Skip to main content
Log in

High frequency of hotspot mutation in PTPN11 gene among Moroccan patients with Noonan syndrome

  • Human Genetics • Original Paper
  • Published:
Journal of Applied Genetics Aims and scope Submit manuscript

Abstract

Noonan syndrome (NS; OMIM 163950) is an autosomal dominant RASopathy with variable clinical expression and genetic heterogeneity. Clinical manifestations include characteristic facial features, short stature, and cardiac anomalies. Variants in protein-tyrosine phosphatase, non-receptor-type 11 (PTPN11), encoding SHP-2, account for about half of NS patients, SOS1 in approximately 13%, RAF1 in 10%, and RIT1 each in 9%. Other genes have been reported to cause NS in less than 5% of cases including SHOC2, RASA2, LZTR1, SPRED2, SOS2, CBL, KRAS, NRAS, MRAS, PRAS, BRAF, PPP1CB, A2ML1, MAP2K1, and CDC42. Several additional genes associated with a Noonan syndrome–like phenotype have been identified. Clinical presentation and variants in patients with Noonan syndrome are this study’s objectives. We performed Sanger sequencing of PTPN11 hotspot (exons 3, 8, and 13). We report molecular analysis of 61 patients with NS phenotype belonging to 58 families. We screened for hotspot variants (exons 3, 8, and 13) in PTPN11 gene by Sanger sequencing. Twenty-seven patients were carrying heterozygous pathogenic variants of PTPN11 gene with a similar frequency (41.4%) compared to the literature. Our findings expand the variant spectrum of Moroccan patients with NS phenotype in whom the analysis of hotspot variants showed a high frequency of exons 3 and 8. This screening test allowed us to establish a molecular diagnosis in almost half of the patients with a good benefit–cost ratio, with appropriate management and genetic counseling.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

Abbreviations

NS:

Noonan syndrome

PCR:

Polymerase chain reaction

NA:

Not available

References

  • Bertola DR, Pereira AC, Albano LMJ, De Oliveira PSL, Kim CA, Krieger JE (2006) PTPN11 gene analysis in 74 Brazilian patients with Noonan syndrome or Noonan-like phenotype. Genet Test 10(3):186–191

    Article  CAS  PubMed  Google Scholar 

  • Digilio M, Marino B (2001) Clinical manifestations of Noonan syndrome. Images Paediatr Cardiol 3(2):19–30

    CAS  PubMed  PubMed Central  Google Scholar 

  • Essawi ML, Ismail MF, Afifi HH, Kobesiy MM, El Kotoury A, Barakat MM (2013) Mutational analysis of the PTPN11 gene in Egyptian patients with Noonan syndrome. J Formos Med Assoc Taiwan Yi Zhi 112(11):707–712

    Article  CAS  PubMed  Google Scholar 

  • Faienza MF, Giordani L, Ferraris M, Bona G, Cavallo L (2009) PTPN11 gene mutation and severe neonatal hypertrophic cardiomyopathy: what is the link? Pediatr Cardiol 30(7):1012–1015

    Article  PubMed  Google Scholar 

  • Ferrero GB, Baldassarre G, Delmonaco AG, Biamino E, Banaudi E, Carta C et al (2008) Clinical and molecular characterization of 40 patients with Noonan syndrome. Eur J Med Genet 51(6):566–572

    Article  PubMed  Google Scholar 

  • Hung CS, Lin JL, Lee YJ, Lin SP, Chao MC, Lo FS (2007) Mutational analysis of PTPN11 gene in Taiwanese children with Noonan syndrome. J Formos Med Assoc Taiwan Yi Zhi 106(2):169–172

    Article  CAS  PubMed  Google Scholar 

  • Kosaki K, Suzuki T, Muroya K, Hasegawa T, Sato S, Matsuo N et al (2002) PTPN11 (protein-tyrosine phosphatase, nonreceptor-type 11) mutations in seven Japanese patients with Noonan syndrome. J Clin Endocrinol Metab 87(8):3529–3533

    Article  CAS  PubMed  Google Scholar 

  • Lee ST, Ki CS, Lee HJ (2007) Mutation analysis of the genes involved in the Ras-mitogen-activated protein kinase (MAPK) pathway in Korean patients with Noonan syndrome. Clin Genet 72(2):150–155

    Article  PubMed  Google Scholar 

  • Lepri FR, Scavelli R, Digilio MC, Gnazzo M, Grotta S, Dentici ML et al (2014) Diagnosis of Noonan syndrome and related disorders using target next generation sequencing. BMC Med Genet 23(15):14

