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Von hippel-lindau disease: a genetic and clinical review.
[von hippel-lindau disease]
Von
Hippel-
Lindau
Disease
(
VHL
)
is
an
autosomal
dominant
inherited
systemic
cancer
syndrome
that
gives
rise
to
cystic
and
highly
vascularized
tumors
in
many
organs
,
including
the
eye
.
Recent
studies
have
contributed
to
the
understanding
of
VHL
pathophysiology
,
genetics
,
and
the
role
of
the
VHL
protein
.
This
article
reviews
recent
studies
on
VHL
clinical
findings
,
genetics
and
tumorigenesis
.
Literature
review
of
articles
on
VHL
genetics
with
correlation
to
clinical
findings
.
Genotype-phenotype
correlation
studies
show
that
patients
with
a
complete
deletion
mutation
of
the
VHL
gene
,
relative
to
participants
with
a
missense
or
protein-truncating
mutation
,
had
better
visual
acuity
and
decreased
tumorigenesis
incidence
of
retinal
hemangioblastomas
.
It
has
also
been
documented
that
higher
levels
of
vascular
endothelial
growth
factor
(
VEGF
)
,
hypoxia
induced
factor
(
HIF
)
,
and
ubiquitin
are
found
in
ocular
hemangioblastomas
.
The
stromal
foamy
vacuolated
cells
seem
to
be
the
true
tumor
cells
of
the
disease
acting
on
the
surrounding
endothelial
cells
in
ocular
hemangioblastomas
.
Tumor
cells
and
ocular
lesions
have
shown
increased
levels
of
Erythropoietin
(
Epo
)
,
Epo
receptor
(
EpoR
)
,
and
CD
133
.
Also
,
CXCR
4
,
a
CXC
chemokine
receptor
,
is
expressed
in
retinal
VHL
hemangioblastomas
.
Recent
studies
suggest
that
the
VHL
mutation
alone
may
not
be
sufficient
to
develop
VHL
-associated
neoplasms
.
Studies
suggest
that
targeting
various
proteins
along
with
anti-angiogenesis
molecules
may
be
a
better
therapeutic
approach
than
targeting
VEGF
alone
.
Understanding
of
the
mechanisms
and
genetics
underlying
VHL
and
its
associated
retinal
hemangioblastomas
has
increased
substantially
in
recent
years
.
This
knowledge
suggests
that
future
advances
may
include
better
identification
of
individuals
at
higher
risk
of
vision
loss
and
the
development
of
novel
individualized
therapies
.
Diseases
Validation
Diseases presenting
"growth factor"
symptom
22q11.2 deletion syndrome
achondroplasia
adrenal incidentaloma
aniridia
cadasil
cholangiocarcinoma
coats disease
dedifferentiated liposarcoma
dentin dysplasia
dentinogenesis imperfecta
dystrophic epidermolysis bullosa
esophageal carcinoma
esophageal squamous cell carcinoma
hodgkin lymphoma, classical
holt-oram syndrome
inclusion body myositis
kallmann syndrome
krabbe disease
liposarcoma
lymphangioleiomyomatosis
oculocutaneous albinism
oral submucous fibrosis
pleomorphic liposarcoma
primary effusion lymphoma
primary hyperoxaluria type 1
severe combined immunodeficiency
systemic capillary leak syndrome
von hippel-lindau disease
wolf-hirschhorn syndrome
x-linked adrenoleukodystrophy
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