1
|
Vella V, Maulida M, Earlia N, Hidayati A, Handriani R, Gondokaryono SP, Dwiyana RF, Doris EE, Pradistha A, Bulqiah M. A fatal case of Harlequin ichthyosis: Experience from low-resource setting. NARRA J 2023; 3:e302. [PMID: 38455615 PMCID: PMC10919709 DOI: 10.52225/narra.v3i3.302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 11/20/2023] [Indexed: 03/09/2024]
Abstract
Harlequin ichthyosis is a severe and fatal presentation of ichthyosis with an autosomal recessive inheritance. Infants with Harlequin ichthyosis have a high mortality rate, and a dismal prognosis; therefore the majority of neonates die shortly after birth from infection, heat loss, dehydration, electrolytic imbalances, or respiratory distress. The aim of this case report was to present a fatal case of Harlequin ichthyosis with no family history of any inherited skin disorder. A 3-day-old baby was presented to the emergency room with congenital abnormalities at birth, fissured hyperkeratotic skin, and thick yellow plates of scales. The parents had no history of consanguineous marriage, no relevant past medical history, and no family history of the same condition. The patient was unwell, pulse 162 times/minute, respiratory rate 48 times/minute, and axillary temperature 36.9oC. APGAR score was 8 in the 1st minute and 9 in the 5th minute. Based on the typical clinical appearance, the patient was diagnosed with Harlequin ichthyosis. Due to a lack of facility, a mutation analysis was not carried out. The patient was then transferred to the neonatal intensive care unit (NICU) and treated in a humidified incubator and medicated with intravenous antibiotics (ampicillin sulbactam 125 mg/12 hour and gentamicin 13 mg/24 hour), topically fusidic acid and mild emollients. A central venous catheter was used for intravenous access. The poor prognosis resulted in the patient dying at the age of 5-day-old. This case highlights that prenatal diagnosis is critical for early detection and disease prevention. Mutation screening for the ABCA12 gene is suggested for consanguinity marriages and with a history of ichthyosis.
Collapse
Affiliation(s)
- Vella Vella
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
- Department of Dermatology and Venereology, Dr. Zaionel Abidin Hospital, Banda Aceh, Indonesia
| | - Mimi Maulida
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
- Department of Dermatology and Venereology, Dr. Zaionel Abidin Hospital, Banda Aceh, Indonesia
| | - Nanda Earlia
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
- Department of Dermatology and Venereology, Dr. Zaionel Abidin Hospital, Banda Aceh, Indonesia
| | - Arie Hidayati
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
- Department of Dermatology and Venereology, Dr. Zaionel Abidin Hospital, Banda Aceh, Indonesia
| | - Risna Handriani
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
- Department of Dermatology and Venereology, Dr. Zaionel Abidin Hospital, Banda Aceh, Indonesia
| | - Srie P. Gondokaryono
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjajaran, Bandung, Indonesia
- Department of Dermatology and Venereology, Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Reiva F. Dwiyana
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjajaran, Bandung, Indonesia
- Department of Dermatology and Venereology, Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Ezigbo E. Doris
- Department of Medical Laboratory Sciences, University of Nigeria, Enugu, Nigeria
| | | | - Mikyal Bulqiah
- Faculty of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
| |
Collapse
|
2
|
Liu Z, Jing C. Two- and three-dimensional sonographic findings of harlequin ichthyosis: case report and literature review. An Bras Dermatol 2023; 98:806-813. [PMID: 37355352 PMCID: PMC10589490 DOI: 10.1016/j.abd.2022.09.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 09/24/2022] [Accepted: 09/30/2022] [Indexed: 06/26/2023] Open
Abstract
BACKGROUND Harlequin ichthyosis (HI) is a rare skin disorder with extremely high lethality due to a mutation of the ABCA12 gene. Because of its rarity and the often-late onset, prenatal screening for HI is extremely difficult, and most pregnant women might easily miss the period for optimal examinations. OBJECTIVE To summarize the sonographic features of HI for prenatal diagnostic purposes. METHODS The authors describe a case of HI with no family history who was diagnosed by using prenatal ultrasound scanning. The sonographic features of HI and the clinical characteristics of pregnant women were summarized by searching relevant literature over nearly two decades. RESULTS The unique sonographic presentations including peeling skin, clenched hands and clubfeet, ectropion, flat nose, fetal growth impairment, polyhydramnios and echogenic amniotic fluid may be primarily related to skin disorders in HI fetuses. The authors also identified a novel pathogenic ABCA12 gene mutation and explained the possible pathogenic mechanisms. STUDY LIMITATIONS Caution should be exercised in summarizing disease characteristics because of the small number of cases, and the authors are faced with the possibility of incomplete case searching. CONCLUSIONS HI has relatively unique sonographic features. Therefore, 2D-ultrasound combined with 3D-ultrasound may be an effective method for the prenatal diagnosis of HI. Moreover, a novel pathogenic ABCA12 gene mutation may provide important clues for future research on the etiology of HI. However, the authors consider that additional studies are needed to provide more evidence for prenatal diagnosis.