    Article  Google Scholar 

  • Linglart L, Gelb BD (2020) Congenital heart defects in Noonan syndrome: diagnosis, management, and treatment. Am J Med Genet C Semin Med Genet 184(1):73–80

    Article  PubMed  PubMed Central  Google Scholar 

  • Musante L, Kehl HG, Majewski F, Meinecke P, Schweiger S, Gillessen-Kaesbach G et al (2003) Spectrum of mutations in PTPN11 and genotype-phenotype correlation in 96 patients with Noonan syndrome and five patients with cardio-facio-cutaneous syndrome. Eur J Hum Genet EJHG 11(2):201–206

    Article  CAS  PubMed  Google Scholar 

  • Narayanan DL, Pandey H, Moirangthem A, Mandal K, Gupta R, Puri RD et al (2017) Hotspots in PTPN11 gene among Indian children with Noonan syndrome. Indian Pediatr 54(8):638–643

    Article  PubMed  Google Scholar 

  • Pierpont ME, Digilio MC (2018) Cardiovascular disease in Noonan syndrome. Curr Opin Pediatr 30(5):601–608

    Article  PubMed  Google Scholar 

  • Razzaque MA, Nishizawa T, Komoike Y, Yagi H, Furutani M, Amo R et al (2007) Germline gain-of-function mutations in RAF1 cause Noonan syndrome. Nat Genet 39(8):1013–1017

    Article  CAS  PubMed  Google Scholar 

  • Roberts AE, Araki T, Swanson KD, Montgomery KT, Schiripo TA, Joshi VA et al (2007) Germline gain-of-function mutations in SOS1 cause Noonan syndrome. Nat Genet 39(1):70–74

    Article  CAS  PubMed  Google Scholar 

  • Roberts AE, Allanson JE, Tartaglia M, Gelb BD (2013) Noonan syndrome. Lancet Lond Engl 381(9863):333–342

    Article  CAS  Google Scholar 

  • Romano AA, Allanson JE, Dahlgren J, Gelb BD, Hall B, Pierpont ME et al (2010) Noonan syndrome: clinical features, diagnosis, and management guidelines. Pediatrics 126(4):746–759

    Article  PubMed  Google Scholar 

  • Sakamoto K, Imamura T, Asai D, Goto-Kawashima S, Yoshida H, Fujiki A et al (2014) Acute lymphoblastic leukemia developing in a patient with Noonan syndrome harboring a PTPN11 germline mutation. J Pediatr Hematol Oncol 36(2):e136-139

    Article  PubMed  Google Scholar 

  • Sarkozy A, Conti E, Seripa D, Digilio MC, Grifone N, Tandoi C et al (2003) Correlation between PTPN11 gene mutations and congenital heart defects in Noonan and LEOPARD syndromes. J Med Genet 40(9):704–708

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Sznajer Y, Keren B, Baumann C, Pereira S, Alberti C, Elion J et al (2007) The spectrum of cardiac anomalies in Noonan syndrome as a result of mutations in the PTPN11 gene. Pediatrics 119(6):e1325-1331

    Article  PubMed  Google Scholar 

  • Tartaglia M, Kalidas K, Shaw A, Song X, Musat DL, van der Burgt I et al (2002) PTPN11 mutations in Noonan syndrome: molecular spectrum, genotype-phenotype correlation, and phenotypic heterogeneity. Am J Hum Genet 70(6):1555–1563

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Tartaglia M, Gelb BD, Zenker M (2011) Noonan syndrome and clinically related disorders. Best Pract Res Clin Endocrinol Metab 25(1):161–179

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Tartaglia M, Aoki Y, Gelb BD (2022) The molecular genetics of RASopathies: An update on novel disease genes and new disorders. Am J Med Genet C Semin Med Genet 190C:425–439

    Article  Google Scholar 

  • Zenker M, Lehmann K, Schulz AL, Barth H, Hansmann D, Koenig R et al (2007) Expansion of the genotypic and phenotypic spectrum in patients with KRAS germline mutations. J Med Genet 44(2):131–135

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

We thank the patients and their families.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Fatima Ouboukss.

Ethics declarations

Consent for publication

Each parent of the patients gave written consent for clinical data to be published.

Additional information

Communicated by: Ewa Ziętkiewicz

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ouboukss, F., Adadi, N., Amasdl, S. et al. High frequency of hotspot mutation in PTPN11 gene among Moroccan patients with Noonan syndrome. J Appl Genetics 65, 303–308 (2024). https://doi.org/10.1007/s13353-023-00803-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13353-023-00803-6

Keywords

Navigation