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先天性无痛觉伴无汗症

Congenital insensitivity to pain with anhidrosis.

作者信息

Ayyazuddin Meher, Maqsood Nushra, Khan Saman Shuja, Ali Muhammad, Kakalia Spenta

机构信息

CMH Lahore Medical College, Lahore, Pakistan. Pakistan.

CMH Lahore Medical College, Lahore, Pakistan.

出版信息

J Pak Med Assoc. 2025 Jun;75(6):984-987. doi: 10.47391/JPMA.11450.

Abstract

Congenital Insensitivity to Pain with Anhidrosis (CIPA) is characterised by disruption of sensory neurons caused by genetic mutations in the Neurotrophic Tyrosine Kinase 1 (NTRK1) gene which leads to impaired pain sensation, accompanied by anhidrosis (the inability to sweat) and varying degrees of intellectual disability. Herein, we report a case of CIPA that presented with infection of an amputated left toe, with prior admissions due to various injuries. The patient had no apparent intellectual disability. A general physical examination yielded various scars with a predilection for the elbows, knees, and shins as well as an early loss of teeth (front incisors of the lower jaw). The patient exhibited anhidrosis, a self-injurious behaviour, and an abnormal response to painful stimuli, all of which led to a clinical diagnosis of CIPA.

摘要

先天性无痛觉伴无汗症(CIPA)的特征是神经营养性酪氨酸激酶1(NTRK1)基因发生基因突变,导致感觉神经元受损,从而引起痛觉减退,并伴有无汗症(无法出汗)和不同程度的智力残疾。在此,我们报告一例CIPA病例,该患者因左脚趾截肢感染前来就诊,此前曾因各种损伤入院。患者无明显智力残疾。全身体格检查发现多处疤痕,好发于肘部、膝盖和胫骨,以及早期牙齿脱落(下颌前切牙)。患者表现出无汗症、自残行为和对疼痛刺激的异常反应,所有这些均导致CIPA的临床诊断。

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