Perinatal Hypophosphatasia in a Premature Infant

Infantile hypophosphatasia: a rare aetiology of recurrent pneumonia

We report a rare case of infantile hypophosphatasia associated with recurrent pneumonia, a condition with few similar cases documented globally. Clinical exome sequencing identified a heterozygous mutation in the alkaline phosphatase (ALPL) gene (c.69_74del; p.Glu23_Lys24del), the first such case reported in India and classified as 'likely pathogenic'. Its causality remains unproven due to limited evidence, including the absence of in vitro studies and pedigree analysis. Phenotypic variability may be influenced by factors such as incomplete penetrance, variable expressivity and environmental or epigenetic modifiers. This case highlights a rare but important cause of recurrent pneumonia in infants. Despite treatment, the child succumbed to severe pneumonia within 2 months. Clinicians should consider infantile hypophosphatasia in cases of recurrent pneumonia, motor delay, seizures, severe malnutrition and persistently low serum alkaline phosphatase. Further genetic and functional studies are needed to validate genotype-phenotype correlations and improve disease management.

The levels of pro- and anti-inflammatory cytokines in premature infants with perinatal infections

Intrauterine infections are an urgent problem of modern neonatology. One of the causes of intrauterine infective foetal lesions is physiological immunosuppression. The purpose of this study is to investigate the cytokine status in newborns infected with perinatal infections, depending on their body weight. The study examined 145 newborns. Taking into account their body weight, they were divided into 2 groups: main and secondary. The study was conducted in the immunological laboratory of the Medical Centre of Marat Ospanov West Kazakhstan Medical University in the city of Aktobe, with the determination of the level of IgM and IgG to the herpes simplex virus (HSV) types 1, 2, cytomegalovirus (CMV), and chlamydia using the MULTISKANASCENT analyser with the "Chemo" T system. The main results of this study are the predominance of the anti-inflammatory component in both normal weight and underweight infants, which is evidence of the Th-cell-mediated immune response prevalence. The applied value of this study lies in the possibility of applying its results in practice to obtain effective methods to counteract the occurrence and development of intrauterine infections.