BackgroundHyaline fibromatosis syndrome (HFS) is a congenital disorder characterized by subcutaneous skin nodules, congenital multiple arthrogryposis, gingival hyperplasia, and chronic pain. The intellectual ability of patients with HFS is generally normal. This syndrome arises from variants of ANTXR2. Thus far, about 100 cases have been reported but few of these were reported from Japan.MethodsThis study reports five additional Japanese patients with genetically confirmed HFS, from unrelatd families, and discusses the clinical course and quality of life of these patients.ResultsAt our last visit the ages of the patients were 3–19 years (the median age was 5 years). All the patients had arthrogryposis, skin nodules, and gingival hyperplasia, and four patients had chronic pain, all of which are distinctive, clinical characteristics of HFS. Four of the patients (80%) had pruritic skin nodules, and three experienced sleep disruptions due to pruritis. The visceral complications are an index of HFS severity. One patient in the present cohort had a mucosal abnormality without any gastrointestinal symptoms.ConclusionPreventive and routine management of pruritis caused by skin nodules should be shared with the patient's family. Even asymptomatic patients might have endoscopic finding, which would be a soft marker that could predict the development of protein losing enteropathy.
{"title":"Prognostic factors for wellbeing in patients with hyaline fibromatosis syndrome","authors":"Hiroshi Futagawa, Shiho Ito, Kenji Hosoi, Ikkei Tamada, Kiyokazu Ogata, Kentaro Fukuda, Haruka Yamanaka, Maho Kuroda, Chiharu Suda, Kenji Shimizu, Hiroshi Yoshihashi","doi":"10.1111/ped.15797","DOIUrl":"https://doi.org/10.1111/ped.15797","url":null,"abstract":"BackgroundHyaline fibromatosis syndrome (HFS) is a congenital disorder characterized by subcutaneous skin nodules, congenital multiple arthrogryposis, gingival hyperplasia, and chronic pain. The intellectual ability of patients with HFS is generally normal. This syndrome arises from variants of <jats:italic>ANTXR2</jats:italic>. Thus far, about 100 cases have been reported but few of these were reported from Japan.MethodsThis study reports five additional Japanese patients with genetically confirmed HFS, from unrelatd families, and discusses the clinical course and quality of life of these patients.ResultsAt our last visit the ages of the patients were 3–19 years (the median age was 5 years). All the patients had arthrogryposis, skin nodules, and gingival hyperplasia, and four patients had chronic pain, all of which are distinctive, clinical characteristics of HFS. Four of the patients (80%) had pruritic skin nodules, and three experienced sleep disruptions due to pruritis. The visceral complications are an index of HFS severity. One patient in the present cohort had a mucosal abnormality without any gastrointestinal symptoms.ConclusionPreventive and routine management of pruritis caused by skin nodules should be shared with the patient's family. Even asymptomatic patients might have endoscopic finding, which would be a soft marker that could predict the development of protein losing enteropathy.","PeriodicalId":20039,"journal":{"name":"Pediatrics International","volume":"16 1","pages":"e15797"},"PeriodicalIF":1.4,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142176704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p>Every neonate requires a detailed examination of the external genitalia for sex assignment. Conventional approaches for the examination in female extremely low birthweight (ELBW) neonates in the closed incubator are challenging. Under direct visual inspection from outside the closed incubator, evaluation may be insufficient, owing to the small body size. It is necessary to lift the lower limbs and buttocks to enable physicians to examine the perineum thoroughly. However, this practice is potentially against the minimal handling protocol for ELBW neonates. In a previous study, an endoscope-assisted technique helped physicians to identify the urethral meatus in a male ELBW neonate with hypospadias.<span><sup>1</sup></span> It remains unknown whether this endoscope-assisted technique can be applied to examinations of perineum of female ELBW neonates. Here, using a mobile airwayscope with a monitor, we examined the external genitalia in a 483 g female neonate.</p>