Collapse
Affiliation(s)
- Zesi Liu
- Department of Gynecology and Obstetrics, The First Affiliated Hospital Dalian Medical University, Dalian, China
| | - Chunli Jing
- Department of Ultrasound of Gynecology and Obstetrics, The Second Affiliated Hospital Dalian Medical University, Dalian, China.
| |
Collapse
|
3
|
Tran VK, Diep QM, Zilong Q, Phuong LT, Tran HA, Van Tung N, Lien NTK, Xuan NT, Ha LT, Van Ta T, Tran TH, Hoang NH. Case Report: Novel rare mutation c.6353C > G in the ABCA12 gene causing harlequin ichthyosis identified by whole exome sequencing. Front Pediatr 2023; 11:1128716. [PMID: 36873642 PMCID: PMC9977293 DOI: 10.3389/fped.2023.1128716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 01/27/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Harlequin ichthyosis (HI) is a severe rare genetic disease that mainly affects the skin. Neonates with this disease are born with thick skin and large diamond-shaped plates covering most of their bodies. Affected neonates lose the ability to control dehydration and regulate temperature and are more susceptible to infections. They also face respiratory failure and feeding problems. These clinical symptoms are factors associated with high mortality rates of neonates with HI. Until now, there are still no effective treatments for HI patients and most patients die in the newborn period. Mutation in the ABCA12 gene, which encodes an adenosine triphosphate-binding cassette (ABC) transporter, has been demonstrated as the major cause of HI. CASE PRESENTATION In this study, we report the case who is one infant that was born prematurely at 32 gestational weeks with the whole body covered with thick plate-like scales of skin. The infant was severely infected with mild edema, multiple cracked skins full of the body, yellow discharge, and necrosis of fingers and toes. The infant was suspected to be affected by HI. Whole exome sequencing (WES) was performed as a tool for detecting the novel mutation in one prematurely born Vietnam infant with HI phenotype. And after that, the mutation was confirmed by the Sanger sequencing method in the patient and the members of his family. In this case, one novel mutation c.6353C > G (p.S2118X, Hom) in the ABCA12 gene, was detected in the patient. The mutation has not been reported in any HI patients previously. This mutation was also found in a heterozygous state in the members of the patient's family, including his parents, an older brother, and an older sister who are no symptoms. CONCLUSIONS In this study, we identified a novel mutation in a Vietnamese patient with HI by whole exome sequencing. The results for the patient and the members of his family will be helpful in understanding the etiology of the disease, diagnosing carriers, assisting in genetic counseling, and emphasizing the need for DNA-based prenatal screening for families with a history of the disease.
