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Cocchi C, Milanese A, Abdul-Messie L, Vestri AR, Longo L. Laryngeal features in Lipoid proteinosis: a systematic review and meta-analysis of individual participant data. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08713-x. [PMID: 38713291 DOI: 10.1007/s00405-024-08713-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 04/29/2024] [Indexed: 05/08/2024]
Abstract
PURPOSE Lipoid proteinosis (LP) or Urbach-Wiethe disease (OMIM 247100) is a rare syndrome characterised by early vocal folds infiltration and subsequent multi-organ involvement. LP is often unrecognised and its associated hoarseness is overlooked. The main objective of the study was to investigate hoarseness in LP and implement a diagnosis among otolaryngologists. METHODS PubMed/MEDLINE and OMIM databases were systematically searched. Authors concentrated the search on published articles starting from the discovery of the pathogenesis of LP by Hamada et al. in 2002. Only cases in which a diagnosis was reported both clinically and through biopsy and/or genetic molecular testing were included. Characteristics of the LP cases were extracted from each included study. Results were obtained through Generalized Estimating Equations. RESULTS The search strategy yielded 217 articles, of which 74 (34.1%) met the selection criteria. A total of 154 cases were included. Hoarseness was described in all LP cases and clearly stated as the onset symptom in 68.8%. The onset was on average at 19 months of age (CI: 3.00-20.00), while the mean age at diagnosis was 15 years (CI: 10.00-30.00). Therefore, the diagnostic delay amounted to 13.42 years (CI: 8.00-23.83). Hoarseness alone was responsible for an LP diagnosis in only 14.3% of cases. In 43.5% of cases, genetic analysis of the ECM1 gene was performed and exon 6 was the most frequently altered portion. CONCLUSION Analysing the largest number of published cases, the study underlined that hoarseness is the key symptom for diagnosing LP since early childhood, though frequently overlooked.
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Affiliation(s)
- Chiara Cocchi
- Department of Sense Organs, Sapienza University of Rome, 00185, Rome, Italy.
- Otorhinolaryngology Unit, Hesperia Hospital, 41125, Modena, Italy.
| | - Alberto Milanese
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185, Rome, Italy
| | | | - Anna Rita Vestri
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185, Rome, Italy
| | - Lucia Longo
- Department of Sense Organs, Sapienza University of Rome, 00185, Rome, Italy
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Gunasekaran AKD, Singal A. Dermatological disorders with varioliform scars: A clinical approach. Indian J Dermatol Venereol Leprol 2024; 0:1-7. [PMID: 38594982 DOI: 10.25259/ijdvl_536_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 10/30/2023] [Indexed: 04/11/2024]
Affiliation(s)
- Anu Kiruba Devi Gunasekaran
- Department of Dermatology & STD, University College of Medical Sciences & GTB Hospital, University of Delhi, New Delhi, India
| | - Archana Singal
- Department of Dermatology & STD, University College of Medical Sciences & GTB Hospital, University of Delhi, New Delhi, India
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Hashmi FN, Huma S, Singireddy H, Zareen N, Suvvari TK, Ansari MH, Sultana N, Hasibuzzaman MA. Lipoid proteinosis: A rare genodermatosis with multisystemic manifestations-A case report. Clin Case Rep 2024; 12:e8512. [PMID: 38328486 PMCID: PMC10847059 DOI: 10.1002/ccr3.8512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 01/20/2024] [Accepted: 01/21/2024] [Indexed: 02/09/2024] Open
Abstract
Lipoid proteinosis (LP) is a rare autosomal recessive genodermatosis, which is characterized by the deposition of amorphous hyaline material in various tissues, including the mucosa, visceral organs, and skin. We report a case of a 11-year-old girl born to consanguineous parents presented with multisystemic manifestations of the disorder. The patient presented with progressive skin lesions evolving from blisters to papules, distinctive beaded papules along eyelid margins, hoarseness of voice, impaired speech, hair loss, and a painful jaw swelling. Clinical examination revealed waxy skin, atrophic scars, and keratotic plaques. Histopathology report revealed amorphous hyaline eosinophilic material deposition. This case report highlights the multisystemic manifestations of LP and the importance of early diagnosis and management.
