Dural ectasia in Loeys-Dietz syndrome: comprehensive study of 30 patients with a TGFBR1 or TGFBR2 mutation

Clin Genet. 2014 Dec;86(6):545-51. doi: 10.1111/cge.12308. Epub 2013 Dec 17.

Abstract

The purpose of this study was to assess the frequency, severity, and clinical associations of dural ectasia (DE) in Loeys-Dietz syndrome (LDS). Database analysis of three German metropolitan regions identified 30 patients with LDS and TGFBR1 mutation in 6 and a TGFBR2 mutation in 24 individuals (17 men; mean age: 31 ± 19 years), as well as 60 age and sex-matched control patients with Marfan syndrome carrying a FBN1 mutation. DE was present in 22 patients with LDS (73%), and it related to skeletal score points (p = 0.008), non-skeletal score points (p < 0.001), and to the presence of ≥7 systemic score points (p = 0.010). Similarly, the severity of DE was related to body height (p = 0.010) and non-skeletal score points (p = 0.004). Frequency (p = 0.131) and severity of DE (p = 0.567) was similar in LDS and Marfan syndrome. DE is a manifestation of LDS that occurs with similar frequency and severity as in Marfan syndrome. Severity of DE may serve as a marker of the overall connective tissue disease severity. LDS may be considered in patients with DE.

Keywords: Loeys-Dietz syndrome; Marfan syndrome; TGFBR1; TGFBR2; dural ectasia.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Body Height
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Dilatation, Pathologic / genetics*
  • Female
  • Humans
  • Loeys-Dietz Syndrome / genetics*
  • Loeys-Dietz Syndrome / physiopathology
  • Magnetic Resonance Imaging
  • Male
  • Marfan Syndrome / genetics
  • Marfan Syndrome / physiopathology
  • Middle Aged
  • Mutation*
  • Protein Serine-Threonine Kinases / genetics*
  • Receptor, Transforming Growth Factor-beta Type I
  • Receptor, Transforming Growth Factor-beta Type II
  • Receptors, Transforming Growth Factor beta / genetics*
  • Young Adult

Substances

  • Receptors, Transforming Growth Factor beta
  • Protein Serine-Threonine Kinases
  • Receptor, Transforming Growth Factor-beta Type I
  • Receptor, Transforming Growth Factor-beta Type II
  • TGFBR1 protein, human