Von Hippel-Lindau disease

General Information (adopted from Orphanet):

Synonyms, Signs: VHL VON HIPPEL-LINDAU SYNDROME, MODIFIERS OF, INCLUDED
VHL
Hippel-Lindau disease
Familial cerebelloretinal angiomatosis
Lindau disease
Von Hippel-Lindau syndrome
Number of Symptoms 71
OrphanetNr: 892
OMIM Id: 193300
ICD-10: Q85.8
UMLs: C0019562
MeSH: D006623
MedDRA: 10047716
Snomed: 46659004

Prevalence, inheritance and age of onset:

Prevalence: 1.1 of 100 000 [Orphanet]
Inheritance: Autosomal dominant
[Orphanet]
Age of onset: Adult
[Orphanet]

Disease classification (adopted from Orphanet):

Parent Diseases: Catecholamine-producing tumor
 -Rare circulatory system disease
 -Rare endocrine disease
 -Rare genetic disease
 -Rare oncologic disease
 -Rare renal disease
Familial cystic renal disease
 -Rare genetic disease
 -Rare renal disease
Genetic central nervous system and retinal vascular disease
 -Rare genetic disease
Inherited cancer-predisposing syndrome
 -Rare genetic disease
 -Rare oncologic disease
Inherited nervous system cancer-predisposing syndrome
 -Rare neurologic disease
Inherited renal cell cancer-predisposing syndrome
 -Rare genetic disease
 -Rare oncologic disease
 -Rare renal disease
Malformation syndrome with hamartosis
 -Rare developmental defect during embryogenesis
 -Rare genetic disease
Multiple polyglandular tumor
 -Rare endocrine disease
 -Rare genetic disease
 -Rare oncologic disease
Rare central nervous system and retinal vascular disease
 -Rare neurologic disease
Rare disease with glaucoma as a major feature
 -Rare eye disease
 -Rare genetic disease
Syndromic developmental defect of the eye
 -Rare developmental defect during embryogenesis
 -Rare eye disease
 -Rare genetic disease