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Affiliation(s)
| | - Sumera Huma
- Shadan Institute of Medical SciencesHyderabadTelanganaIndia
| | | | - Nikhat Zareen
- Shadan Institute of Medical SciencesHyderabadTelanganaIndia
| | | | | | - Nudrat Sultana
- Shadan Institute of Medical SciencesHyderabadTelanganaIndia
| | - Md. Al Hasibuzzaman
- The First Affiliated Hospital of Ningbo UniversityNingboChina
- Institute of Nutrition and Food ScienceUniversity of DhakaDhakaBangladesh
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Jahanimoghadam F, Hasheminejad J. Oral Manifestations and Dental Management Considerations of Lipoid Proteinosis: A Case Report and Review of Literature. JOURNAL OF DENTISTRY (SHIRAZ, IRAN) 2022; 23:321-326. [PMID: 36506885 PMCID: PMC9719597 DOI: 10.30476/dentjods.2021.89748.1435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 05/29/2021] [Accepted: 07/17/2021] [Indexed: 12/15/2022]
Abstract
Lipoid proteinosis (LP) is a sporadic congenital metabolic disorder characterized by deposition of hyaline material in various organs. It has a very low prevalence rate of approximately 300 cases reported up to now. It has a vast spectrum of manifestations ranging from asymptomatic skin lesions to the rare but life-threatening laryngeal obstruction. The knowledge of the clinical features of the disease such as hoarseness of voice from infancy, mucocutaneous manifestations, moniliform blepharosis (multiple, beaded papules along the eyelash line) and dental anomalies such as hypoplasia or aplasia of teeth may help oral health care practitioners improve the quality of their patient's life. This case report describes a typical 10-year-old boy who presented to the Department of Pediatric Dentistry, Faculty of Dentistry, University of Medical Sciences, Kerman, Iran with the typical recurrent skin and mucosal lesions, hoarseness, and blepharosis. In addition, he stated a gradual hearing loss, which is not reported as a common manifestation. Moreover, psychosocial issues regarding his appearance and quality of voice had led to absenteeism from school. A punch biopsy obtained from a lesion on his forearm revealed the characteristic histopathological view and directed to the diagnosis of lipoid proteinosis. Dental treatment was initiated with focus on preventive dentistry due to the restricted mouth opening, which was expected to get worse overtime. There is no definitive cure for this disease and the treatment is symptomatic in most cases. A proper workup can result in early diagnosis and management of dental complications, which are difficult to control due to restricted mouth opening, which may significantly affect the patient's social life.
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Affiliation(s)
- Fatemeh Jahanimoghadam
- Social Determinants on Oral Health Research Center, Kerman University of Medical Sciences, Kerman Iran
| | - Jelveh Hasheminejad
- Pediatric Dentistry Resident, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran
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Shah JS, Shah HA. Lipoid proteinosis: Review of Indian cases. J Oral Maxillofac Pathol 2022; 26:236-241. [PMID: 35968171 PMCID: PMC9364649 DOI: 10.4103/jomfp.jomfp_249_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 09/05/2021] [Indexed: 11/24/2022] Open
Abstract
Lipoid proteinosis (LP) is a rare autosomal recessive disorder characterized by the deposition of amorphous hyaline material in the dermis and submucosal connective tissue. To date <500 cases of LP have been described and oral manifestations described in a very few reports. Indian cases are much less reported and reviewed. Hence, here review of 51 Indian LP cases along with a case of histologically proven LP in 12-year-old male patient with typical skin, ocular, laryngeal, oral and radiographic features is done. Cases from 1969 to 2021 were collected using keyword LP on google and google scholar and Indian cases were analyzed afterward. Review with case presentation regarding oral manifestations will help the oral physician to diagnose LP in early stage.
