Noonan syndrome with multiple lentigines (NSML) which is part of a group called Ras/MAPK pathway syndromes, is a rare autosomal dominant, multisystem disease caused by a mutation in the protein tyrosine phosphatase, non-receptor type 11 gene (PTPN11). The disease is a complex of features, mostly involving the skin, skeletal and cardiovascular systems, which may or may not be present in all patients. The nature of how the mutation causes each of the conditions symptoms is not well known; however, research is ongoing. It is a RASopathy. Noonan syndrome with multiple lentigines is caused by a different missense mutation of the same gene. Noonan syndrome is fairly common (1:1,000 to 1:2,500 live births), and neurofibromatosis 1 (which was once thought to be related to NSML) is also common (1:3500); however, no epidemiological data exists for NSML. Signs and symptoms
An alternative name of the condition, LEOPARD syndrome, is a mnemonic, originally coined in 1969, as the condition is characterized by some of the following seven conditions, the first letters of which spell LEOPARD, along with the characteristic "freckling" of the skin, caused by the lentigines that is reminiscent of the large cat. Lentigines — Reddish-brown to dark brown macules (surface skin lesion) generally occurring in a high number (10,000+) over a large portion of the skin, at times higher than 80% coverage. These can even appear inside the mouth (buccal), or on the surface of the eye (scleral).
Inheritance within families
In most of the families reported so far, tetra-amelia syndrome appears to have an autosomal recessive pattern of inheritance. This means the defective gene responsible for the disorder is located on an autosome , and two copies of the defective gene (one inherited from each parent) are required in order to be born with the disorder. The parents of an individual with an autosomal recessive disorder both carry one copy of the defective gene, but usually do not experience any signs or symptoms of the disorder. Epidemiology
Tetra-amelia syndrome has been reported in only a few families worldwide. According to a 2011 study by Bermejo-Sanchez, amelia – that is, the lacking of one or more limbs – occurs in roughly 1 out of every 71,000 pregnancies. People with tetra-amelia syndrome
Joanne ORiordan of Millstreet, Cork, Ireland. At the age of 16 she addressed the United Nations in New York. She appeared before the International Telecommunication Union’s conference ‘Girls in Technology’, receiving a standing ovation after delivering the keynote speech. Hirotada Ototake
Nick Vujicic, founder of Life Without Limbs. Prince Randian
Violetta (entertainer)
Kent Bell (1965-2015) of Jacksonville, FL, scoreboard operator and disabled rights advocate, appeared on Oprah Winfrey show and in numerous print articles over the course of his life. Rob Mendez, varsity football team offensive coordinator at Francis Parker School (San Diego). Christian Arndt of Germany, media presenter. References
External links

"Tetra-amelia syndrome - Genetics Home Reference". U.S. National Library of Medicine. Retrieved 2009-01-09.