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Is osseous dysplasia a primary feature of neurofibromatosis 1 (NF1)?

Authors

  • S Alwan,

    Corresponding author
    1. Department of Medical Genetics, University of British Columbia, and
      Sura Alwan, Department of Medical Genetics, Room 300H Wesbrook Building, 6174 University Boulevard, Vancouver, BC V6T 1Z3, Canada.
      Tel.: +1 604 822 2749;
      fax: +1 604 822 5348;
      e-mail: alwans@interchange.ubc.ca
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  • SJ Tredwell,

    1. Department of Orthopedics, British Columbia's Children's Hospital, Vancouver, BC, Canada
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  • JM Friedman

    1. Department of Medical Genetics, University of British Columbia, and
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Sura Alwan, Department of Medical Genetics, Room 300H Wesbrook Building, 6174 University Boulevard, Vancouver, BC V6T 1Z3, Canada.
Tel.: +1 604 822 2749;
fax: +1 604 822 5348;
e-mail: alwans@interchange.ubc.ca

Abstract

Characteristic skeletal lesions are a cardinal feature of the autosomal dominant condition, neurofibromatosis 1 (NF1). The most frequently involved skeletal sites are the sphenoid wing, vertebrae, and tibia. Osseous lesions may range in severity in NF1 but are often progressive. They may lead to serious clinical consequences and be resistant to treatment. The skeletal lesions of NF1 are usually considered to be ‘dysplasias’, i.e. primary defects of bone, although there is no direct evidence supporting this interpretation. Moreover, it is difficult to understand why a generalized dysplasia of bone would produce focal lesions that show such a striking predisposition to only a few bones. We review the clinical and pathological features of NF1 skeletal lesions and propose that they result from an abnormal response of NF1 halpoinsufficient bone to abnormal mechanical forces rather than from a primary osseous dysplasia.

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