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Affiliation(s)
- Jigna S Shah
- Department of Oral Medicine and Radiology, Government Dental College and Hospital, Ahmedabad, Gujarat, India
| | - Himali A Shah
- Department of Oral Medicine and Radiology, Government Dental College and Hospital, Ahmedabad, Gujarat, India,Address for correspondence: Dr. Himali A Shah, Department of Oral Medicine and Radiology, Government Dental College and Hospital, Ahmedabad, Gujarat, India. E-mail:
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Oral manifestations of lipoid proteinosis in a 10-year-old female: A case report and literature update. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 126:e228-e232. [DOI: 10.1016/j.oooo.2018.01.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 01/24/2018] [Accepted: 01/28/2018] [Indexed: 11/17/2022]
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The management of laryngeal lipoid proteinosis. The Journal of Laryngology & Otology 2018; 132:936-939. [DOI: 10.1017/s0022215118001329] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractBackgroundLipoid proteinosis is a rare autosomal recessive disorder caused by mutations in the extracellular matrix protein 1 gene. It is characterised by deposition of hyaline material in the skin and mucous membranes. This paper describes the management of two cases with laryngopharyngeal disease.MethodsTwo patients with a biopsy diagnosis of lipoid proteinosis were identified from the surgical pathology archive covering the period 2004–2016. Their notes were reviewed.ResultsAn adult male and an adult female were identified. Both had dysphonia and laryngopharyngeal lesions. The patients underwent interval laser microlaryngoscopy to debulk disease but minimise mucosal injury and scarring, using a ‘pepper pot’ technique. Both had adequate symptom control.ConclusionLipoid proteinosis is a rare genetic condition, which typically presents in infancy with dysphonia and subsequent skin involvement. Two cases are presented to demonstrate that laryngotracheal symptoms can be controlled with interval laser debulking and the ‘pepper pot’ technique without causing stenosis.
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Barut Selver O, Palamar M, Onay H, Furundaoturan O, Akalın T, Noyan MA. Moniliform blepharosis in lipoid proteinosis with a homozygous ECM1 gene mutation. Ophthalmic Genet 2018; 39:550-552. [DOI: 10.1080/13816810.2018.1466339] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
| | - Melis Palamar
- Department of Ophthalmology, Ege University, Izmir, Turkey
| | - Huseyin Onay
- Department of Medical Genetics, Ege University, Izmir, Turkey
| | | | - Taner Akalın
- Department of Pathology, Ege University, Izmir, Turkey
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Lipoid proteinosis: A clinical and molecular study in Egyptian patients. Gene 2017; 628:308-314. [PMID: 28720532 DOI: 10.1016/j.gene.2017.07.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 06/17/2017] [Accepted: 07/10/2017] [Indexed: 11/20/2022]
Abstract
Lipoid proteinosis (LP) is an autosomal recessive disorder caused by the loss of function of ECM1 gene. Clinical features include varying degrees of skin thickening, hoarseness of voice and less frequently neuropsychiatric abnormalities. Twelve patients from ten unrelated families with a clinical diagnosis of lipoid proteinosis were enrolled in this study. Extraction of DNA samples of the 12 patients and their parents from peripheral blood by standard methods was performed. Polymerase chain reaction (PCR) amplification of the ECM1 gene was conducted using eight pairs of primers spanning over the 10 exons and splice junctions. Patients exhibited a variety of clinical manifestations with skin affection and hoarseness of voice being the consistent feature. We identified five novel homozygous insertion, small deletion, missense, and splice site mutations as well as two homozygous previously published splice site mutation c.70+1G>C in intron 1 and c.1305-2A>G in intron 8. The specific mutations were: c.10_11insC in exon 1, c.690_691delAG in exon 6, c.734G>A in exon 7, c.1286_1287delAA in exon 8 and c.1393-1G>T in intron 9. The novel mutations c.1393-1G>T and c.10_11insC occurred in three (30%) and two (20%) unrelated patients of the studied families, respectively. Further studies may designate an increased frequency of these mutations among Egyptian LP patients. Identification of pathogenic ECM1 mutations is important for accurate diagnosis and proper genetic counseling.
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Kamath SJ, Marthala H, Manapragada B. Ocular manifestations in lipoid proteinosis: A rare clinical entity. Indian J Ophthalmol 2016; 63:793-5. [PMID: 26655007 PMCID: PMC4728981 DOI: 10.4103/0301-4738.171517] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Lipoid proteinosis is a rare autosomal recessive genodermatosis with abnormal lipid protein complexes deposition in different parts of the body, especially in the skin and mucus membranes of the upper aerodigestive tract. Though ocular involvement in lipoid proteinosis is rare, ophthalmologists may encounter diverse ocular complications accompanying this syndrome in clinical practice. We describe a case of lipoid proteinosis involving bilateral eyelids with pathognomonic moniliform blepharosis in a 33-year-old gentleman who presented with the complaints of itching of eye lids on and off since 10 years.
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Affiliation(s)
| | - HimaBindu Marthala
- Department of Ophthalmology, Kasturba Medical College, Mangalore, Karnataka, India
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