Urbach-Wiethe disease: a rare pediatric case report
DOI:
https://doi.org/10.18203/2349-3291.ijcp20233615Keywords:
Acitretin, ECM 1, Hyaline material, Lipoid proteinosis, Hoarseness of voiceAbstract
Urbach-Wiethe disease also known as lipoid proteinosis (LP) is a rare autosomal recessive Geno dermatosis.1 It is characterized by the deposition of an amorphous hyaline material in the skin, mucosa and viscera and is also known as cutaneous-mucosal hyalinosis.2,3 Parental consanguinities is identified in approximately 20% of Urbach-Wiethe disease cases. The classic manifestation due to laryngeal infiltration is a hoarse cry with its onset in infancy. Skin and mucous membrane changes become clinically apparent important consequences.4 Rarely, the central nervous system and respiratory tract may be involved resulting in seizures and airway obstruction, respectively. The lifespan is generally normal. We report a case of Urbach-Wiethe disease in a 6-year-old boy with hoarseness of voice who was started on oral acitretin therapy following his diagnosis. Oral acitretin can prove useful in cases of lipoid proteinosis who present with hoarseness of voice or vocal cord palsy. The mutations in the gene encoding extracellular matrix protein 1 (ECM1) have been linked to lipoid proteinosis. Even though no effective treatment is known, acitretin has proved to reverse hoarseness of voice in few reported cases and was started in our case as it was his chief presenting complaint.
References
Hamada T. Lipoid proteinosis. Clin Exp Dermatol. 2002;27:624-9.
Mcgrath JA. Lipoid proteinosis. Handb Clin Neurol. 2015;132:317-22.
Krafchik B, Lara-Corrales l. Lipoid proteinosis. Orphanet encyclopedia. 2014. Available at: https://www.orpha.net/consor/cgi-bin/OC_Exp.php? Lng=GB&Expert=530. Accessed on 09 September 2023.
Savage M, Crockett DM, McCabe BF. Lipoid proteinosis of the larynx: a cause of voice change in the infant and young child. Int J Pediatr Otorhinolaryngol. 1988;15:33-8.
Chan I, Liu L, Hamada T, Sethuraman G, McGrath JA. The molecular basis of lipoid proteinosis: Mutations in extracellular matrix protein 1. Exp Dermatol. 2007;16:881-90.
Srinivas SM, Maganthi M, Chandrasekaran PJ, Gowdra A, Palany R. Clinical and molecular characterization of lipoid proteinosis in three Indian families. Indian J Paediatr Dermatol. 2020;21:167-73.
Dyer JA. Chapter 137: Lipoid Proteinosis and Heritable Disorders of Connective Tissue. Fitzpatrick’s Dermatology in General Medicine.8th edition. McGraw-Hill Education. 2012.
Trupthi MC, Syed KA, Sivaranjini R, Mukhopadhyay S, Varghese AM. Lipoid Proteinosis-A Pediatric Otolaryngologist’s Perspective: A Case Report and Review of Literature. Int J Otorhinolaryngol Clin. 2015;7(2):97-9.
Hamada T, McLean WH, Ramsay M, Ashton GH, Nanda A, Jenkins T, et al. Lipoid proteinosis maps to 1q21 and is caused by mutations in the extracellular matrix protein 1 gene (ECM1). Hum Mol Genet. 2002;11:833-40.
Di Giandomenico S, Masi R, Cassandrini D, El-Hachem M, De Vito R, Bruno C, et al. Lipoid proteinosis: Case report and review of the literature. Acta Otorhinolaryngol Ital. 2006;26:162-7.
Toosi S, Ehsani AH. Treatment of lipoid proteinosis with acitretin: A case report. J Eur Acad Dermatol Venereol. 2009;23:482-3.
Kote SP, Chopkar AD, Supekar BB, Mukhi JI. Successful use of acitretin in an Indian child with lipoid proteinosis. Indian J Paediatr Dermatol. 2022;23:238-41.