Abstract
Progress in identifying causal mutations has reshaped the way primary lymphedema is managed. Classifying primary lymphedema simply as congenital, praecox, or tarda is no longer adequate. Mutation testing is the way forward, but deep phenotyping is still needed to help discriminate different forms of primary lymphedema for which causal genes are still not known. A proposed algorithm can help with diagnosis. How best to approach those forms of primary lymphedema, which are familial, is presented.
Highlighted References
Connell F, Gordon K, Brice G, et al. The classification and diagnostic algorithm for primary lymphatic dysplasia: an update from 2010 to include molecular findings. Clin Genet. 2013;84(4):303–14.
Alders M, Al-Gazali L, Cordeiro I, et al. Hennekam syndrome can be caused by FAT4 mutations and be allelic to Van Maldergem syndrome. Hum Genet. 2014;133(9):1161–7.
Fotiou E, Martin-Almedina S, Simpson MA, Lin S, Gordon K, Brice G, et al. Novel mutations in PIEZO1 cause an autosomal recessive generalized lymphatic dysplasia with non-immune hydrops fetalis. Nat Commun. 2015;6:8085.
Martin-Almedina S, Martinez-Corral I, Holdhus R, Vicente A, Fotiou E, Lin S, et al. EPHB4 kinase-inactivating mutations cause autosomal dominant lymphatic-related hydrops fetalis. J Clin Invest. 2016;126(8):3080–8.
Ostergaard P, Simpson MA, Connell FC, et al. Mutations in GATA2 cause primary lymphedema associated with a predisposition to acute myeloid leukemia (Emberger syndrome). Nat Genet. 2011;43(10):929–31.
References
Tekola Ayele F, Adeyemo A, Finan C, et al. HLA class II locus and susceptibility to podoconiosis. N Engl J Med. 2012;366(13):1200–8.
Newman B, Lose F, Kedda MA, et al. Possible genetic predisposition to lymphedema after breast cancer. Lymphat Res Biol. 2012;10(1):2–13.
Atton G, Gordon K, Brice G, Keeley V, Riches K, Ostergaard P, et al. The lymphatic phenotype in Turner syndrome: an evaluation of nineteen patients and literature review. Eur J Hum Genet. 2015;12:1634–9.
Joyce S, Gordon K, Brice G, Ostergaard P, Nagaraja R, Short J, et al. The lymphatic phenotype in Noonan and Cardiofaciocutaneous syndrome. Eur J Hum Genet. 2015;24(5):690–6.
Opitz JM. On congenital lymphedema. Am J Med Genet. 1986;24(1):127–9.
Jeffries GH, Chapman A, Sleisenger MH. Low-fat diet in intestinal lymphangiectasia. Its effect on albumin metabolism. N Engl J Med. 1964;270:761–6.
Hennekam RC, Geerdink RA, Hamel BC, et al. Autosomal recessive intestinal lymphangiectasia and lymphedema, with facial anomalies and mental retardation. Am J Med Genet. 1989;34(4):593–600.
Bellini C, Mazzella M, Arioni C, et al. Hennekam syndrome presenting as nonimmune hydrops fetalis, congenital chylothorax, and congenital pulmonary lymphangiectasia. Am J Med Genet A. 2003;120A(1):92–6.
Alders M, Hogan BM, Gjini E, et al. Mutations in CCBE1 cause generalized lymph vessel dysplasia in humans. Nat Genet. 2009;41(12):1272–4.
Jeltsch M, Jha SK, Tvorogov D, Anisimov A, Leppänen VM, Holopainen T, et al. CCBE1 enhances lymphangiogenesis via aA disintegrin and metalloprotease with thrombospondin motifs-3-mediated vascular endothelial growth factor-C activation. Circulation. 2014;129(19):1962–71.
Irrthum A, Devriendt K, Chitayat D, Matthijs G, Glade C, Steijlen PM, et al. Mutations in the transcription factor gene SOX18 underlie recessive and dominant forms of hypotrichosis-lymphedema-telangiectasia. Am J Hum Genet. 2003;72(6):1470–8.
Karkkainen MJ, Ferrell RE, Lawrence EC, et al. Missense mutations interfere with VEGFR-3 signalling in primary lymphoedema. Nat Genet. 2000;25(2):153–9.
Connell FC, Ostergaard P, Carver C, Brice G, Williams N, Mansour S, Mortimer PS, Jeffery S; Lymphoedema Consortium. Analysis of the coding regions of VEGFR3 and VEGFC in Milroy disease and other primary lymphoedemas. Hum Genet 2009;124(6):625–31.