Collapse
Affiliation(s)
- Van Khanh Tran
- Department of Molecular Pathology Faculty of Medical Technology and Center for Gene and Protein Research, Hanoi Medical University, Hanoi, Vietnam
| | - Quang Minh Diep
- Assisted Reproductive Technology Center, Quang Ninh Hospital for Obstetric and Pediatric, Quang ninh, Vietnam
| | - Qiu Zilong
- BGI Genomics, BGI-Shenzhen, Shenzhen, China
| | - Le Thi Phuong
- Department of Molecular Pathology Faculty of Medical Technology and Center for Gene and Protein Research, Hanoi Medical University, Hanoi, Vietnam
| | - Hai Anh Tran
- Department of Molecular Pathology Faculty of Medical Technology and Center for Gene and Protein Research, Hanoi Medical University, Hanoi, Vietnam
| | - Nguyen Van Tung
- Institute of Genome Research, Vietnam Academy of Science and Technology, Hanoi, Vietnam.,Graduate University of Science and Technology, Vietnam Academy of Science and Technology, Hanoi, Vietnam
| | - Nguyen Thi Kim Lien
- Institute of Genome Research, Vietnam Academy of Science and Technology, Hanoi, Vietnam
| | - Nguyen Thi Xuan
- Institute of Genome Research, Vietnam Academy of Science and Technology, Hanoi, Vietnam
| | - Le Thi Ha
- Neonatal Care Center, Vietnam National Hospital of Pediatrics, Hanoi, Vietnam
| | - Thanh Van Ta
- Department of Molecular Pathology Faculty of Medical Technology and Center for Gene and Protein Research, Hanoi Medical University, Hanoi, Vietnam
| | - Thinh Huy Tran
- Department of Molecular Pathology Faculty of Medical Technology and Center for Gene and Protein Research, Hanoi Medical University, Hanoi, Vietnam
| | - Nguyen Huy Hoang
- Institute of Genome Research, Vietnam Academy of Science and Technology, Hanoi, Vietnam.,Graduate University of Science and Technology, Vietnam Academy of Science and Technology, Hanoi, Vietnam
| |
Collapse
|
4
|
Zhou Y, Li L, Wang L, Zhang C. Prenatal diagnosis of a rare variant of harlequin ichthyosis with literature review. BMC Med Imaging 2021; 21:56. [PMID: 33743627 PMCID: PMC7981911 DOI: 10.1186/s12880-021-00586-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 03/15/2021] [Indexed: 11/10/2022] Open
Abstract
Background Harlequin ichthyosis (HI) is a rare and severe genetic skin disorder that occurs within the developing foetus. Due to the extremely poor prognosis, prenatal diagnosis becomes very important, especially for foetuses with no family history. There are few reports on prenatal diagnosis in PubMed. Case presentation We report two cases of HI with no family history who were diagnosed by prenatal ultrasound. We searched for reports on the prenatal ultrasonic diagnosis of HI over nearly two decades and summarized the sonographic features of HI, the reasons for missed diagnoses and matters needing attention. A total of 10 articles of congenital harlequin ichthyosis diagnosed by prenatal ultrasound in PubMed were retrieved. There have been even fewer reports of late-trimester disease with no family history. Combining the two cases we reported with the literature review, we summarize the ultrasonic image characteristics of HI. Conclusion HI can be easily detected by 2D ultrasound combined with 3D, but attention should be paid to a systematic examination in the third trimester of pregnancy according to the clinical characteristics of the disease.
Collapse
Affiliation(s)
- Yi Zhou
- Department of Ultrasound, First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022, Anhui, China
| | - Liang Li
- Department of Ultrasound, First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022, Anhui, China
| | - Ling Wang
- Department of Ultrasound, First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022, Anhui, China
| | - Chaoxue Zhang
- Department of Ultrasound, First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022, Anhui, China.
| |
Collapse
|
5
|
Brandão P, Seco S, Loureiro T, Ramalho C. Prenatal sonographic diagnosis of Harlequin ichthyosis. JOURNAL OF CLINICAL ULTRASOUND : JCU 2019; 47:228-231. [PMID: 30508257 DOI: 10.1002/jcu.22675] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Revised: 10/25/2018] [Accepted: 11/07/2018] [Indexed: 06/09/2023]
Abstract
Harlequin ichthyosis is the most severe form of autosomal recessive congenital ichthyoses. So far, there are only a few reports of prenatal diagnosis in the literature, as prenatal sonographic features are quite subtle. We report a case of prenatal diagnosis of Harlequin ichthyosis on third-trimester sonographic examination in a consanguineous couple with no history of the disease and describe its characteristic sonographic features.
