Marín-Hernández Eduardo, Reyes-Salcedo César A, Cárdenas-Conejo Alan, Peregrino-Bejarano Leoncio, Reyes-Cuayahuitl Araceli, Rayo-Mares Darío, Siordia-Reyes Georgina A
Servicio de Dermatología Pediátrica, Unidad Médica de Alta Especialidad (UMAE) Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS). Ciudad de México, México.
Centro Dermatológico Dr. Ladislao de la Pascua, Unidad Médica de Alta Especialidad (UMAE) Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS). Ciudad de México, México.
Bol Med Hosp Infant Mex. 2020;77(6):331-336. doi: 10.24875/BMHIM.20000030.
Calcinosis cutis is the deposit of insoluble calcium salts in the skin. It is classified according to its pathogenesis in dystrophic, metastatic, idiopathic, iatrogenic, and calciphylaxis. Idiopathic calcinosis is asymptomatic, occurs in healthy patients, and includes scrotal calcinosis, Winer's nodular calcinosis or subepidermal calcified nodules, and familial tumor calcinosis. The latter is a rare condition characterized by periarticular calcium deposition in normocalcemic patients with no bone connection.
The case of a 5-month-old male patient, who on the seventh day of life was hospitalized for multifactorial jaundice, late neonatal sepsis, and apnea with epileptic seizures is described. His evolution was torpid, with hospital admissions due to epileptic seizures that were difficult to manage with partial response to the use of diphenylhydantoin and electrolyte alterations. By means of exome sequencing directed, a pathogenic variant of wrong direction in FGF12 was detected and the diagnosis of early epileptic encephalopathy number 47 was confirmed. Also, the patient showed disseminated congenital dermatosis to lower extremities affecting thighs, asymptomatic, bilateral and symmetrical, constituted by hypopigmentation and fovea hard to deep palpation. The biopsy showed dystrophic calcification.
The case of an infant with deep congenital cutis calcinosis associated with a pathogenic variant in the FGF12 gene with epileptic encephalopathy is described. To date, this clinical situation has not been previously reported in the literature.
皮肤钙化症是皮肤中不溶性钙盐的沉积。根据其发病机制可分为营养不良性、转移性、特发性、医源性和钙化防御性。特发性钙化症无症状,发生于健康患者,包括阴囊钙化症、维纳结节性钙化症或表皮下钙化结节以及家族性肿瘤性钙化症。后者是一种罕见病症,其特征为在血钙正常且无骨连接的患者关节周围出现钙沉积。
描述了一名5个月大男婴的病例,该男婴在出生后第7天因多因素黄疸、晚期新生儿败血症及伴有癫痫发作的呼吸暂停而住院。其病情进展缓慢,因癫痫发作多次入院,使用苯妥英钠治疗效果不佳且出现电解质紊乱。通过定向外显子测序,检测到FGF12基因存在致病方向错误的变异,确诊为47型早期癫痫性脑病。此外,该患者双下肢出现弥漫性先天性皮肤病,累及大腿,无症状,双侧对称,表现为色素减退和深部触诊时可触及的小凹。活检显示为营养不良性钙化。
描述了一名患有深部先天性皮肤钙化症且与FGF12基因致病变异相关的癫痫性脑病婴儿的病例。迄今为止,这种临床情况在文献中尚未有过报道。