Symptom Information: Sort by abundance 

1
(HPO:0000077) Abnormality of the kidney Frequent [Orphanet] 73 / 7739
2
(HPO:0005562) Multiple renal cysts 16 / 7739
3
(HPO:0000113) Polycystic kidney dysplasia Frequent [Orphanet] 75 / 7739
4
(HPO:0005584) Renal cell carcinoma 13 / 7739
5
(HPO:0009726) Renal neoplasm Very frequent [Orphanet] 20 / 7739
6
(HPO:0009715) Papillary cystadenoma of the epididymis 3 / 7739
7
(HPO:0000107) Renal cyst Frequent [Orphanet] 126 / 7739
8
(HPO:0001357) Plagiocephaly Occasional [Orphanet] 106 / 7739
9
(HPO:0000505) Visual impairment Very frequent [Orphanet] 297 / 7739
10
(HPO:0000541) Retinal detachment Occasional [Orphanet] 87 / 7739
11
(HPO:0008046) Abnormality of the retinal vasculature Very frequent [Orphanet] 41 / 7739
12
(HPO:0000639) Nystagmus Very frequent [Orphanet] 555 / 7739
13
(HPO:0000572) Visual loss Occasional [Orphanet] 272 / 7739
14
(HPO:0000501) Glaucoma Occasional [Orphanet] 180 / 7739
15
(HPO:0000518) Cataract Occasional [Orphanet] 454 / 7739
16
(HPO:0008059) Aplasia/Hypoplasia of the macula Occasional [Orphanet] 21 / 7739
17
(HPO:0009711) Retinal capillary hemangioma 2 / 7739
18
(HPO:0000360) Tinnitus 29 / 7739
19
(HPO:0002321) Vertigo 58 / 7739
20
(HPO:0000407) Sensorineural hearing impairment Very frequent [Orphanet] 524 / 7739
21
(HPO:0000365) Hearing impairment Occasional [Orphanet] 539 / 7739
22
(HPO:0002066) Gait ataxia Frequent [Orphanet] 327 / 7739
23
(HPO:0006880) Cerebellar hemangioblastoma 1 / 7739
24
(HPO:0002668) Paraganglioma 7 / 7739
25
(HPO:0002516) Increased intracranial pressure Occasional [Orphanet] 47 / 7739
26
(HPO:0001288) Gait disturbance Frequent [Orphanet] 318 / 7739
27
(HPO:0002666) Pheochromocytoma 9 / 7739
28
(HPO:0002167) Neurological speech impairment Very frequent [Orphanet] 308 / 7739
29
(HPO:0004374) Hemiplegia/hemiparesis Frequent [Orphanet] 158 / 7739
30
(HPO:0003474) Sensory impairment Frequent [Orphanet] 54 / 7739
31
(HPO:0011442) Abnormality of central motor function Frequent [Orphanet] 76 / 7739
32
(HPO:0002315) Headache Frequent [Orphanet] 175 / 7739
33
(HPO:0100634) Neuroendocrine neoplasm Occasional [Orphanet] 8 / 7739
34
(HPO:0009713) Spinal hemangioblastoma 1 / 7739
35
(HPO:0002894) Neoplasm of the pancreas 17 / 7739
36
(HPO:0012090) Abnormality of pancreas morphology Occasional [Orphanet] 31 / 7739
37
(HPO:0001392) Abnormality of the liver 28 / 7739
38
(HPO:0002017) Nausea and vomiting Frequent [Orphanet] 134 / 7739
39
(HPO:0001737) Pancreatic cysts Very frequent [Orphanet] 15 / 7739
40
(HPO:0005954) Pulmonary capillary hemangiomatosis 2 / 7739
41
(HPO:0100585) Telangiectasia of the skin Frequent [Orphanet] 66 / 7739
42
(HPO:0001052) Nevus flammeus Frequent [Orphanet] 88 / 7739
43
(HPO:0100761) Visceral angiomatosis Very frequent [Orphanet] 21 / 7739
44
(HPO:0011276) Vascular skin abnormality Very frequent [Orphanet] 24 / 7739
45
(HPO:0100735) Hypertensive crisis Occasional [Orphanet] 9 / 7739
46
(HPO:0000822) Hypertension Occasional [Orphanet] 224 / 7739
47
(HPO:0100026) Arteriovenous malformation Very frequent [Orphanet] 38 / 7739
48
(HPO:0011675) Arrhythmia Occasional [Orphanet] 226 / 7739
49
(HPO:0100659) Abnormality of the cerebral vasculature Very frequent [Orphanet] 25 / 7739
50
(HPO:0100742) Vascular neoplasm Very frequent [Orphanet] 3 / 7739
51
(HPO:0001901) Polycythemia 16 / 7739
52
(HPO:0002664) Neoplasm Occasional [Orphanet] 111 / 7739
53
(HPO:0100763) Abnormality of the lymphatic system Occasional [Orphanet] 18 / 7739
54
(OMIM) Endolymphatic sac tumors (ELSTs) 1 / 7739
55
(HPO:0000006) Autosomal dominant inheritance 2518 / 7739
56
(OMIM) Spinal cord hemangioblastoma 1 / 7739
57
(OMIM) Bilateral papillary cystadenoma of the epididymis 1 / 7739
58
(HPO:0030424) Epididymal cyst 1 / 7739
59
(HPO:0040096) Neoplasm of the inner ear Occasional [Orphanet] 1 / 7739
60
(OMIM) Adenocarcinoma of ampulla of Vater 1 / 7739
61
(OMIM) Retinal angioma 2 / 7739
62
(HPO:0002334) Abnormality of the cerebellar vermis Very frequent [Orphanet] 137 / 7739
63
(OMIM) Hearing loss, sensorineural, associated with ELSTs 1 / 7739
64
(OMIM) Epididymal cyst 2 / 7739
65
(OMIM) Adrenal hemangiomas 1 / 7739
66
(OMIM) Bilateral papillary cystadenomas of the broad ligament 1 / 7739
67
(OMIM) Renal hemangioblastoma 1 / 7739
68
(HPO:0000238) Hydrocephalus Frequent [Orphanet] 278 / 7739
69
(OMIM) Pancreatic hemangioblastoma 1 / 7739
70
(OMIM) Liver hemangiomas 1 / 7739
71
(HPO:0003812) Phenotypic variability 129 / 7739

Associated genes:

ClinVar (via SNiPA)

Gene symbol Variation Clinical significance Reference

Additional Information:

Description: (OMIM) Von Hippel-Lindau syndrome (VHL) is a dominantly inherited familial cancer syndrome predisposing to a variety of malignant and benign neoplasms, most frequently retinal, cerebellar, and spinal hemangioblastoma, renal cell carcinoma (RCC), pheochromocytoma, and pancreatic tumors.

