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Neonatal incontinentia pigmenti: Six cases and a literature review
Yang Yang1, Yan Guo1, Ying Ping1
1Department of Neonates, Nanjing Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu 210008, P.R. China.
Insights
This study analyzed incontinentia pigmenti (IP) in Chinese infants, finding most cases present within a week of birth with varied clinical manifestations. Early diagnosis and management are crucial for improving outcomes in neonatal IP.
Area of Science:
- Neonatology
- Dermatology
- Genetics
Background:
- Incontinentia pigmenti (IP) is a rare X-linked dominant genetic disorder.
- Neonatal presentation of IP requires understanding of its diverse clinical spectrum and outcomes.
Purpose of the Study:
- To analyze clinical characteristics and outcomes of neonatal incontinentia pigmenti (IP) in China.
- To compare findings with existing Chinese literature on IP.
- To provide insights for diagnosis and treatment of neonatal IP.
Main Methods:
- Retrospective analysis of six neonatal IP cases.
- Literature review of 60 additional Chinese IP cases.
- Data compilation on demographics, clinical features, investigations, and follow-up.
Main Results:
- Most cases occurred within the first week of life, predominantly in term infants.
- Cutaneous, neurological, and ocular manifestations were common; TORCH infections and autoimmune markers were occasionally identified.
- Follow-up data indicated varied outcomes, including recurrence, persistence, and mortality.
Conclusions:
- Neonatal IP in China presents with distinct epidemiological and clinical features.
- Comprehensive assessment including dermatological, neurological, and ophthalmological evaluations is essential.
- Further research is needed to optimize management strategies for IP in neonates.
Abstract:
The aim of this study was to retrospectively analyze the cases of six infants with incontinentia pigmenti (IP) in the Department of Neonates and compare their data with 60 cases of IP reported in the available Chinese literature, in order to determine the clinical characteristics and outcomes of neonatal IP in China. The majority of the cases were located near the eastern and southern coasts of China, and ~98.5% of IP cases occurred within 1 week of birth. The majority of the babies with IP were term infants. Twelve cases had a positive family history of IP. The mothers of 10 patients had a history of recurrent spontaneous abortions, and the mothers of five patients had infectious or autoimmune diseases during pregnancy. Cutaneous manifestations were shown at stage I in 59 cases, at stage II in 28 cases and at stage III in three cases (multiple stages were recorded in certain cases). Neurological changes occurred in 18 cases and ocular changes were observed in 12 cases. The toxoplasmosis, rubella, cytomegalovirus and herpes simplex (TORCH) test showed positive results in three cases; autoantibody positivity was found in three cases and high blood eosinophil levels were observed in 20 cases. Brain scans revealed positive results in 16 cases and complications were observed in 21 cases. Thirty-four cases were followed for 1-6 months, six cases for 7-12 months and 17 cases for 13-84 months. Among these cases, 34 exhibited no evidence of recurrence. Five patients, including one male, succumbed in the long course of the follow-up. Two IP cases persisted after five years of follow-up. The data from the present study may reflect the characteristics of IP in the Chinese population and provide useful information for the diagnosis and treatment of IP by dermatologists and neonatologists.
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