Coexisting PTPN11 and TNNT2 mutations in noonan syndrome with multiple lentigines

Learning points for cliniciansNoonan Syndrome with Multiple Lentigines denotes a unique subtype of Noonan Syndrome characterized by cutaneous manifestations.In addition to possessing mutations commonly linked to NS, patients may also exhibit mutations typical of cardiomyopathy.The combination of these mutations may enhance myocardial expression, leading to an accelerated onset of cardiac dysfunction.