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  lüll Noonan syndrome van der Burgt IOrphanet J Rare Dis  2007[Jan]; 2 (ä): 4Noonan Syndrome (NS) is characterised by short stature, typical facial  dysmorphology and congenital heart defects. The incidence of NS is estimated to  be between 1:1000 and 1:2500 live births. The main facial features of NS are  hypertelorism with down-slanting palpebral fissures, ptosis and low-set  posteriorly rotated ears with a thickened helix. The cardiovascular defects most  commonly associated with this condition are pulmonary stenosis and hypertrophic  cardiomyopathy. Other associated features are webbed neck, chest deformity, mild  intellectual deficit, cryptorchidism, poor feeding in infancy, bleeding tendency  and lymphatic dysplasias. The syndrome is transmitted as an autosomal dominant  trait. In approximately 50% of cases, the disease is caused by missense mutations  in the PTPN11 gene on chromosome 12, resulting in a gain of function of the  non-receptor protein tyrosine phosphatase SHP-2 protein. Recently, mutations in  the KRAS gene have been identified in a small proportion of patients with NS. A  DNA test for mutation analysis can be carried out on blood, chorionic villi and  amniotic fluid samples. NS should be considered in all foetuses with  polyhydramnion, pleural effusions, oedema and increased nuchal fluid with a  normal karyotype. With special care and counselling, the majority of children  with NS will grow up and function normally in the adult world. Management should  address feeding problems in early childhood, evaluation of cardiac function and  assessment of growth and motor development. Physiotherapy and/or speech therapy  should be offered if indicated. A complete eye examination and hearing evaluation  should be performed during the first few years of schooling. Preoperative  coagulation studies are indicated. Signs and symptoms lessen with age and most  adults with NS do not require special medical care.|Adolescent[MESH]|Adult[MESH]|Child[MESH]|Child Development[MESH]|Child, Preschool[MESH]|Female[MESH]|Genetic Counseling/methods[MESH]|Humans[MESH]|Infant[MESH]|Infant, Newborn[MESH]|Intracellular Signaling Peptides and Proteins/genetics[MESH]|Mutation, Missense[MESH]|Noonan Syndrome/*diagnosis/genetics/physiopathology/*therapy[MESH]|Pregnancy[MESH]|Prenatal Diagnosis/methods[MESH]|Prognosis[MESH]|Protein Tyrosine Phosphatase, Non-Receptor Type 11[MESH]|Protein Tyrosine Phosphatases/genetics[MESH] |