[Congenital cutis laxa: a case study]

Comprehensive analysis of pseudoxanthoma elasticum: epidemiological, genetic, and clinical findings from the leading Italian center

BACKGROUND

Pseudoxanthoma elasticum (PXE) is a rare genetic autosomal recessive metabolic disease characterized by progressive mineralization and fragmentation of elastic fibers from soft connective tissues. The objective of our study was to analyze the epidemiological, genetic, cutaneous, and extracutaneous clinical data from the largest Italian monocentric cohort of PXE patients.

METHODS

We included all patients diagnosed with PXE and referred to Neurocutaneous Rare Diseases at Umberto I Polyclinic Hospital (Rome, Italy) between January 1983 and February 2024. A retrospective analysis of their data was performed.

RESULTS

We enrolled 86 patients (77.9% women), revealing compound heterozygosity in 19.8% of cases and homozygosity in 5.8%. Missense (34.9%), non-sense (5.8%), splice-site (5.8%), deletion (4.7%), and frameshift (2.3%) mutations were disclosed. Cutaneous alterations were noted in the neck (69.7%), axilla (33.7%), inguinal (17.5%), and cubital folds (11.7%). The most common ocular findings were angioid streaks (64.0%) and choroidal neovascularization (18.6%), with blindness reported in 5.8% of cases. Thicker intima-media was observed around the mid-fifties in the supra-aortic trunks (40.7%), lower limb arteries (32.6%), and renal arteries (4.7%). Regurgitation was more common in atrioventricular valves (48.8%) than in semilunar ones (10.5% and 9.3%). Dyslipidemia (19.8%), hypertension (18.8%), and fatty liver disease (12.8%) were prevalent, with calcifications found in the kidneys (25.6%), liver (15.1%), spleen (11.6%), and testicles (8.1% of males). Autoimmune diseases and depression were observed in 11.6% and 4.7% of cases, respectively.

CONCLUSIONS

Enhanced understanding of PXE can improve patients' quality of life and facilitate the development of more effective therapeutic strategies.

Análisis de la mutación c.187 C>T en el gen ATP6V0A2 mediante PCR-ARMS

Los desórdenes congénitos de la glicosilación (CDG) son enfermedades poco frecuentes (EPOF) de tipo metabólico y hereditarias que ocurren como consecuencia de mutaciones en los genes que codifican para proteínas que participan, directa o indirectamente, en este proceso. La enfermedad clínicamente denominada Cutis Laxa Autosómica Recesiva tipo II-A (ARCL2A) es un tipo de CDG (ATP6V0A2-CDG) causado por mutaciones en ATP6V0A2, que codifica para la subunidad a2 del dominio v0 de una ATPasa vacuolar que tiene como función el transporte de iones H+ a través de las membranas celulares, regulando así el pH de los compartimentos celulares, e incluye la acidificación del aparato de Golgi. En 2014, nuestro grupo de investigación reportó por primera vez en México, la existencia de dos pacientes con ATP6V0A2-CDG. En este trabajo, se estableció una metodología para identificar a los portadores de la mutación c.187 C>T en el ATP6V0A2 mediante PCR-ARMS.