title: The ominous sequence in patients with tuberous sclerosis complex.
abstract: BACKGROUND
  The clinical phenotypes and their severity in patients with tuberous sclerosis complex can be quite variable and are sometimes never determined simply by the primary mutation. These make clinically selecting appropriate treatments and predicting disease outcome difficult. In this report, the prognostic ominous sequence was evaluated in association with clinical manifestations and gene mutations.
  
  
  METHODS
  The patients were classified by each renal lesion of angiomyolipomas and polycystic disease. The other clinical manifestations and outcomes of epilepsy, mental retardation, facial angiofibromas, subependymal giant cell astrocytoma, cortical tubers were reviewed and each gene mutations were analyzed in seven unrelated patients.
  
  
  RESULTS
  Two patients with multiple and large proliferative renal angiomyolipoma showed poor clinical outcome than the patients with other renal lesions. These patients presented with progressively proliferative facial angiofibroma, West syndrome, Lennox-Gastaut syndrome, severe mental retardation, subependymal giant cell astrocytoma and they were affected by TSC2 gene mutations.
  
  
  CONCLUSIONS
  The sequence of progressively proliferative renal angiomyolipoma, facial angiofibroma, West syndrome and TSC2 gene mutations might be prognostic ominous factors.
authors: Department of Pediatrics and Child Neurology, Oita University Faculty of Medicine, Oita, Japan. Electronic address: hyamada@oita-u.ac.jp.
authors: Hiroshi
authors: H
authors: Yamada
authors: Department of Pediatrics and Child Neurology, Oita University Faculty of Medicine, Oita, Japan.
authors: Kensuke
authors: K
authors: Akiyoshi
authors: Department of Pediatrics and Child Neurology, Oita University Faculty of Medicine, Oita, Japan.
authors: Tatsuro
authors: T
authors: Izumi
mesh_terms: D000293:Adolescent; D000328:Adult; D018322:Angiofibroma / Q000175:diagnosis / Q000235:genetics / Q000503:physiopathology; D018207:Angiomyolipoma / Q000175:diagnosis / Q000235:genetics / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005153:Facial Neoplasms / Q000175:diagnosis / Q000235:genetics / Q000503:physiopathology; D005260:Female; D006801:Humans; D007223:Infant; D007680:Kidney Neoplasms / Q000175:diagnosis / Q000235:genetics / Q000503:physiopathology; D008297:Male; D009154:Mutation; D007690:Polycystic Kidney Diseases / Q000175:diagnosis / Q000235:genetics / Q000503:physiopathology; D011379:Prognosis; D013036:Spasms, Infantile / Q000175:diagnosis / Q000235:genetics / Q000503:physiopathology; D014402:Tuberous Sclerosis / Q000175:diagnosis* / Q000235:genetics / Q000503:physiopathology*; D000077004:Tuberous Sclerosis Complex 1 Protein; D000077005:Tuberous Sclerosis Complex 2 Protein; D025521:Tumor Suppressor Proteins / Q000235:genetics
chemical_list: C000624650:TSC1 protein, human; C000624653:TSC2 protein, human; D000077004:Tuberous Sclerosis Complex 1 Protein; D000077005:Tuberous Sclerosis Complex 2 Protein; D025521:Tumor Suppressor Proteins
keywords: Angiomyolipomas; TSC1; TSC2; Tuberous sclerosis complex; West syndrome