Collapse
Affiliation(s)
- Pedro Brandão
- Department of Obstetrics and Gynaecology, Centro Hospitalar Tâmega e Sousa, Penafiel, Portugal
| | - Sandra Seco
- Department of Obstetrics and Gynaecology, Centro Hospitalar São João, Porto, Portugal
| | - Teresa Loureiro
- Department of Obstetrics and Gynaecology, Centro Hospitalar São João, Porto, Portugal
| | - Carla Ramalho
- Department of Obstetrics and Gynaecology, Centro Hospitalar São João, Porto, Portugal
- Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| |
Collapse
|
6
|
Malhotra R, Hernández-Martın A, Oji V. Ocular manifestations, complications and management of congenital ichthyoses: a new look. Br J Ophthalmol 2017; 102:586-592. [DOI: 10.1136/bjophthalmol-2017-310615] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 10/06/2017] [Accepted: 10/06/2017] [Indexed: 02/04/2023]
Abstract
Congenital ichthyoses (CI) are rare genetic skin keratinisation diseases characterised by generalised scaling and a variable degree of erythema and hyperkeratosis. Ocular involvement includes the eyelids, conjunctiva and all layers of the cornea. Ophthalmic input should include regular slit lamp review with the primary aim to prevent a corneal epithelial defect, secondary bacterial infection, scarring or perforation. This review highlights the current literature regarding ophthalmic findings and management of CI.
Collapse
|
7
|
Al-Amry MA. Ocular manifestation of Ichthyosis. Saudi J Ophthalmol 2015; 30:39-43. [PMID: 26949357 PMCID: PMC4759502 DOI: 10.1016/j.sjopt.2015.12.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 11/26/2015] [Accepted: 12/14/2015] [Indexed: 11/18/2022] Open
Abstract
PURPOSE Ichthyosis is a rare dermato-ocular disease. This study evaluates the presenting ocular signs, symptoms, complications and prognosis of ichthyosis in a case series from Saudi Arabia. METHODS A retrospective chart review was performed for 11 patients with ichthyosis who presented to King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia, over the last 20 years. RESULTS The most common presenting ocular diagnosis was ectropion of both the lids. Two patients developed corneal perforation with poor prognosis. Most of the patients underwent skin grafting to repair eyelid ectropion. The visual prognosis was excellent because timely surgical interventions were performed. Hence the rate of corneal complications such as perforation was low. CONCLUSION The most ocular presentation of ichthyosis is ectropion of both the upper and lower lids. Despite good visual prognosis, there were some devastating corneal complications such as perforation with unpredictable outcomes.
Collapse
Affiliation(s)
- Mohammad A. Al-Amry
- Address: Anterior Segment/Emergency Room, King Khaled Eye Specialist Hospital, PO Box 7191, Riyadh 11462, Saudi Arabia. Tel.: +966 1 4821234x3861.Anterior Segment/Emergency RoomKing Khaled Eye Specialist HospitalPO Box 7191Riyadh11462Saudi Arabia
| |
Collapse
|
8
|
Abstract
Genetic skin diseases, or genodermatoses, often have extracutaneous manifestations. Ocular manifestations in particular can have significant clinical implications, like blindness. Other manifestations, such as the corneal opacities that occur in X-linked ichthyosis, are asymptomatic but characteristic of a particular genodermatosis. Ophthalmologic examination can aid in diagnosis when characteristic findings are seen. The genodermatoses with ocular manifestations will be reviewed, but neurocutaneous, syndromes, genetic pigmentary disorders, and genetic metabolic diseases are not included because they are covered elsewhere in this issue.
