A novel association of the additional intracranial calcification in lipoid proteinosis: a case report

Patient With Lipoid Proteinosis Presenting With Sudden-Onset Lower Limb Weakness: A Rare Case

Lipoid proteinosis (LP), or Urbach-Wiethe disease, is an infrequent autosomal recessive disorder typified by hyaline material deposition in diverse tissues, including the skin, mucous membranes, and internal organs. This case report addresses an unusual presentation of LP in a 25-year-old male, whose initial symptom was sudden-onset left lower limb weakness. This deviation from the typical dermatological and laryngeal manifestations prevalent in LP compels us to consider LP as a potential causative factor in neurological deficits. Physical examination revealed motor weakness in the left lower limb with several dermatological manifestations. Laboratory tests indicated potential thyroid, liver, and urinary tract pathologies. Brain imaging studies revealed bilateral mesial temporal lobe calcifications consistent with LP with associated cortico-subcortical infarcts and hemorrhagic transformation. Additionally, foraminal disc protrusion at L5-S1 in the patient's back MRI suggested nerve compression contributing to limb weakness. This patient's sudden-onset left lower limb weakness accompanied by imaging findings of cortical and subcortical abnormalities aligns with the spectrum of neurological manifestations associated with LP but is less commonly reported. Moreover, the disturbed liver and thyroid blood tests in this patient suggest a potential link between LP and thyroid and liver pathologies, which needs further investigation. This case illustrates that motor weakness, potentially due to cerebral infarcts and intracerebral hemorrhage, is a possible complication of LP. Further research is necessary to confirm and understand the phenomenology of this complication.

Oral Manifestations and Dental Management Considerations of Lipoid Proteinosis: A Case Report and Review of Literature

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.

Lipoid proteinosis: Review of Indian cases

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.

Lipoid proteinosis: A rare entity

Urbach-Wiethe syndrome or lipoid proteinosis is a rare autosomal recessive disorder characterized histologically by infiltration of Periodic acid Schiff-positive hyaline material in the skin, upper aerodigestive tract, eyelids, and internal organs. Classical clinical features include scarring of the skin, beaded eyelid papules (moniliform blepharosis) and laryngeal infiltration leading to hoarseness of voice. Lipoid proteinosis can lead to life-threatening conditions such as acute respiratory distress and seizures. Awareness among ophthalmologists about this rare entity is crucial for appropriate management of these patients.

Lipoid proteinosis: a rare encounter in dental office

Lipoid proteinosis is a sporadic congenital metabolic disorder which is characterized by deposition of hyaline material in dermis, submucosal connective tissue, and various internal organs. It has an extremely low prevalence rate with less than 300 cases reported so far. This progressive disease has a vast spectrum of manifestations ranging from asymptomatic lesions to fatal seizures and respiratory obstruction making timely diagnosis of this rare disorder an imperative task for oral health care practitioners. We report a case of characteristic oral manifestations of lipoid proteinosis in a 28-year-old male patient along with a review of relevant prevailing literature.