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Genotype-phenotype correlations, and retinal function and structure in von Hippel-Lindau disease.
[von hippel-lindau disease]
To
investigate
genotype-phenotype
correlation
and
to
analyze
functional
and
structural
changes
in
the
retina
of
patients
with
von
Hippel-
Lindau
(
VHL
)
disease
.
Thirteen
patients
from
four
families
(
A
,
B
,
C
and
D
)
with
known
VHL
disease
and
known
mutations
in
the
VHL
gene
were
examined
.
All
patients
underwent
clinical
examination
and
optical
coherence
tomography
(
OCT
)
.
Full-field
electroretinography
(
full-field
ERG
)
was
performed
in
twelve
patients
.
Family
A
,
with
deletion
of
exon
3
in
the
VHL
gene
,
and
family
B
,
with
the
missense
mutation
p
.
R
79
P
,
exhibited
type
1
VHL
characterized
by
the
absence
of
pheochromocytoma
and
a
high
incidence
of
central
nervous
system
hemangioblastomas
.
One
member
of
family
B
exhibited
Goldenhar
syndrome
.
A
novel
missense
mutation
(
p
.
L
198
P
)
was
identified
in
the
VHL
gene
in
the
patient
from
family
C
.
This
p
.
L
198
P
mutation
caused
a
phenotype
with
early
onset
of
a
neuroendocrine
tumor
of
the
pancreas
,
bilateral
pheochromocytomas
,
and
optic
nerve
hemangioblastoma
.
Full-field
ERG
showed
significantly
prolonged
implicit
times
of
the
b
-wave
and
maximal
combined
a-wave
in
VHL
patients
,
compared
to
controls
.
Examination
of
the
retinal
structure
in
all
patients
with
VHL
,
using
OCT
,
showed
a
significant
decrease
in
retinal
thickness
in
VHL
patients
without
ocular
hemangioblastomas
,
compared
to
controls
.
Our
findings
support
previously
established
genotype-phenotype
correlations
.
However
,
we
here
describe
an
unusual
phenotype
with
a
novel
missense
mutation
,
p
.
L
198
P
,
and
report
the
finding
that
VHL
disease
can
be
associated
with
Goldenhar
syndrome
.
Electrophysiological
and
structural
findings
suggest
that
VHL
disease
is
a
progressive
,
neurodegenerative
disease
of
the
retina
.
Diseases
Validation
Diseases presenting
"known mutations in the vhl gene"
symptom
von hippel-lindau disease
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