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FBN1<br />

89308<br />

range of variability, including intrafamilial variability, in expressivity among FBN1 mutations.<br />

Approximately two thirds of FBN1 mutations are missense mutations, with the majority of these being<br />

cysteine substitutions. Approximately 25% to 33% of FBN1 mutations are de novo mutations, in which an<br />

individual has no family history of disease. FBN1 mutations have been shown to occur across the gene<br />

with very few genotype-phenotype correlations, with the exception of the association of neonatal MFS<br />

and mutations in exons 24 through 32. Genetic testing for FBN1 mutations allows for the confirmation of<br />

a suspected genetic disease. Confirmation of MFS or other FBN1-associated genetic diseases allows for<br />

proper treatment and management of the disease and preconception, prenatal, and family counseling.<br />

Useful For: Genetic testing of individuals at risk for a known FBN1 mutation<br />

Interpretation: An interpretive report will be provided.<br />

Reference Values:<br />

An interpretive report will be provided.<br />

Clinical References: 1. Faivre L, Collod-Beroud G, Loeys BL, et al: Effect of mutation type and<br />

location on clinical outcome of 1013 probands with Marfan syndrome or related phenotypes and FBN1<br />

mutations: an international study. Am J Hum Genet 2007 Sept;81(3):454-466 2. Tjeldhorn L,<br />

Rand-Hendriksen S, Gervin K, et al: Rapid and efficient FBN1 mutation detection using automated<br />

sample preparation and direct sequencing as the primary strategy. Genet <strong>Test</strong> 2006;10(4):258-264 3.<br />

Boileau C, Jondeau G, Mizuguchi T, Matsumoto N: Molecular genetics of Marfan syndrome. Curr Opin<br />

Cardiol 2005May;20(3):194-200 4. Sood S, Eldadah ZA, Krause WL, et al: Mutation in fibrillin-1 and the<br />

Marfanoid-craniosynostosis (Shprintzen-Goldberg) syndrome. Nat Genet 1996 Feb;12(2):209-211 5.<br />

Faivre L, Gorlin RJ, Wirtz MK, et al: In frame fibrillin-1 gene deletion in autosomal dominant<br />

Weill-Marchesani syndrome. J Med Genet 2003 Jan;40(1):34-36<br />

FBN1, Full Gene Sequence<br />

Clinical Information: Fibrillin-1 is a 320-kD cysteine-rich glycoprotein found in the extracellular<br />

matrix. Monomers of fibrillin-1 associate to form microfibrils, which provide mechanical stability and<br />

elastic properties to connective tissues. Fibrillin-1 is encoded by the FBN1 gene, which contains 65 exons<br />

and is located at chromosome 15q21. FBN1 mutations are most commonly associated with Marfan<br />

syndrome (MFS), an autosomal dominant connective tissue disorder involving the ocular, skeletal, and<br />

cardiovascular systems. Ocular MFS manifestations most commonly include myopia and lens<br />

displacement. Skeletal manifestations can include arachnodactyly (abnormally long and slender fingers<br />

and toes), dolichostenomelia (long limbs), pectus (chest wall) deformity, and scoliosis. Cardiovascular<br />

manifestations, which are the major cause of early morbidity and mortality in MFS, include aortic dilation<br />

and aortic aneurysm and dissection, as well as mitral valve and tricuspid valve prolapse. There is<br />

significant inter- and intrafamilial variability in MFS phenotype. FBN1 mutations have also been reported<br />

in several other rare phenotypes with variable overlap with classic MFS. These conditions include<br />

neonatal MFS, autosomal dominant ectopia lentis (displacement of the lens of the eye), familial thoracic<br />

aortic aneurysm and dissection, isolated skeletal features of MFS, MASS phenotype (mitral valve<br />

prolapse, aortic diameter increased, stretch marks, skeletal features of MFS), Shprintzen-Goldberg<br />

syndrome (Marfanoid-craniosynostosis; premature ossification and closure of sutures of the skull), and<br />

autosomal dominant Weill-Marchesani syndrome (short stature, short fingers, ectopia lentis). Hundreds of<br />

mutations have been identified in FBN1, many of them unique to individual families. There is a wide<br />

range of variability, including intrafamilial variability, in expressivity among FBN1 mutations.<br />

Approximately two thirds of FBN1 mutations are missense mutations, with the majority of these being<br />

cysteine substitutions. Approximately 25% to 33% of FBN1 mutations are de novo mutations, in which an<br />

individual has no family history of disease. FBN1 mutations have been shown to occur across the gene<br />

with very few genotype-phenotype correlations, with the exception of the association of neonatal MFS<br />

and mutations in exons 24 through 32. Genetic testing for FBN1 mutations allows for the confirmation of<br />

a suspected genetic disease. Confirmation of MFS or other FBN1-associated genetic diseases allows for<br />

proper treatment and management of the disease and preconception, prenatal, and family counseling.<br />

Useful For: Aiding in the diagnosis of FBN1-associated Marfan syndrome, neonatal Marfan syndrome,<br />

autosomal dominant ectopia lentis, isolated ascending aortic aneurysm and dissection, isolated skeletal<br />

Current as of January 4, 2013 7:15 pm CST 800-533-1710 or 507-266-5700 or <strong>Mayo</strong><strong>Medical</strong><strong>Laboratories</strong>.com Page 730

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