Congenital insensitivity to pain with anhidrosis and compensatory hyperhidrosis

Abstract Background Orthopedic manifestations of congenital insensitivity to pain (CIP) can be devastating if left untreated. Knee deformities are common in patients with CIP and might lead to joint destruction and loss of walking ability. The purpose of the present study was to report the results and complications of guided growth procedures around the knee in patients with CIP. Methods In a retrospective review, all patients with CIP who underwent guided growth procedures around the knee from 2009 to 2017 at a tertiary referral hospital were evaluated. Patients with secondary insensitivity to pain (e.g., syringomyelia), as well as patients with incomplete records, were excluded. Demographic data, clinical findings, correction rate, and complications were recorded. Results Ten knees in six patients fulfilled the inclusion criteria. The median age was 10 (range, 5–12), with a mean follow-up of 31 months (range, 16–56). Distal femoral tension-band hemiepiphysiodesis was the most common procedure, followed by proximal tibial hemiepiphysiodesis. The mean correction rate was 0.28°/month for femoral deformity. Staples were removed prematurely in one patient due to extrusion. No cases of infection or skin dehiscence were observed. None of the patients needed a reconstructive knee procedure during the study period. Conclusions The findings of this study suggest that guided growth procedures might have a role in the correction of knee deformities in patients with CIP. However, the correction rate is lower than that of typically developing children, patients should be closely followed to prevent complications, and stringent patient selection criteria should be followed to ensure success.

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Nerve growth factor, pain, itch and inflammation: lessons from congenital insensitivity to pain with anhidrosis

Expert Review of Neurotherapeutics ◽

10.1586/ern.10.154 ◽

2010 ◽

Vol 10 (11) ◽

pp. 1707-1724 ◽

Cited By ~ 27

Author(s):

Yasuhiro Indo

Keyword(s):

Nerve Growth Factor ◽

Growth Factor ◽

Nerve Growth ◽

Congenital Insensitivity ◽

Congenital Insensitivity To Pain ◽

Insensitivity To Pain

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Identification of a novel nonsense mutation of the neurotrophic tyrosine kinase receptor type 1 gene in two siblings with congenital insensitivity to pain with anhidrosis

Journal of International Medical Research ◽

10.1177/0300060517691699 ◽

2017 ◽

Vol 45 (2) ◽

pp. 549-555 ◽

Cited By ~ 3

Author(s):

Ting Wang ◽

Haibo Li ◽

Jingjing Xiang ◽

Bin Wei ◽

Qin Zhang ◽

...

Keyword(s):

Tyrosine Kinase ◽

Nonsense Mutation ◽

Mutation Screening ◽

Receptor Type ◽

Tyrosine Kinase Receptor ◽

Site Mutation ◽

Congenital Insensitivity ◽

Congenital Insensitivity To Pain ◽

Insensitivity To Pain

Objective To explore the aetiology of congenital insensitivity to pain with anhidrosis (CIPA) in two Chinese siblings with typical CIPA symptoms including insensitivity to pain, inability to sweat, and self-mutilating behaviours. Methods Clinical examination and genetic testing were conducted of all available family members, and the findings were used to create a pedigree. Mutation screening using PCR amplification and DNA Sanger sequencing of the entire neurotrophic tyrosine kinase receptor type 1 gene ( NTRK1) including intron–exon boundaries was used to identify mutations associated with CIPA. Results A novel nonsense mutation (c.7C > T, p. Arg3Ter) and a known splice-site mutation (c.851-33 T > A) were detected in NTRK1 and shown to be associated with CIPA. Conclusion Our findings expand the known mutation spectrum of NTRK1 and provide insights into the aetiology of CIPA.

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