Update Review and Clinical Presentation in Congenital Insensitivity to Pain and Anhidrosis

Introduction. Congenital insensitivity to pain and anhidrosis (CIPA) or hereditary sensory and autonomic neuropathy type IV is an extremely rare syndrome. Three clinical findings define the syndrome: insensitivity to pain, impossibility to sweat, and mental retardation. This pathology is caused by a...

Full description

Saved in:
Bibliographic Details
Main Authors: L. M. Pérez-López, M. Cabrera-González, D. Gutiérrez-de la Iglesia, S. Ricart, G. Knörr-Giménez
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Case Reports in Pediatrics
Online Access:http://dx.doi.org/10.1155/2015/589852
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1841524646643499008
author L. M. Pérez-López
M. Cabrera-González
D. Gutiérrez-de la Iglesia
S. Ricart
G. Knörr-Giménez
author_facet L. M. Pérez-López
M. Cabrera-González
D. Gutiérrez-de la Iglesia
S. Ricart
G. Knörr-Giménez
author_sort L. M. Pérez-López
collection DOAJ
description Introduction. Congenital insensitivity to pain and anhidrosis (CIPA) or hereditary sensory and autonomic neuropathy type IV is an extremely rare syndrome. Three clinical findings define the syndrome: insensitivity to pain, impossibility to sweat, and mental retardation. This pathology is caused by a genetic mutation in the NTRK1 gene, which encodes a tyrosine receptor (TrkA) for nerve growth factor (NGF). Methods. The consultation of a child female in our center with CIPA and a tibia fracture in pseudoarthrosis encouraged us to carefully review literature and examine the therapeutic possibilities. A thorough review of literature published in Pubmed was done about CIPA and other connected medical issues mentioned in the paper. Conclusions. The therapeutic approach of CIPA remains unclear. The preventive approach remains the only possible treatment of CIPA. We propose two new important concepts in the therapeutic approach for these patients: (1) early surgical treatment for long bone fractures to prevent pseudoarthrosis and to allow early weight bearing, decreasing the risk of further osteopenia, and (2) bisphosphonates to avoid the progression of osteopenia and to reduce the number of consecutive fractures.
format Article
id doaj-art-8f6a3e777c454acf801bea9d0360f698
institution Kabale University
issn 2090-6803
2090-6811
language English
publishDate 2015-01-01
publisher Wiley
record_format Article
series Case Reports in Pediatrics
spelling doaj-art-8f6a3e777c454acf801bea9d0360f6982025-02-03T05:47:50ZengWileyCase Reports in Pediatrics2090-68032090-68112015-01-01201510.1155/2015/589852589852Update Review and Clinical Presentation in Congenital Insensitivity to Pain and AnhidrosisL. M. Pérez-López0M. Cabrera-González1D. Gutiérrez-de la Iglesia2S. Ricart3G. Knörr-Giménez4Pediatric Orthopaedic Surgery Department, Sant Joan de Déu Children’s Hospital, University of Barcelona, Barcelona, SpainPediatric Orthopaedic Surgery Department, Sant Joan de Déu Children’s Hospital, University of Barcelona, Barcelona, SpainPediatric Orthopaedic Surgery Department, Sant Joan de Déu Children’s Hospital, University of Barcelona, Barcelona, SpainPediatric Rheumatology Department, Sant Joan de Déu Children’s Hospital, University of Barcelona, Barcelona, SpainPediatric Orthopaedic Surgery Department, Sant Joan de Déu Children’s Hospital, University of Barcelona, Barcelona, SpainIntroduction. Congenital insensitivity to pain and anhidrosis (CIPA) or hereditary sensory and autonomic neuropathy type IV is an extremely rare syndrome. Three clinical findings define the syndrome: insensitivity to pain, impossibility to sweat, and mental retardation. This pathology is caused by a genetic mutation in the NTRK1 gene, which encodes a tyrosine receptor (TrkA) for nerve growth factor (NGF). Methods. The consultation of a child female in our center with CIPA and a tibia fracture in pseudoarthrosis encouraged us to carefully review literature and examine the therapeutic possibilities. A thorough review of literature published in Pubmed was done about CIPA and other connected medical issues mentioned in the paper. Conclusions. The therapeutic approach of CIPA remains unclear. The preventive approach remains the only possible treatment of CIPA. We propose two new important concepts in the therapeutic approach for these patients: (1) early surgical treatment for long bone fractures to prevent pseudoarthrosis and to allow early weight bearing, decreasing the risk of further osteopenia, and (2) bisphosphonates to avoid the progression of osteopenia and to reduce the number of consecutive fractures.http://dx.doi.org/10.1155/2015/589852
spellingShingle L. M. Pérez-López
M. Cabrera-González
D. Gutiérrez-de la Iglesia
S. Ricart
G. Knörr-Giménez
Update Review and Clinical Presentation in Congenital Insensitivity to Pain and Anhidrosis
Case Reports in Pediatrics
title Update Review and Clinical Presentation in Congenital Insensitivity to Pain and Anhidrosis
title_full Update Review and Clinical Presentation in Congenital Insensitivity to Pain and Anhidrosis
title_fullStr Update Review and Clinical Presentation in Congenital Insensitivity to Pain and Anhidrosis
title_full_unstemmed Update Review and Clinical Presentation in Congenital Insensitivity to Pain and Anhidrosis
title_short Update Review and Clinical Presentation in Congenital Insensitivity to Pain and Anhidrosis
title_sort update review and clinical presentation in congenital insensitivity to pain and anhidrosis
url http://dx.doi.org/10.1155/2015/589852
work_keys_str_mv AT lmperezlopez updatereviewandclinicalpresentationincongenitalinsensitivitytopainandanhidrosis
AT mcabreragonzalez updatereviewandclinicalpresentationincongenitalinsensitivitytopainandanhidrosis
AT dgutierrezdelaiglesia updatereviewandclinicalpresentationincongenitalinsensitivitytopainandanhidrosis
AT sricart updatereviewandclinicalpresentationincongenitalinsensitivitytopainandanhidrosis
AT gknorrgimenez updatereviewandclinicalpresentationincongenitalinsensitivitytopainandanhidrosis