Pal Dominique, Forster Nicole, Madan Monika, Whitney Robyn, Farncombe Kirsten M, Kim Raymond H
Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Fred A. Litwin Family Centre in Genetic Medicine, University Health Network, Toronto, ON, Canada.
Can J Neurol Sci. 2024 Sep;51(5):636-643. doi: 10.1017/cjn.2023.332. Epub 2023 Dec 27.
Our study goal was to characterize the relative frequencies of molecular and phenotypic traits of tuberous sclerosis complex (TSC) in a Canadian adult population. Previous studies have sought to identify TSC-related genotypic and phenotypic trends in pediatric cohorts, but little is known about clinical manifestations and severity when it presents in adults.
We conducted a retrospective chart review of adult patients seen at the TSC clinic at the University Health Network genetics clinics (Toronto, Ontario) to compare trends in the relative frequency of TSC manifestations with genotype.
Fifty-one patients were eligible for this study. Eight patients had a pathogenic/likely pathogenic variant in the tuberous sclerosis complex 1 ( gene, 18 had a tuberous sclerosis complex 2 ( pathogenic/likely pathogenic variant, 6 patients had multiple variants identified in / or /, 11 had no mutation identified (NMI) and 8 had no genetic testing done. Patients with a pathogenic/likely pathogenic variant in presented with an increased involvement of multiple systems and a higher frequency of TSC-related manifestations relative to the other mutation groups.
Previous studies comparing the wide phenotypic variability with TSC genotype have mainly comprised pediatric cohorts. With a focus on adults, we found trends to be similar across previous literature. An informed multidisciplinary approach should be taken to ensure proper surveillance and management of adults with TSC until a correlation between genotype and phenotype, especially past infancy, is better understood.
我们的研究目标是描述加拿大成年人群中结节性硬化症(TSC)分子和表型特征的相对频率。以往的研究试图确定儿科队列中与TSC相关的基因型和表型趋势,但对于其在成人中的临床表现和严重程度知之甚少。
我们对在大学健康网络遗传学诊所(安大略省多伦多)的TSC诊所就诊的成年患者进行了回顾性病历审查,以比较TSC表现的相对频率与基因型的趋势。
51名患者符合本研究条件。8名患者在结节性硬化症1(TSC1)基因中有致病性/可能致病性变异,18名患者在结节性硬化症2(TSC2)基因中有致病性/可能致病性变异,6名患者在TSC1或TSC2中鉴定出多个变异,11名患者未鉴定出突变(NMI),8名患者未进行基因检测。与其他突变组相比,TSC1基因中有致病性/可能致病性变异的患者多系统受累增加,TSC相关表现的频率更高。
以往比较TSC基因型广泛表型变异性的研究主要包括儿科队列。以成年人为重点,我们发现趋势与以往文献相似。应采取明智的多学科方法,以确保对成年TSC患者进行适当的监测和管理,直到更好地理解基因型与表型之间的相关性,尤其是婴儿期以后的相关性。