Aftab Hammad, Escudero Ivan A, Sahhar Fatin
Department of Family Medicine, Detroit Medical Center-DMC/Michigan State University College of Medicine, Detroit, USA.
Cureus. 2023 Jun 13;15(6):e40383. doi: 10.7759/cureus.40383. eCollection 2023 Jun.
Hypohidrotic ectodermal dysplasia (HED) is a rare genetic disorder caused by a mutation in either the ectodysplasin (EDA), ectodysplasin A receptor (EDAR), EDAR associated via death domain (EDARADD), or Wnt family member 10A (WNT10A) genes that result in impaired development of ectodermal-derived structures. The literature defines two types of ectodermal dysplasia, which are hypohidrotic and hidrotic. X-linked hypohidrotic ectodermal dysplasia (XLHED), also known as Christ-Siemens-Touraine syndrome, is the most common form and is a variant of ectodermal dysplasia characterized by a classical triad of hypo/adontia, hypohidrosis, and hypotrichosis; whereas, hidrotic type of ectodermal dysplasia, also known as Clouston syndrome, is characterized by a triad of onychodysplasia, hypotrichosis, and palmoplantar hyperkeratosis while sparing the sweat glands. Symptoms of XLHED can begin early in life between the ages of one month to 23 months. XLHED is more commonly seen in males due to the x-linked characteristics of the gene mutations. This disease can be diagnosed by physical exam alone, or in combination with molecular genetic testing. XLHED specifically has an estimated occurrence of one in every 20,000 newborns worldwide. Approximately 5,000 people in the United States have the disease. In this case report, we present an adult patient diagnosed with XLHED. Our objective is to emphasize the significance of early diagnosis, advocate for a multidisciplinary management approach, and shed light on the potential of recombinant protein and targeted gene therapy for further research. By raising awareness of this condition, we aim to improve patient outcomes not only in newborns but also in adults who have already been diagnosed with XLHED.
少汗型外胚层发育不良(HED)是一种罕见的遗传性疾病,由外胚层发育不良蛋白(EDA)、外胚层发育不良蛋白A受体(EDAR)、通过死亡结构域相关的EDAR(EDARADD)或Wnt家族成员10A(WNT10A)基因的突变引起,这些突变导致外胚层衍生结构发育受损。文献定义了两种类型的外胚层发育不良,即少汗型和多汗型。X连锁少汗型外胚层发育不良(XLHED),也称为克里斯-西门子-图赖讷综合征,是最常见的形式,是外胚层发育不良的一种变体,其特征为典型的三联征:牙发育不全/无牙、少汗和毛发稀少;而多汗型外胚层发育不良,也称为克劳斯顿综合征,其特征为三联征:甲发育不良、毛发稀少和掌跖角化过度,同时汗腺不受影响。XLHED的症状可在1个月至23个月大的早期出现。由于基因突变的X连锁特征,XLHED在男性中更为常见。这种疾病仅通过体格检查或结合分子基因检测即可诊断。XLHED在全球每20000名新生儿中的估计发病率约为1例。美国约有5000人患有这种疾病。在本病例报告中,我们介绍了一名被诊断为XLHED的成年患者。我们的目的是强调早期诊断的重要性,倡导多学科管理方法,并阐明重组蛋白和靶向基因治疗在进一步研究中的潜力。通过提高对这种疾病的认识,我们旨在不仅改善新生儿的患者预后,也改善已被诊断为XLHED的成年人的患者预后。
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