Infantile systemic hyalinosis: a clinicopathological study

Germán Rodríguez Criado1, Antonio González-Meneses, Manuela Cañadas

  • 1Dysmorphology Unit, Hospitales Universitarios Virgen del Rocío, Sevilla, Spain. german@cica.es

Insights

Infantile systemic hyalinosis (ISH) is a rare genetic disorder causing painful symptoms and skin abnormalities. This study details two cases, highlighting the characteristic extracellular matrix accumulation and early mortality in ISH.

Area of Science:

  • Genetics
  • Pathology
  • Pediatrics

Background:

  • Infantile systemic hyalinosis (ISH) is an autosomal recessive connective tissue disorder.
  • Clinical manifestations typically emerge at birth or shortly after, leading to significant morbidity.

Observation:

  • Two unrelated patients with ISH were studied, focusing on clinical and pathological aspects.
  • Symptoms included pain, joint swelling, dermal anomalies, failure to thrive, and recurrent infections.
  • Skin showed diminished elasticity with characteristic pearly papules.

Findings:

  • Retrospective diagnosis in one patient after death.
  • Ultrastructural examination revealed extracellular matrix accumulation of fibrillogranular material.
  • Presence of long-spacing collagen (90 nm) was noted in both patients.

Implications:

  • ISH is associated with a poor prognosis, with affected children often succumbing by age 2-3.
  • Understanding the ultrastructural pathology aids in diagnosing this rare condition.
  • Further research into the genetic basis and potential treatments for ISH is warranted.