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Clinical, familial, and neuroimaging features of CADASIL-like patients.
[cadasil]
Cerebral
autosomal
dominant
arteriopathy
with
subcortical
infarcts
and
leukoencephalopathy
(
CADASIL
)
is
an
inherited
small
vessel
disease
caused
by
NOTCH
3
mutations
.
There
are
no
clinical
and
neuroimaging
findings
pathognomonic
of
the
disease
.
The
aim
of
this
paper
was
to
provide
a
description
of
a
group
of
NOTCH
3
-
negative
patients
with
a
phenotype
closely
resembling
that
of
CADASIL
.
We
performed
NOTCH
3
analysis
(
exons
2
-
23
)
in
117
probands
because
of
a
clinician
's
suspicion
of
CADASIL
.
The
CADASIL
scale
,
a
recently
developed
tool
that
allows
to
better
select
patients
for
NOTCH
3
analysis
,
was
retrospectively
applied
to
NOTCH
3
-
negative
patients
;
the
patient
subgroup
that
scored
higher
than
the
screening
cutoff
for
CADASIL
was
defined
as
CADASIL
-like
.
Thirty
-
four
CADASIL
-like
patients
(
mean
age
at
onset
57
.
8
Â
years
[
52
.
1
-
63
.
4
]
,
50
%
males
)
were
identified
.
Compared
with
25
patients
with
CADASIL
for
clinical
,
familial
,
and
neuroimaging
features
,
only
the
following
variables
were
significantly
(
α
level
<
0
.
05
)
different
in
frequency
between
patients
with
CADASIL
and
CADASIL
-like
patients
:
a
positive
family
history
for
stroke
at
age
≤
60
Â
years
,
more
frequent
in
patients
with
CADASIL
,
and
hypertension
,
more
frequent
in
CADASIL
-like
patients
.
Our
experience
highlights
the
growing
number
of
patients
presenting
with
a
high
suspicion
of
a
cerebral
small
vessel
disease
with
an
autosomal
dominant
pattern
of
inheritance
and
a
phenotype
closely
similar
to
that
of
CADASIL
but
without
NOTCH
3
mutations
.
This
group
remains
to
be
characterized
from
the
genetic
point
of
view
.
The
role
of
other
genes
or
NOTCH
3
alterations
on
exons
other
than
2
-
23
or
introns
has
to
be
further
assessed
.
Diseases
Validation
Diseases presenting
"hypertension"
symptom
achondroplasia
acute rheumatic fever
adrenal incidentaloma
aniridia
aromatase deficiency
cadasil
child syndrome
cohen syndrome
congenital adrenal hyperplasia
congenital diaphragmatic hernia
cushing syndrome
cystinuria
erdheim-chester disease
erythropoietic protoporphyria
esophageal adenocarcinoma
fabry disease
familial hypocalciuric hypercalcemia
gm1 gangliosidosis
heparin-induced thrombocytopenia
hereditary cerebral hemorrhage with amyloidosis
holt-oram syndrome
homocystinuria without methylmalonic aciduria
hydrocephalus with stenosis of the aqueduct of sylvius
inclusion body myositis
kallmann syndrome
kindler syndrome
lamellar ichthyosis
lymphangioleiomyomatosis
pendred syndrome
primary effusion lymphoma
scrub typhus
severe combined immunodeficiency
sneddon syndrome
typhoid
von hippel-lindau disease
well-differentiated liposarcoma
werner syndrome
x-linked adrenoleukodystrophy
zellweger syndrome
This symptom has already been validated