Mid-aortic syndrome with renovascular hypertension and multisystem involvement in a girl with familiar neurofibromatosis von Recklinghausen type 1.
OBJECTIVE
Neurofibromatosis von Recklinghausen type 1 (NF1) is an autosomal dominant neurocutaneous disorder affecting one in 3 000-4 000 individuals. Mid-aortic syndrome (MAS) is a rare condition characterized by segmental narrowing of abdominal aorta and stenosis of its major branches - mainly renal arteries, including manifestation of renovascular hypertension. MAS can be caused by different diseases, including NF1.


RESULTS
A 9 years old girl with primary diagnosis of NF1 combined with renovascular hypertension due to MAS, suffered of bilateral optic and chiasm glioma, pubertas praecox, speech disorder, light mental retardation and scoliosis. We have found a mutation in exone 34 of the NF1 gene (17q11.2). Her father has been also diagnosed with NF1 and hypertension developed at early age. He has the same mutation in exone 34 of NF1 gene. The girl is currently treated with conservative antihypertensive medication with positive effect. Bilateral optic and chiasm glioma are asymptomatic at the time and they had been without progress over period of time. Any vascular surgery, neurosurgical and oncological therapy are not indicated at the present time.


CONCLUSIONS
This article is a summary of clinical findings in patient with NF1 due to NF1 gene mutation in exone 34. It confirms the importance of complex multidisciplinar approach to examination and taking care of NF1 patients and their families.
Department of Child Neurology, Charles University, 2nd Medical School and University Hospital Motol, Prague, Czech Republic. borivoj.petrak@post.cz
Borivoj
B
Petrak
Sarka
S
Bendova
Tomas
T
Seeman
Tibor
T
Klein
Jiri
J
Lisy
Tomas
T
Zatrapa
Tana
T
Marikova
D001012:Aorta, Abdominal / Q000002:abnormalities / Q000473:pathology; D001018:Aortic Diseases / Q000150:complications* / Q000235:genetics / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D003251:Constriction, Pathologic; D005260:Female; D005910:Glioma / Q000150:complications* / Q000235:genetics / Q000473:pathology; D006801:Humans; D006978:Hypertension, Renovascular / Q000150:complications* / Q000235:genetics / Q000473:pathology; D017379:Hypertrophy, Left Ventricular / Q000150:complications / Q000235:genetics; D009154:Mutation; D009456:Neurofibromatosis 1 / Q000150:complications / Q000235:genetics* / Q000378:metabolism / Q000473:pathology; D025542:Neurofibromin 1 / Q000235:genetics* / Q000378:metabolism; D009897:Optic Chiasm / Q000473:pathology; D019574:Optic Nerve Neoplasms / Q000150:complications* / Q000235:genetics / Q000473:pathology; D014176:Protein Biosynthesis; D012333:RNA, Messenger / Q000378:metabolism; D012077:Renal Artery / Q000473:pathology; D013577:Syndrome
D025542:Neurofibromin 1; D012333:RNA, Messenger