One Clinical Picture, Two Clinical Entities: A Case Report and Literature Review of Neurofibromatosis and Hemochromatosis.

backgroundType I neurofibromatosis (NF1) represents an autosomal dominant inherited genodermatosis predisposing to tumor occurrence, caused by mutations in the CASE PRESENTATION: The aim of this case report is to underline the importance of a multidisciplinary approach for a precise diagnosis. A 17-year-old male teenager with a past medical history of multiple abdominal surgical interventions presented to the emergency department for diarrhea and abdominal pain. The physical examination revealed weight deficit, café-au-lait macules, axillary and inguinal freckling, and mild abdominal tenderness. Laboratory evaluation revealed high CRP, mild leucocytosis and lymphopenia. The surgical consult ruled out an acute surgical cause. The abdominal X-ray, stool culture, fecal cytology, urinalysis and urine culture were negative, but ferritin level and serum iron level were very high. Ophthalmological consult described a Lisch nodule. Multiplex Ligation-dependent Probe Amplification (MLPA) genetic testing found no deletions or duplications within the

conclusionsThe overlapping dermatological findings of both NF1 and HC might lead to diagnostic delays. The holistic approach to all pediatric patients presenting with particular hyperpigmentation involves thorough laboratory investigations, neurological, ophthalmological, cardiological and genetic examinations. In the absence of DNA Copy Number Variations (CNVs) that can be identified rapidly and cost-effectively by MLPA, sequencing is indicated to analyze small DNA variations, especially when two conditions with similar clinical pictures coexist.