Collapse
Affiliation(s)
- Melinda Jen
- Section of Pediatric Dermatology, Children's Hospital of Philadelphia; Departments of Pediatrics and Dermatology, Perelman School of Medicine at the University of Pennsylvania, 3550 Market St, Second floor, Philadelphia, PA, 19104.
| | - Sudha Nallasamy
- The Vision Center, Children's Hospital Los Angeles; Department of Ophthalmology, Keck School of Medicine, University of Southern California, 4650 Sunset Blvd, MS #88, Los Angeles, CA, 90027
| |
Collapse
|
9
|
Rathore S, David LS, Beck MM, Bindra MS, Arunachal G. Harlequin Ichthyosis: Prenatal Diagnosis of a Rare Yet Severe Genetic Dermatosis. J Clin Diagn Res 2015; 9:QD04-6. [PMID: 26675324 DOI: 10.7860/jcdr/2015/15250.6705] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 07/31/2015] [Indexed: 11/24/2022]
Abstract
Harlequin Ichthyosis (HI) is an extremely rare genetic skin disorder. It is the most severe type of ichthyosis. It is characterized by thickened, dry, rough and armor like plates of skin with deep cracks in between. Alternative names for HI include- keratosis diffusafetalis, ichthyosis congenital, icthyosis fetalis, harlequin fetus and icthyosis congenital gravior. It is an autosomal recessive disorder with the majority of affected individuals being homozygous for mutation in the ABCA 12 gene. This condition presents with a wide range of severity and symptoms. Affected neonates usually do not survive beyond first few days of life. We are presenting prenatal diagnosis of a case of this rare condition.
Collapse
Affiliation(s)
- Swati Rathore
- Assistant Professor, Department of Obstetrics and Gynaecology, Christian Medical College , Vellore, Tamil Nadu, India
| | - Liji Sarah David
- Assistant Professor, Department of Obstetrics and Gynaecology, Christian Medical College , Vellore, Tamil Nadu, India
| | - Manisha Madhai Beck
- Associate Professor, Department of Obstetrics and Gynaecology, Christian Medical College , Vellore, Tamil Nadu, India
| | - Mandeep Singh Bindra
- Assistant Professor, Department of General Pathology, Christian Medical College , Vellore, Tamil Nadu, India
| | - Gautham Arunachal
- Assistant Professor, Department of Medical Genetics, Christian Medical College , Vellore, Tamil Nadu, India
| |
Collapse
|
10
|
Shibata A, Akiyama M. Epidemiology, medical genetics, diagnosis and treatment of harlequin ichthyosis in Japan. Pediatr Int 2015; 57:516-22. [PMID: 25857373 DOI: 10.1111/ped.12638] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Revised: 02/01/2015] [Accepted: 02/13/2015] [Indexed: 11/30/2022]
Abstract
Ichthyoses are a group of disorders marked by whitish, brown or dark-brown scales on the skin of almost the whole body. Harlequin ichthyosis (HI) is the most severe form. Neonatal death from HI was once common. Due to intensive neonatal care and, probably, to the early introduction of oral retinoids, HI outcome has improved. For definitive diagnosis and the exclusion of other disorders, such as lamellar ichthyosis, which also shows a collodion baby phenotype, it is helpful to refer to electron microscopy of abnormal or absent lamellar granules and a heavy accumulation of lipid droplets in the keratinocytes. ATP-binding cassette transporter A12 (ABCA12) is known as the causative gene of HI. Severe ABCA12 deficiency results in malformation of intercellular lipid layers in the cornified layers and leads to epidermal lipid barrier disruption. In HI patients, at least one mutation on each allele must be a truncation or deletion mutation to cause serious loss of ABCA12 function. Identification of the gene underlying HI has enabled DNA-based prenatal diagnosis for HI at the earlier stages of pregnancy with low risk. There are no curative treatments for HI. Abca12-deficient mice were created as a model of HI. Treatment of the model mice with retinoid or steroid has not been successful.
