European Journal of Pediatrics

, Volume 172, Issue 8, pp 1023–1031

Early respiratory and ocular involvement in X-linked hypohidrotic ectodermal dysplasia

  • Jasna Dietz
  • Thomas Kaercher
  • Anne-Theres Schneider
  • Theodor Zimmermann
  • Kenneth Huttner
  • Ramsey Johnson
  • Holm Schneider
Original Article

DOI: 10.1007/s00431-013-1985-8

Cite this article as:
Dietz, J., Kaercher, T., Schneider, AT. et al. Eur J Pediatr (2013) 172: 1023. doi:10.1007/s00431-013-1985-8

Abstract

X-linked hypohidrotic ectodermal dysplasia (XLHED; ectodysplasin deficiency) has been classically described as affecting hair, sweat glands, and dentition. What may be underappreciated is the effect ectodysplasin deficiency has on glands surrounding the airways and eyes and the resulting chronic health issues. In this study, 12 male children (age range 6–13 years) and 14 male adults with XLHED (18–58 years of age) were investigated by pulmonary function tests, measurement of fractional exhaled nitric oxide, and by ophthalmologic assessments. Twelve healthy individuals (six children, six adults) served as controls. Signs of airway constriction and inflammation were detected in eight children with XLHED, including the youngest subject, and in ten adult XLHED patients. Increased tear osmolarity, reduced tear film break-up time, and other ocular abnormalities were also present at an early age. Five of 12 XLHED subjects not reporting a history of asthma and 7 of the 12 patients not reporting a history of dry eye issues showed at least two abnormal test results in the respective organ system. The presence of residual sweat ducts, suggestive of partial ectodysplasin gene expression, correlated with milder disease in two XLHED subjects with mutations affecting the collagen-like domain of ectodysplasin. Conclusion: The high prevalence of asthma-like symptoms in XLHED patients as young as 6 years and a similar prevalence of dry eye problems indicate that screening evaluation, regular monitoring, and consideration of therapeutic intervention should begin in early childhood.

Keywords

Ectodermal dysplasiaEctodysplasinSeromucous glandsInflammationAsthmaDry eye

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Jasna Dietz
    • 1
  • Thomas Kaercher
    • 1
  • Anne-Theres Schneider
    • 1
  • Theodor Zimmermann
    • 1
  • Kenneth Huttner
    • 2
  • Ramsey Johnson
    • 2
  • Holm Schneider
    • 1
    • 3
  1. 1.German Competence Centre for Children with Ectodermal Dysplasias, Department of PediatricsUniversity of Erlangen-NürnbergErlangenGermany
  2. 2.Edimer Pharmaceuticals Inc.CambridgeUSA
  3. 3.Children’s HospitalUniversity of Erlangen-NürnbergErlangenGermany