In some people, MAP is associated with developing hundreds of polyps, and it appears to be similar to the other hereditary conditions of familial adenomatous polyposis (FAP) and attenuated familial adenomatous polyposis (AFAP). In other cases, people with MAP can be diagnosed with fewer polyps (less than 20) and/or colorectal cancer at a young age. MYH9 encodes myosin-9, a protein of 1960 amino acids also known as the heavy chain of the non-muscle myosin IIA. Myosin-9 dimerizes and assembles with two essential and two regulatory light chains to constitute a hexameric molecule, the non-muscle myosin IIA (NMMIIA). NMMIIA assembles into functional bipolar filaments, which – interacting with actin – generate the mechanical force necessary for a variety of cellular processes, including motility and migration, cytokinesis, shape maintenance and change, and polarization. Before entering MyHR please remember that this contains personal information so it is important to ensure you are doing so in a secure environment. MUTYH (MYH)-associated polyposis (MAP) is a hereditary condition. People with MAP tend to develop multiple adenomatous colon polyps during their lifetime and will have an increased risk of colorectal cancer if they are not monitored closely with regular colonoscopies. An adenomatous polyp is an area where the normal cells that line the inside of the colon begin to form a mass. At first, a polyp is benign, meaning it is noncancerous and will not spread. However, some polyps can eventually turn malignant, meaning cancerous, and cancers can spread to other parts of the body. It is likely that people with MAP will develop many polyps, and therefore their risk for colorectal cancer may be increased if these polyps are not removed.

For too many young British Muslims, the feeling of never quite belonging and having to meet conflicting social expectations, creates despair during the formative years of adolescence. In a community where most social issues are a cultural taboo, increasing numbers of young people are resorting to self-harm and substance abuse for escape, and mental health problems appear disproportionately higher. ​ Antifibrinolytic agents. Several authors recommend the systemic administration of antifibrinolytic agents, such as tranexamic or epsilon-aminocaproic acid, to treat mild or moderate mucocutaneous bleeding [ Althaus & Greinacher 2009]. Antifibrinolytic drugs are also used empirically as prophylaxis to cover surgery or other hemostatic challenges, especially low-risk procedures, in persons with MYH9-RD [ Orsini et al 2017]. Hearing loss is usually bilateral. Once diagnosed, hearing loss frequently progresses over time, although it can remain stable in a minority of affected individuals. Earlier-onset hearing loss often progresses more rapidly and may result in severe-to-profound deafness [ Verver et al 2016]. Thrombocytopenia ranges from mild to severe. The degree of thrombocytopenia usually remains stable in each individual throughout life. Because platelet counts at the lower limit of the normal range have been reported in very few individuals with MYH9-RD, platelet macrocytosis and aggregates of the MYH9 protein in neutrophils are the only findings shared among all affected individuals. The diagnosis of MYH9-related disease is established in a proband with suggestive findings and a heterozygous pathogenic variant in MYH9 identified by molecular genetic testing (see Table 1).MAP is considered as a possible diagnosis when a person has multiple adenomatous colon polyps but does not have an alteration in the APC gene associated with FAP and AFAP. It may also be considered if someone has a brother or sister with multiple colon polyps, but there is no history of colon problems in previous generations. MAP is diagnosed when a person is found to have 2 alterations in the MUTYH gene. Although most individuals with MAP carry at least 1 of the 2 most common alterations in MUTYH ( Y165C and G382D), there are additional MUTYH alterations that can be detected by complete gene sequencing tests. What are the estimated cancer risks associated with MAP? Urinalysis, 24-hour protein, or protein (or albumin)-to-creatinine ratio on a spot urine sample; serum concentration of creatinine Cataracts. The mean age of onset of cataracts is 37 years, but congenital cataracts have been reported. In most individuals, cataracts are bilateral and progress over time. Presence and severity of a spontaneous bleeding tendency correlate with the degree of thrombocytopenia. Most affected individuals have no spontaneous bleeding or only easy bruising, and are at risk of significant hemorrhages only after hemostatic challenges. About 30% of persons with MYH9-RD have spontaneous mucocutaneous bleeding – mainly menorrhagia, epistaxis, and gum bleeding [ Pecci et al 2014a]. Life-threatening bleeding is rare. Web software, connecting to the HR database is accessed through a secure connection over QMUL's intranet.

Molecular genetic testing approaches can include a combination of gene-targeted testing (single-gene testing and multigene panel) and comprehensive genomic testing ( exome sequencing and genome sequencing) depending on the phenotype. Some people with MAP have an increased risk of developing polyps in the upper gastrointestinal tract, such as the stomach and small intestine. The risk of thyroid cancer may also be increased in individuals with MAP. What causes MAP? Ultrasound of the thyroid gland may be considered to screen for thyroid cancer, starting at age 25 to 30

Physical growth delay, ID, craniofacial dysmorphism, cryptorchidism, malformations of multiple organs Most colorectal cancer is sporadic, meaning it occurs by chance with no known cause. The percentage of colorectal cancer that can be attributed to MAP is unknown. It is estimated that as many as 1 in every 100 people may carry a single mutation in the MUTYH gene. How is MAP diagnosed? Agents/circumstances to avoid: Drugs that inhibit platelet function or reduce platelet count, and drugs that are ototoxic, nephrotoxic, or hepatotoxic should be used only after assessment of risk-to-benefit ratio. Hazardous noise and activities with high risk of injury should be avoided.