The diagnosis of neurofibromatosis-1 in the child under the age of 6 years.
One-hundred sixty children under the age of 6 years presented for diagnostic evaluation regarding neurofibromatosis-1 (NF-1). Using the National Institutes of Health Consensus Conference criteria, 151 (94%) of the children were classified on initial examination: 112 were diagnosed as having NF-1 and 39 were found to be unaffected (all 39 have remained asymptomatic on follow-up). Nine could not be classified (3 have subsequently met minimal diagnostic criteria on follow-up). Clinical manifestations of NF-1 include cafe au lait spots (97%), freckling in the axillary or inguinal region (81%), Lisch nodules (30%), neurofibromas (15%), pseudoarthrosis (6%), and optic nerve gliomas (4%). More than minimal diagnostic criteria were met by 80% of the children who had a positive family history and by 32% of those who did not. Thus, the clinical diagnosis of NF-1 is possible in the child who is under 6 years of age, and the National Institutes of Health criteria are useful and applicable.
Obringer
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AC
Division of Oncology, Children's Hospital of Philadelphia, PA 19104.
Meadows
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AT
Zackai
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EH
D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005192:Family Health; D005500:Follow-Up Studies; D006801:Humans; D009456:Neurofibromatosis 1 / Q000150:complications / Q000175:diagnosis*; D010808:Physical Examination / Q000379:methods; D011379:Prognosis; D012880:Skin Pigmentation