Prevalence of neurofibromatosis 1 in German children at elementary school enrollment.

OBJECTIVE To determine the prevalence of neurofibromatosis 1 (NF1) among 6-year-old children in Germany. SETTING AND PATIENTS A total of 152819 children aged 6 years in 6 German states were screened for NF1 during routine medical examinations at elementary school enrollment in cooperation with local health departments in 2000 and 2001. MAIN OUTCOME MEASURE The prevalence of NF1 among 6-year-old German children was estimated to be 1:2996 (95% confidence interval, 1:2260 to 1:3984). RESULTS Fifty-one NF1 cases were identified and confirmed by evaluation by appropriate medical specialists. Seven other children were found to have multiple cafe au lait spots without other apparent features of NF1. A minimum estimate of the crude prevalence was 3.0 per 10 000 (95% confidence interval, 2.3-4.0 per 10 000 population). The incidence of NF1 in this population was probably in the range of 30 to 38 cases per 100 000 live births. CONCLUSION Our study obtained a nearly unbiased birth incidence of NF1 of approximately 1 in 2600 to 1 in 3000 and demonstrates that NF1 can be diagnosed by age 6 years in most cases by routine physical examination with special attention to the disease-associated skin stigmata.

[1]  J. Szudek,et al.  Use of the National Institutes of Health Criteria for Diagnosis of Neurofibromatosis 1 in Children , 2000, Pediatrics.

[2]  B. Brownstein,et al.  Type 1 neurofibromatosis gene: identification of a large transcript disrupted in three NF1 patients. , 1990, Science.

[3]  J. Jung,et al.  A genetic study of neurofibromatosis 1 in south-western Ontario. I. Population, familial segregation of phenotype, and molecular linkage. , 1991, Journal of medical genetics.

[4]  V. Riccardi,et al.  Neurofibromatosis: Phenotype, Natural History and Pathogenesis , 1993 .

[5]  W. Grove Statistical Methods for Rates and Proportions, 2nd ed , 1981 .

[6]  Q. Yang,et al.  Mortality in neurofibromatosis 1: an analysis using U.S. death certificates. , 2001, American journal of human genetics.

[7]  B. Everitt,et al.  Statistical methods for rates and proportions , 1973 .

[8]  A. Laor,et al.  Neurofibromatosis type 1 in Israel: survey of young adults. , 1994, Journal of medical genetics.

[9]  S. Huson,et al.  A genetic study of von Recklinghausen neurofibromatosis in south east Wales. I. Prevalence, fitness, mutation rate, and effect of parental transmission on severity. , 1989, Journal of medical genetics.

[10]  R. Gardner,et al.  Prevalence of von Recklinghausen neurofibromatosis in Dunedin, New Zealand. , 1989, Neurofibromatosis.

[11]  Alastair Compston,et al.  The Neurofibromatoses. A pathogenetic and clinical overview , 1994 .

[12]  B. Korf Diagnostic outcome in children with multiple café au lait spots. , 1992, Pediatrics.

[13]  E. Ballone,et al.  Prevalence of neurofibromatosis type 1 among the young adult population of central Italy. , 1998, Archives of dermatology.

[14]  B. Korf,et al.  The diagnostic evaluation and multidisciplinary management of neurofibromatosis 1 and neurofibromatosis 2. , 1997, Journal of the American Medical Association (JAMA).

[15]  P. O'Connell,et al.  A major segment of the neurofibromatosis type 1 gene: cDNA sequence, genomic structure, and point mutations , 1990, Cell.

[16]  E. Zackai,et al.  The diagnosis of neurofibromatosis-1 in the child under the age of 6 years. , 1989, American journal of diseases of children.

[17]  V. Ingordo,et al.  Segmental neurofibromatosis: is it uncommon or underdiagnosed? , 1995, Archives of dermatology.

[18]  B. Katz Neurofibromatosis: Phenotype, Natural History and Pathogenesis , 2001 .

[19]  M. Denckla,et al.  Cognitive function and academic performance in neurofibromatosis. 1: consensus statement from the NF1 Cognitive Disorders Task Force. , 1997, Neurology.

[20]  A. S. Sergeyev On the mutation rate of neurofibromatosis , 1975, Human Genetics.

[21]  D. Grobbee,et al.  Minor disease features in neurofibromatosis type 1 (NF1) and their possible value in diagnosis of NF1 in children < or = 6 years and clinically suspected of having NF1. Neurofibromatosis team of Sophia Children's Hospital. , 1998, Journal of medical genetics.

[22]  T. Matsuishi,et al.  Mutation analysis of the methyl-CpG binding protein 2 gene (MECP2) in patients with Rett syndrome , 2000, Journal of medical genetics.

[23]  B. Samuelsson,et al.  Neurofibromatosis. A clinical and genetic study of 96 cases in Gothenburg, Sweden. , 1981, Acta dermato-venereologica. Supplementum.

[24]  R. Tenconi,et al.  Neurofibromatosis-1: a maximum likelihood estimation of mutation rate , 2004, Human Genetics.

[25]  P. O'Connell,et al.  Deletions and a translocation interrupt a cloned gene at the neurofibromatosis type 1 locus , 1990, Cell.