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Published on: May 15, 2019
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.
Abstract:
Infantile systemic hyalinosis (ISH) is a presumed autosomal recessive connective tissue condition. Symptoms usually begin at birth or shortly thereafter, and are characterized by pain when handled, painful and swollen joints and, later on, dermal anomalies, diarrhea, failure to thrive and recurrent infections, which usually lead to death around the age of 2. The skin has generally diminished elasticity with small pearly papules appearing on neck, ears, coccygeal region, and face. We present two unrelated patients with ISH, with specific focus on clinical and pathologic studies. In the first patient the diagnosis was made several years after she died, in a retrospective study of her clinical file. On ultrastructural examination both patients showed an accumulation of fibrillogranular material in the extracellular matrix with long-spacing collagen of 90 nm. The first child died at the age of 1(1/2) years and the second at 3 years.
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