Infantile Systemic Hyalinosis

Imaging manifestations of juvenile hyaline fibromatosis: a case report and literature review

Objective:

Juvenile hyaline fibromatosis (JHF) is an autosomal recessive condition caused by a mutation in capillary morphogenesis gene 2 (CMG2) on chromosome 4q21. JHF is an extremely rare genetic disorder, and fewer than a hundred cases have been reported worldwide. In this case report, the clinical features, histopathological features and imaging manifestations of a case of JHF are presented. We present imaging manifestations of one case of JHF to deepen the radiologist’s understanding of this condition. The histopathological feature of JHF is hyaline degeneration involving skeletal muscle. Therefore, the lesion has a slightly high density on CT imaging, iso- or hypointense signal on T₁WI and hypointense signal on T₂WI. The boundary between the lesion and skeletal muscle is unclear.

Methods:

An 8-year-old male (Case 1) was examined in our department with a complaint of multiple masses on the head, neck and back in 2021. The boy was the only child of his parents and was delivered at 40 weeks gestation by caesarean section. His parents were non-consanguineous.

Results :

JHF displays multiple slowly or rapidly growing subcutaneous nodules. The imaging manifestations can reflect histopathological components, including nodular connective tissue and amorphous, partially calcified hyaline material.

Juvenile hyaline fibromatosis: A clinicopathological study of five cases

Juvenile hyaline fibromatosis (JHF) is an extremely rare autosomal recessive disease that typically presents in infancy or early childhood. Largely due to the rarity, JHF is still not widely recognized by clinicians and pathologists in China. It is not uncommonly to misdiagnose the disease as other types of disorders. In this study, we present our experience with five cases of JHF to enhance the recognition of this rare but distinctive entity. There were 4 males and 1 female, with age at presentation ranging from 5 to 44 years. All patients presented with multiple subcutaneous nodular lesions of varying size in various parts of the body since birth or early childhood. Three patients also had joint involvement. Pathologically, the lesions were poorly circumscribed, located mainly in the dermis and subcutis. All five cases were characterized by abundant homogeneous hyaline-like matrix that differs sharply from the adjacent connective tissue, which stained strongly with periodic acid-Schiff (PAS) and was diastase resistant. Embedded within the eosinophilic glassy matrix were cords or small clusters of plump spindled to epithelioid cells, frequently with clear cytoplasm. Familiarity with the characteristic features of JHF is not only important in avoiding misdiagnosis but also essential for clinical management and prognostic evaluation.

Juvenile hyaline fibromatosis: a rare oral disease case report and literature review

Juvenile hyaline fibromatosis (JHF) is a rare recessive autosomal hereditary disorder characterized by papulonodular skin, gingival hyperplasia, flexural joint contractures, and osteolytic bone lesions. Worldwide, less than 70 cases have been reported. JHF is thought to be a disorder of collagen metabolism which is caused by genomic sequence variations in the ANTXR2/CMG2 gene and is characterized by homogenous amorphous hyaline material and fibrous tissue. JHF is most commonly diagnosed in infants and in children less than 5 years. We report a 28-month-old child of a consanguineous marriage who presented with severe gingival hyperplasia, multiple facial nodules, posterior occipital tumors, joint contractures, and osteolytic bone lesions. His limbs and fingers cannot be straightened, with a posture of frog pose. The occlusal and incisal surfaces of the teeth were completely covered with the gingival overgrowth. The gingival hypertrophy and facial swellings were surgically removed, with pathological features of monomorphic spindled cell proliferation surrounded by an abundant amorphous hyaline matrix. The genome sequencing was performed that a homozygous nucleotide mutation of ANTXR2/CMG2 gene was found. We outline this particular patient's presentation, followed by a discussion highlighting the characteristics that change with the condition and the treatments of this disease. The treatment of JHF is generally symptomatic treatment and requires multidisciplinary care. Physical rehabilitation has been advocated for a lifetime.

The physical education and the Infantile Systemic Hyalinosis: A case report

The purpose of this case report is to present the case study of a child with Systemic Infantile Hyalinosis in the educational attendance specialized in Physical Education and Art (dance). The collection took place through the Teachers' Field Diary and the interview with the child's mother. The pedagogical intervention lasted 15 months and took place at the swimming and dance workshops at the Catholic University of Brasilia, with two weekly classes in each workshop lasting 30 min each. The intervention was based on Henri Wallon's theory of emotions and sought freedom of expression, body experience, and the discovery of a body marked by disease and, in many moments, disrespected in its possibilities. At the end of the intervention, mobility, and range of motion gains were observed in motor terms, which were compromised due to the instability caused by the progressive disease. However, there were significant gains regarding self-esteem, which were relevant and significantly contributed to a better quality of life of the child.