Hirschsprung's disease in cartilage-hair hypoplasia has poor prognosis.
OBJECTIVE
Cartilage-hair hypoplasia (CHH) is a chondrodysplasia with growth failure, impaired immunity, and high incidence of Hirschsprung disease (HD). This study describes the outcome of CHH patients with HD.


METHODS
Among 147 patients with CHH, 13 were identified to have HD. Their medical records were analyzed for treatment, outcome, and complications of HD and compared with a control group of 169 patients with HD but not CHH.


RESULTS
Eight CHH patients had classic HD with rectosigmoid involvement, 2 had long segment colonic disease, and 3 patients had total colonic aganglionosis. Six of the 13 CHH patients (46%) had episodes of enterocolitis before the first surgery. Enterocolitis was complicated by colonic perforation in 2 cases. Eleven CHH patients (85%) had at least one episode of postoperative enterocolitis. Five patients (38%) with CHH and HD had died; 4 of enterocolitis-related septic infection and one of non-Hodgkin's lymphoma. In the control group, preoperative enterocolitis occurred in 14% and postoperative enterocolitis in 8%. Two controls (1.2%) had died.


CONCLUSIONS
HD associated with CHH has poor prognosis in terms of postoperative morbidity and risk of death. These patients require particular attention during postoperative follow-up to detect potentially lethal complications.
Mäkitie
Outi
O
Hospital for Children and Adolescents and the Department of Clinical Genetics, University of Helsinki, Helsinki, Finland.
Heikkinen
Marja
M
Kaitila
Ilkka
I
Rintala
Risto
R
D002356:Cartilage / Q000002:abnormalities; D016022:Case-Control Studies; D015897:Comorbidity; D005260:Female; D005387:Finland / Q000453:epidemiology; D006197:Hair / Q000002:abnormalities; D006627:Hirschsprung Disease / Q000453:epidemiology* / Q000601:surgery; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010009:Osteochondrodysplasias / Q000453:epidemiology*; D011183:Postoperative Complications / Q000453:epidemiology; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D013577:Syndrome