Is neurofibromatosis type 1 diagnosed in every patient who presents with café au lait macules? A single-center experience

Abstract

Objective: Neurofibromatosis type 1 (NF1) is the most common hereditary neurocutaneous syndrome. The most crucial morbidity of
 NF1 is tumors that may develop. Cases with café-au-lait macules (CALMs) which is the first clinical finding of NF1, due to the anxiety
 of its associated morbidity, are referred to the pediatric oncology clinic. In this study, we aimed to examine the characteristics of the
 patients who applied to our outpatient clinic with CALMs.
 Patients and Methods: The data of 157 pediatric patients who applied to our institution with the diagnosis of CALMs between June
 2010 and November 2020 were analyzed retrospectively.
 Results: There were 157 pediatric cases referred to us for CALMs. According to the National Institutes of Health (NIH) diagnostic
 criteria, 109 (69.4%) cases were diagnosed with NF1. The diagnosis of 22 cases with NF1 were supported by genetic examination.
 Optic glioma was detected in 39 (24.8%) cases. In 15 (38.4%) of cases with optic glioma, visual functions were also affected. Second
 diagnostic criterion did not develop during the follow-up period, except for macules, in 48 cases (30.5%).
 Conclusion: In cases with multiple CALMs, the probability of NF1 diagnosis is high, and close and regular follow-up is of great
 importance in catching the development of the second clinical criterion and minimizing its morbidity.