Neumann ...

Diagnosis OMIM Seizinger et al. (1991) pointed out that visceral cysts of the kidney, pancreas, and epididymis occur not only as features of VHL but also in the general population, and that the presence of such cysts, unaccompanied by other ...
Clinical Description OMIM The cardinal features of von Hippel-Lindau syndrome are angiomata of the retina and hemangioblastoma of the cerebellum. Hemangioma of the spinal cord has also been observed. Pheochromocytoma occurs in some patients. The combination of hypertension with angioma may ...
Genotype-Phenotype Correlations OMIM Although pheochromocytoma occurs in only about 7% of VHL patients, marked interfamilial differences are often observed. Examining the relationship between VHL gene mutations and phenotype in 65 VHL kindreds, Crossey et al. (1994) found that large deletions or ...
Molecular genetics OMIM In 28 of 221 kindreds with von Hippel-Lindau syndrome, Latif et al. (1993) identified rearrangements of the VHL gene. Eighteen of these rearrangements were due to deletion in the VHL gene: 1 of these was an in-frame 3-nucleotide ...
Population genetics OMIM Maher et al. (1991) estimated the point prevalence of heterozygotes in East Anglia to be 1 in 53,000, with an estimated birth incidence of 1 in 36,000 live births. Reproductive fitness was 0.83. Direct and indirect estimates of ...
Diagnosis GeneReviews The clinical diagnosis of von Hippel-Lindau (VHL) disease is established in [Lonser et al 2003, Butman et al 2008, Maher et al 2011]:...
Clinical Description GeneReviews Von Hippel-Lindau (VHL) disease is characterized by hemangioblastomas of the brain, spinal cord, and retina; renal cysts and renal cell carcinoma; pheochromocytoma; pancreatic cysts and neuroendocrine tumors; endolymphatic sac tumors; and epididymal and broad ligament cysts. Some clustering of tumors occurs, resulting in the designation of specific VHL disease phenotypes. The manifestations and severity are highly variable both within and between families, even among those with the same mutation....
Genotype-Phenotype Correlations GeneReviews Four general VHL disease phenotypes have been suggested based on the likelihood of pheochromocytoma or renal cell carcinoma. Many lines of research support the conclusion that the molecular etiology of pheochromocytomas appears to be distinct from other VHL lesions. Therefore, the most relevant genotype-phenotype correlations rely mostly on scoring the presence/absence of pheochromocytomas associated with a given allele. The following discussion summarizes the genotype-phenotype studies published to date, with the cautionary note that further investigation is needed. In conclusion, the patterns are not clear-cut, and genotype-phenotype correlations have no current diagnostic or therapeutic value and are used for academic purposes only. ...
Differential Diagnosis GeneReviews The level of mutation detection obtained by molecular genetic testing of VHL makes it possible to effectively rule out von Hippel-Lindau (VHL) disease with a high degree of certainty in individuals with (1) isolated hemangioblastoma, retinal angioma, or clear cell renal cell carcinoma and (2) no detectable VHL disease-causing germline mutation. Somatic mosaicism for VHL mutation could still be considered in such individuals. A younger individual, especially one with multiple lesions, is more likely to have a germline VHL mutation than an older individual with a single lesion [Neumann et al 2002]. ...
Management GeneReviews To establish the extent of disease in an individual diagnosed with von Hippel-Lindau (VHL) disease, the following evaluations are recommended:...
Molecular genetics GeneReviews Information in the Molecular Genetics and OMIM tables may differ from that elsewhere in the GeneReview: tables may contain more recent information. —ED....