RASA1 Mutations and Associated Phenotypes in 68 Families with Capillary Malformation–Arteriovenous Malformation

N Revencu, LM Boon, A Mendola… - Human …, 2013 - Wiley Online Library
N Revencu, LM Boon, A Mendola, MR Cordisco, J Dubois, P Clapuyt, F Hammer, DJ Amor
Human mutation, 2013Wiley Online Library
Capillary malformation–arteriovenous malformation (CM–AVM) is an autosomal‐dominant
disorder, caused by heterozygous RASA 1 mutations, and manifesting multifocal CM s and
high risk for fast‐flow lesions. A limited number of patients have been reported, raising the
question of the phenotypic borders. We identified new patients with a clinical diagnosis of
CM–AVM, and patients with overlapping phenotypes. RASA 1 was screened in 261 index
patients with: CM–AVM (n= 100), common CM (s)(port‐wine stain; n= 100), S turge–W eber …
Abstract
Capillary malformation–arteriovenous malformation (CM–AVM) is an autosomal‐dominant disorder, caused by heterozygous RASA1 mutations, and manifesting multifocal CMs and high risk for fast‐flow lesions. A limited number of patients have been reported, raising the question of the phenotypic borders. We identified new patients with a clinical diagnosis of CM–AVM, and patients with overlapping phenotypes. RASA1 was screened in 261 index patients with: CM–AVM (n = 100), common CM(s) (port‐wine stain; n = 100), Sturge–Weber syndrome (n = 37), or isolated AVM(s) (n = 24). Fifty‐eight distinct RASA1 mutations (43 novel) were identified in 68 index patients with CM–AVM and none in patients with other phenotypes. A novel clinical feature was identified: cutaneous zones of numerous small white pale halos with a central red spot. An additional question addressed in this study was the “second‐hit” hypothesis as a pathophysiological mechanism for CM–AVM. One tissue from a patient with a germline RASA1 mutation was available. The analysis of the tissue showed loss of the wild‐type RASA1 allele. In conclusion, mutations in RASA1 underscore the specific CM–AVM phenotype and the clinical diagnosis is based on identifying the characteristic CMs. The high incidence of fast‐flow lesions warrants careful clinical and radiologic examination, and regular follow‐up.
Wiley Online Library