1. Rapidly progressive hypertrophic cardiomyopathy in an infant with Noonan syndrome with multiple lentigines: Palliative treatment with a rapamycin analog
- Author
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Reinhard Kandolf, Susanne von Gerlach, Martin Zenker, Bruce D. Gelb, K. Behnke-Hall, Josef Thul, Anne Schänzer, Dietmar Schranz, Boyan K. Garvalov, Tushiha Logeswaran, Maria I. Kontaridis, Andreas Hahn, Jessica Lauriol, and Nuray Böğürcü
- Subjects
Male ,medicine.medical_specialty ,Palliative care ,medicine.medical_treatment ,DNA Mutational Analysis ,Mutation, Missense ,Protein Tyrosine Phosphatase, Non-Receptor Type 11 ,Article ,Muscle hypertrophy ,Internal medicine ,LEOPARD Syndrome ,Genetics ,medicine ,Humans ,Everolimus ,cardiovascular diseases ,Genetic Association Studies ,Genetics (clinical) ,Heart transplantation ,Base Sequence ,business.industry ,Myocardium ,Palliative Care ,Hypertrophic cardiomyopathy ,Cardiomyopathy, Hypertrophic ,medicine.disease ,Brain natriuretic peptide ,Endocrinology ,Heart failure ,Disease Progression ,cardiovascular system ,Cardiology ,Heart Transplantation ,business ,Immunosuppressive Agents ,Noonan Syndrome with Multiple Lentigines ,medicine.drug - Abstract
Noonan syndrome with multiple lentigines (NSML) frequently manifests with hypertrophic cardiomyopathy (HCM). Recently, it was demonstrated that mTOR inhibition reverses HCM in NSML mice. We report for the first time on the effects of treatment with a rapamycin analog in an infant with LS and a malignant form of HCM. In the boy, progressive HCM was diagnosed during the first week of life and diagnosis of NSML was established at age 20 weeks by showing a heterozygous Q510E mutation in the PTPN11 gene. Immunoblotting with antibodies against pERK, pAkt, and pS6RP in fibroblasts demonstrated reduced RAS/MAPK and enhanced Akt/mTOR pathway activities. Because of the patient’s critical condition, everolimus therapy was started at age 24 weeks and continued until heart transplantation at age 36 weeks. Prior to surgery, heart failure improved from NYHA stage IV to II and brain natriuretic peptide values decreased from 9600 to
- Published
- 2015
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