Twin infant with lymphatic dysplasia diagnosed with Noonan syndrome by molecular genetic testing

Fetal Pediatr Pathol. 2014 Aug;33(4):253-7. doi: 10.3109/15513815.2014.904026. Epub 2014 Apr 22.

Abstract

Noonan Syndrome is an autosomal dominant disorder characterized by short stature, congenital heart defects, developmental delay, dysmorphic facial features and occasional lymphatic dysplasias. The features of Noonan Syndrome change with age and have variable expression. The diagnosis has historically been based on clinical grounds. We describe a child that was born with congenital refractory chylothorax and subcutaneous edema suspected to be secondary to pulmonary lymphangiectasis. The infant died of respiratory failure and anasarca at 80 days. The autopsy confirmed lymphatic dysplasia in lungs and mesentery. The baby had no dysmorphic facial features and was diagnosed postmortem with Noonan syndrome by genomic DNA sequence analysis as he had a heterozygous mutation for G503R in the PTPN11 gene.

Keywords: Noonan syndrome; chylothorax; genomic DNA sequence; lymphatic dysplasia; pulmonary lymphangiectasis.

Publication types

  • Case Reports

MeSH terms

  • Chylothorax / congenital
  • Chylothorax / pathology
  • DNA Mutational Analysis
  • Diseases in Twins / diagnosis
  • Diseases in Twins / genetics
  • Diseases in Twins / pathology*
  • Fatal Outcome
  • Humans
  • Infant
  • Lung / pathology
  • Lymphangiectasis / congenital
  • Lymphangiectasis / pathology
  • Lymphatic Abnormalities / pathology*
  • Male
  • Noonan Syndrome / diagnosis
  • Noonan Syndrome / genetics
  • Noonan Syndrome / pathology*
  • Protein Tyrosine Phosphatase, Non-Receptor Type 11 / genetics
  • Twins, Dizygotic

Substances

  • PTPN11 protein, human
  • Protein Tyrosine Phosphatase, Non-Receptor Type 11

Supplementary concepts

  • Chylothorax, congenital