European Journal of Pediatrics

, 168:919

Noonan syndrome caused by germline KRAS mutation in Taiwan: report of two patients and a review of the literature

  • Fu-Sung Lo
  • Ju-Li Lin
  • Min-Tzu Kuo
  • Pao-Chin Chiu
  • San-Ging Shu
  • Mei-Chyn Chao
  • Yann-Jinn Lee
  • Shuan-Pei Lin
Original Paper


Noonan syndrome is a highly variable disorder that has significant phenotypic overlap with Costello syndrome and cardio-facio-cutaneous syndrome. KRAS mutation was the second reported gene for Noonan syndrome. This study screened for mutation of the KRAS gene in 57 unrelated ethnic Chinese children suffering from Noonan syndrome without PTPN11 gene mutation in Taiwan. This work only identified two patients with different missense mutations (c.40G>A, p.Val14Ile; c.108A>G, p.Ile36Met) in the exon 1 of KRAS gene. This study also analyzed the characteristics of 34 reported cases involving KRAS mutations in the literature. All these patients presented with variable phenotypes, including Noonan syndrome (n = 19), cardio-facio-cutaneous syndrome (n = 7), Costello syndrome (n = 6), and Noonan/cardio-facio-cutaneous syndrome (n = 1). The phenotype of KRAS mutations was generally severe, including short stature, mental retardation, heart defects, etc. In conclusion, this investigation demonstrates that KRAS mutations are the cause in a minority of cases of Chinese patients with Noonan syndrome in Taiwan.


Noonan syndrome KRAS Mutation analysis Cardio-facio-cutaneous syndrome Costello syndrome 



Noonan syndrome


Cardio-facio-cutaneous syndrome


Costello syndrome


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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Fu-Sung Lo
    • 1
  • Ju-Li Lin
    • 1
  • Min-Tzu Kuo
    • 1
  • Pao-Chin Chiu
    • 2
  • San-Ging Shu
    • 3
  • Mei-Chyn Chao
    • 4
  • Yann-Jinn Lee
    • 5
  • Shuan-Pei Lin
    • 5
  1. 1.Division of Pediatric Endocrinology, Department of Pediatrics, Chang Gung Memorial HospitalChung Gung University College of MedicineTaoyuanTaiwan
  2. 2.Department of PediatricsKaohsiung Veterans General HospitalKaohsiungTaiwan
  3. 3.Department of PediatricsTaichung Veterans General HospitalTaichungTaiwan
  4. 4.Department of PediatricsKaoshiung Medical University HospitalKaoshiungTaiwan
  5. 5.Departments of PediatricsMackay Memorial HospitalTaipeiTaiwan

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