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Published on: October 9, 2018
Noonan syndrome
1Department of Medical Genetics, Sydney Children's Hospital, Randwick, New South Wales, Australia.
Insights
Noonan syndrome is a genetic disorder causing distinct facial features and developmental issues. Identifying mutations in genes like PTPN11 aids diagnosis and genetic counseling for affected families.
Area of Science:
- Genetics
- Pediatrics
- Medical Diagnostics
Background:
- Noonan syndrome is a common autosomal dominant disorder with variable clinical presentation.
- Key features include facial dysmorphism, congenital heart defects, short stature, and learning disabilities.
- Diagnosis can be delayed in mildly affected individuals until a more severely affected child is born.
Purpose of the Study:
- To review the genetic basis of Noonan syndrome.
- To highlight the importance of molecular confirmation in diagnosis and management.
- To emphasize the role of increased pediatrician awareness in early detection and genetic counseling.
Main Methods:
- Review of germline mutations in the PTPN11 gene.
- Identification of mutations in other genes within the rat sarcoma (RAS) pathway.
- Discussion of molecular confirmation for diagnosis.
Main Results:
- Germline mutations in the PTPN11 gene explain approximately 50% of Noonan syndrome cases.
- Mutations in additional RAS pathway genes are identified in a portion of remaining cases.
- Molecular confirmation is now feasible for many families.
Conclusions:
- Molecular diagnosis is crucial for guiding Noonan syndrome management.
- Enhanced pediatrician awareness facilitates earlier diagnosis.
- Accurate genetic counseling, including reproductive options, is vital for families.
Abstract:
Noonan syndrome is a common autosomal dominant condition, readily recognisable in childhood. It is characterised by a pattern of typical facial dysmorphism and malformations including congenital cardiac defects, short stature, abnormal chest shape, broad or webbed neck, and a variable learning disability. Mildly affected adults may not be diagnosed until the birth of a more obviously affected child. The phenotype is highly variable. Important progress in understanding the molecular basis of this and other related conditions was made in 2001 when germline mutations in the PTPN11 gene were found to account for ∼50% of cases. Since then, mutations in additional genes in the rat sarcoma (RAS) pathway have been identified in a proportion of the remainder. Molecular confirmation of diagnosis is now possible for many families and has become increasingly important in guiding management. Increased awareness by paediatricians will lead to earlier diagnosis, and provide patients and their families with accurate genetic counselling, including options when planning pregnancy.
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