Toll Agustí, Parera Elisabet, Giménez-Arnau Ana M, Pou Alejandro, Lloreta Josep, Limaye Nisha, Vikkula Miikka, Pujol Ramon M
Department of Dermatology, Hospital del Mar, IMAS, Barcelona ES-08003, Spain.
Dermatology. 2009;218(4):307-13. doi: 10.1159/000199461. Epub 2009 Jan 31.
Cerebral cavernous malformations (CCMs) are vascular lesions characterized by abnormally enlarged capillary cavities without intervening brain parenchyma. Although often asymptomatic, seizures, cerebral haemorrhages and focal neurological deficits are well-documented complications. Mutations in the CCM1 (7q21-22), CCM2 (7p13-15) and CCM3 (3q25.2-27) genes have been identified in familial CCM. In rare instances, the association of congenital hyperkeratotic cutaneous capillary-venous malformations (HCCVMs) with CCM1 has been reported.
We studied 6 members of a family with CCMs. Four members of the family developed late-onset multiple, tiny, bluish, soft, cutaneous papules, mainly located on the face, arm and abdominal area, corresponding histologically to venous malformations. A splice donor site mutation in intron 4 (c. 1146 + 1 G-->A) in the CCM1 gene was identified.
Our findings suggest that mutations in the KRIT1 gene may cause phenotypically heterogeneous cutaneous vascular lesions other than those previously described as HCCVMs.
脑海绵状血管畸形(CCM)是一种血管病变,其特征为毛细血管腔异常扩大且无中间脑实质。尽管通常无症状,但癫痫发作、脑出血和局灶性神经功能缺损是有充分记录的并发症。在家族性CCM中已鉴定出CCM1(7q21 - 22)、CCM2(7p13 - 15)和CCM3(3q25.2 - 27)基因的突变。在罕见情况下,已有先天性角化过度性皮肤毛细血管 - 静脉畸形(HCCVM)与CCM1关联的报道。
我们研究了一个患有CCM的家族的6名成员。该家族的4名成员出现了迟发性多发性、微小、蓝色、柔软的皮肤丘疹,主要位于面部、手臂和腹部区域,组织学上对应静脉畸形。在CCM1基因的内含子4中鉴定出一个剪接供体位点突变(c. 1146 + 1 G→A)。
我们的研究结果表明,KRIT1基因的突变可能导致表型异质性的皮肤血管病变,而非先前描述的HCCVM。