Mellor RH, Hubert CE, Stanton AWB, et al. Lymphatic dysfunction, not aplasia, underlies Milroy disease. Microcirculation. 2010;17(4):281–96.
Brice G, Child AH, Evans A, et al. Milroy disease and the VEGFR-3 mutation phenotype. J Med Genet. 2005;42(2):98–102.
Gordon K, Schulte D, Brice G, et al. Mutation in vascular endothelial growth factor-C, a ligand for vascular endothelial growth factor receptor-3, is associated with autosomal dominant Milroy-like primary lymphedema. Circ Res. 2013;112(6):956.
Kuchler AM, Gjini E, Peterson-Maduro J, Cancilla B, Wolburg H, Schulte-Merker S. Development of the zebrafish lymphatic system requires VEGFC signaling. Curr Biol. 2006;16(12):1244–8.
Aagenaes O, Sigstad H, Bjorn-Hansen R. Lymphoedema in hereditary recurrent cholestasis from birth. Arch Dis Child. 1970;45:690–5.
Ostergaard P, Simpson MA, Mendola A, et al. Mutations in KIF11 cause autosomal-dominant microcephaly variably associated with congenital lymphedema and chorioretinopathy. Am J Hum Genet. 2012;90(2):356–62.
Bull LN. Mapping of the locus for cholestasis-lymphedema syndrome (Aagenaes syndrome) to a 6.6-CM interval on chromosome 15q. Am J Hum Genet. 2000;67:994–9.
Shah S, Conlin LK, Gomez L, Aagenaes Ø, Eiklid K, Knisely AS, et al. CBE1 mutation in two siblings, one manifesting lymphedema-cholestasis syndrome, and the other, fetal hydrops. PLoS One. 2013;8:e75770.
Brice G, Mansour S, Bell R, et al. Analysis of the phenotypic abnormalities in lymphoedema-distichiasis syndrome in 74 patients with FOXC2 mutations or linkage to 16q24. J Med Genet. 2002;39(7):478–83.
Fang JM, Dagenais SL, Erickson RP, et al. Mutations in FOXC2 (MFH-1), a forkhead family transcription factor, are responsible for the hereditary lymphedema-distichiasis syndrome. Am J Hum Genet. 2000;67(6):1382–8.
Petrova TV, Karpanen T, Norrmen C, et al. Defective valves and abnormal mural cell recruitment underlie lymphatic vascular failure in lymphedema distichiasis. Nat Med. 2004;10(9):974–81.
Mellor RH, Brice G, Stanton AWB, et al. Mutations in FOXC2 are strongly associated with primary valve failure in veins of the lower limb. Circulation. 2007;115(14):1912–20.
Meige H. Dystrophie oedemateuse hereditaire. Presse Méd. 1898;6:341–3.
Rezaie T, Ghoroghchian R, Bell R, et al. Primary non-syndromic lymphoedema (Meige disease) is not caused by mutations in FOXC2. Eur J Hum Genet. 2008;16(3):300–4.
Ostergaard P, Simpson MA, Brice G, et al. Rapid identification of mutations in GJC2 in primary lymphoedema using whole exome sequencing combined with linkage analysis with delineation of the phenotype. J Med Genet. 2011;48(4):251–5.
Emberger JM, Navarro M, Dejean M, Izarn P. Deaf mutism, lymphedema of the lower limbs and hematological anomalies (acute-leukemia, cytopenia) with autosomal dominant transmission. J Genet Hum. 1979;27(3):237–45.
Mansour S, Connell F, Steward C, Ostergaard P, Brice G, Smithson S, et al. Lymphoedema Research Consortium. Emberger syndrome-primary lymphedema with myelodysplasia: report of seven new cases. Am J Med Genet A. 2010;152A(9):2287–96.
Spinner MA, Sanchez LA, Hsu AP, et al. GATA2 deficiency: a protean disorder of hematopoiesis, lymphatics, and immunity. Blood. 2014;123(6):809–21.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG
About this chapter
Cite this chapter
Mortimer, P.S., Gordon, K., Brice, G., Mansour, S. (2018). Hereditary and Familial Lymphedemas. In: Lee, BB., Rockson, S., Bergan, J. (eds) Lymphedema. Springer, Cham. https://doi.org/10.1007/978-3-319-52423-8_3
Download citation
DOI: https://doi.org/10.1007/978-3-319-52423-8_3
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-52421-4
Online ISBN: 978-3-319-52423-8
eBook Packages: MedicineMedicine (R0)