Germline Mutations in RASA1 Are Not Found in Patients with Klippel-Trenaunay Syndrome or Capillary Malformation with Limb Overgrowth

The RASA1 gene encodes p120RASGAP, a multidomain cytoplasmic protein that acts as a negative regulator of the RAS signalling pathway. Heterozygous loss-of-function RASA1 mutations were identified in patients with Parkes Weber syndrome and multifocal capillary malformations. This syndrome is characterised by a capillary blush on an extremity, arteriovenous microfistulas, and bony and soft tissue hypertrophy. The aim of this study was to test RASA1 in 2 disorders characterised by asymmetric limb enlargement and vascular malformations, namely Klippel-Trenaunay syndrome and regional capillary malformation with overgrowth. We did not identify any clear pathogenic change in these patients. Thus, besides clinical and radiological criteria, RASA1 testing constitutes an additional tool to differentiate Parkes Weber syndrome of capillary malformation-arteriovenous malformation (CM-AVM) from overlapping disorders.

[1]  Julie C. Sapp,et al.  Mosaic overgrowth with fibroadipose hyperplasia is caused by somatic activating mutations in PIK3CA , 2012, Nature Genetics.

[2]  J. Shendure,et al.  De novo germline and postzygotic mutations in AKT3, PIK3R2 and PIK3CA cause a spectrum of related megalencephaly syndromes , 2012, Nature Genetics.

[3]  Ugur M Ayturk,et al.  Somatic mosaic activating mutations in PIK3CA cause CLOVES syndrome. , 2012, American journal of human genetics.

[4]  J. Mulliken,et al.  Klippel-Trenaunay Syndrome and Spinal Arteriovenous Malformations: An Erroneous Association , 2010, American Journal of Neuroradiology.

[5]  M. Vikkula,et al.  From germline towards somatic mutations in the pathophysiology of vascular anomalies. , 2009, Human molecular genetics.

[6]  J. Mulliken,et al.  Parkes Weber syndrome, vein of Galen aneurysmal malformation, and other fast‐flow vascular anomalies are caused by RASA1 mutations , 2008, Human mutation.

[7]  R. Hennekam,et al.  Klippel-Trenaunay Syndrome: Diagnostic Criteria and Hypothesis on Etiology , 2008, Annals of plastic surgery.

[8]  P. Lapunzina,et al.  The G397A (E133K) change in the AGGF1 (VG5Q) gene is a single nucleotide polymorphism in the Spanish population , 2006, American journal of medical genetics. Part A.

[9]  W. Foulkes,et al.  Is the E133K allele of VG5Q associated with Klippel-Trenaunay and other overgrowth syndromes? , 2005, Journal of Medical Genetics.

[10]  J. Merland,et al.  Vascular anomalies and the growth of limbs: a review. , 2004, Journal of pediatric orthopedics. Part B.

[11]  P. Szafranski,et al.  Identification of an angiogenic factor that when mutated causes susceptibility to Klippel–Trenaunay syndrome , 2004, Nature.

[12]  Miikka Vikkula,et al.  Capillary malformation-arteriovenous malformation, a new clinical and genetic disorder caused by RASA1 mutations. , 2003, American journal of human genetics.

[13]  M. M. Cohen,et al.  Klippel-Trenaunay syndrome. , 2000, American journal of medical genetics.

[14]  D. Pinto-Escalante,et al.  A new case of Klippel-Trenaunay-Weber (KTW) syndrome: evidence of autosomal dominant inheritance. , 1996, American journal of medical genetics.

[15]  R. Steiner,et al.  Klippel-Trenaunay-Weber syndrome associated with a 5:11 balanced translocation. , 1995, American journal of medical genetics.

[16]  N. Craven,et al.  Familial Klippel–Trenaunay syndrome: a case report , 1995, Clinical and experimental dermatology.

[17]  P. Jorens,et al.  Genetic aspects of the Klippel–Trenaunay syndrome , 1991, The British journal of dermatology.

[18]  J. Mulliken,et al.  Vascular Birthmarks: Hemangiomas and Malformations , 1988 .

[19]  S. F. Mahmoud,et al.  Klippel-Trenaunay syndrome. , 1988, Journal of the American Academy of Dermatology.

[20]  D. L. Viljoen Klippel-Trenaunay-Weber syndrome (angio-osteohypertrophy syndrome). , 1988, Journal of medical genetics.

[21]  M. Servelle Klippel and Trenaunay's Syndrome: 768 Operated Cases , 1985, Annals of surgery.

[22]  J. Mulliken,et al.  Skeletal changes associated with vascular malformations. , 1984, Plastic and reconstructive surgery.

[23]  S. Lindenauer The Klippel‐Trenaunay Syndrome: Varicosity, Hypertrophy and Hemangioma With No Arteriovenous Fistula , 1965, Annals of surgery.

[24]  Perez Fontana,et al.  [Klippel-Trenaunay syndrome]. , 1953 .

[25]  J. Stockman,et al.  A Mosaic Activating Mutation in AKT1 Associated with the Proteus Syndrome , 2013 .

[26]  S. Fishman,et al.  Management of combined vascular malformations. , 2011, Clinics in plastic surgery.

[27]  M. Wassef,et al.  Color Atlas of Vascular Tumors and Vascular Malformations: Introduction: ISSVA Classification , 2007 .