Kanti Children's Hospital, Maharajgunj, Kathmandu, Nepal.
JNMA J Nepal Med Assoc. 2022 Feb 15;60(246):187-191. doi: 10.31729/jnma.7102.
Carvajal syndrome is a rare variant of Naxos disease, a recessive mutation of the desmoplakin gene characterized by presence of woolly hair, palmoplantar keratoderma and dilated cardiomyopathy, mainly left ventricular involvement. The main clinical complication is progressive heart disease which may lead to heart failure and sudden cardiac death in childhood and adolescence. Cardiomyopathy is diagnosed by Task Force Criteria. The goal of treatment is to prevent sudden cardiac death by lifestyle modification and regular clinical monitoring with pharmacotherapy. We report a nine years female who had skin and hair abnormality and was admitted with features of heart failure. She was clinically diagnosed as Carvajal syndrome, an under-recognized cardio cutaneous manifestation in children. Clinicians should be aware, if any child present with keratoderma of palm and soles with woolly hair since birth should evaluate for cardiomyopathy. Genetic tests should be done whenever available, for confirming the diagnosis and counseling.
卡瓦哈尔综合征是纳克斯病的一种罕见变异,是桥粒芯糖蛋白基因突变导致的隐性遗传病,其特征为羊毛状发、掌跖角化过度和扩张型心肌病,主要累及左心室。主要的临床并发症是进行性心脏病,可能导致儿童和青少年心力衰竭和心源性猝死。心肌病的诊断依据工作组标准。治疗的目标是通过生活方式的改变和定期的临床监测及药物治疗来预防心源性猝死。我们报告了一例 9 岁女性,她有皮肤和毛发异常,并因心力衰竭特征入院。她被临床诊断为卡瓦哈尔综合征,这是一种在儿童中认识不足的心-皮肤表现。如果有任何儿童出生时即有手掌和足底的角化过度和羊毛状发,临床医生应该评估是否有心肌病。只要有可能,就应该进行基因检测,以明确诊断并提供咨询。