Collapse
Affiliation(s)
- Akitaka Shibata
- Department of Dermatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masashi Akiyama
- Department of Dermatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| |
Collapse
|
11
|
Rajagopal MD, Ch Toi P, Plakkal N, Ayyanar P. Harlequin Infant Born to a Varicella Infected Mother: A Case Report. Fetal Pediatr Pathol 2015; 34:241-7. [PMID: 26083791 DOI: 10.3109/15513815.2015.1051253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Harlequin ichthyosis is a rare, severe form of congenital ichthyosis characterised by distinct physical appearance of the infant. It has occurrence of 1 in 1 million births and over 100 cases have been reported so far. It is caused by mutation in ABCA12 gene involved in lipid transport leading to profound thickening of stratum corneum. The mainstay of management relies on supportive care & administration of retinoid derivatives. Outcome is usually fatal and most of the babies die during neonatal period. In this article, we report a case of harlequin baby born of non-consanguineous marriage with history of chicken pox in the mother during first trimester of pregnancy.
Collapse
|
12
|
Harlequin ichthyosis: Case report. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2013; 18:1004-5. [PMID: 24520234 PMCID: PMC3906774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2012] [Revised: 04/08/2013] [Accepted: 05/20/2013] [Indexed: 11/13/2022]
Abstract
Harlequin fetus is a rare and the most severe form of the congenital ichthyosis with an autosomal recessive inheritance. Incidence of the disease is nearly 1 in 3,00,000 live births. The disease might be lethal at birth and the affected babies are often premature. Harlequin ichthyosis (HI) is marked by severe keratinized and alligator-like horned skin. The present study reports a new case with HI and adds to the collective knowledge of this rare skin disorder. HI has been linked to mutation in the ABCA12 gene; therefore, genetic counseling and mutation screening of this gene should be considered.
Collapse
|
13
|
Follmann J, Macchiella D, Whybra C, Mildenberger E, Poarangan C, Zechner U, Bartsch O. Identification of novel mutations in the ABCA12 gene, c.1857delA and c.5653-5655delTAT, causing harlequin ichthyosis. Gene 2013; 531:510-3. [PMID: 24055722 DOI: 10.1016/j.gene.2013.07.046] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 07/09/2013] [Accepted: 07/12/2013] [Indexed: 10/26/2022]
Abstract
Harlequin ichthyosis (HI) is a severe autosomal recessive developmental disorder of the skin that is frequently but not always fatal in the first few days of life. In HI, mutations in both ABCA12 gene alleles must have a severe impact on protein function and most mutations are truncating. The presence of at least one nontruncating mutation (predicting a residual protein function) usually causes a less severe congenital ichthyosis (lamellar ichthyosis or congenital ichthyosiform erythroderma). Here we report on a girl with severe HI diagnosed by prenatal ultrasound at 33 5/7 week gestation. Ultrasound findings included ectropion, eclabium, deformed nose, hands and feet, joint contractures, hyperechogenic amniotic fluid and polyhydramnion. After birth, palliative treatment was provided and she died on her first day of life. Sequence analysis of the ABCA12 gene identified two novel mutations, c.1857delA (predicting p.Lys619) in exon 15 and c.5653-5655delTAT (predicting p.1885delTyr) in exon 37, each in heterozygous state. The c.5653-5655delTAT mutation is not truncating, but the deleted tyrosine at position 1885 is perfectly conserved among vertebrates and molecular studies evaluated the mutation as probably disease causing and damaging.
Collapse
Affiliation(s)
- Johannes Follmann
- Institute of Human Genetics, University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany.
| | | | | | | | | | | | | |
Collapse
|
14
|
BELIKOV AN, ALBANOVA VI, KOMLEVA LF, GOLCHENKO VA. Harlequin ichtyosis (harlequin fetus): case description. VESTNIK DERMATOLOGII I VENEROLOGII 2012. [DOI: 10.25208/vdv690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Harlequin ichtyosis was observed at a girl, who managed to survive till 4 months age. Results of postmortem examination were presented. Diagnostic criteria were described, issues of prenatal diagnostics and treatment opportunities are being discussed.
Collapse
|