield in monogenic disorders and defining of more detailed genoptype- phenotype correlations. In addition, whole-exome or whole-genome sequencing has led to the identification of the genetic basis of many known genetic disorders and to the identification and delineation of novel disorders thus allowing a diagnosis in more patients. Fulfilling the potential of the increasing number of options for genetic testing for accurate diagnosis requires close collaboration between clinical geneticists and paediatricians. © 2013 Verlag Hans Huber, Hogrefe AG, Bern.

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