Ligneous conjunctivitis, hydrocephalus, hydrocele, and pulmonary involvement in a child with homozygous type I plasminogen deficiency.
Ligneous conjunctivitis is a rare and unusual form of chronic pseudomembranous conjunctivitis which usually starts in early infancy. Plasminogen deficiency has recently been associated with ligneous conjunctivitis. The disease may be associated with pseudomembranous lesions of other mucous membranes in the mouth, nasopharynx, trachea, and female genital tract and also with congenital hydrocephalus. In this report, a 1-month-old Turkish boy who had pseudomembranous conjunctivitis, occlusive hydrocephalus, and hydrocele is presented. After surgery for ventriculo-peritoneal shunt establishment, he developed inspiratory stridor, respiratory distress, and pulmonary atelectasis. Tracheal pseudomembranes were also demonstrated by bronchoscopy. Plasminogen antigen level and plasminogen activity were very low. Genomic DNA from the patient was screened for mutations in the plasminogen gene and a homozygous L650fsX652 mutation (deletion of 2081C) was detected. Both of his parents were heterozygous for this mutation. He died due to respiratory failure during follow-up.


CONCLUSIONS
Ligneous conjunctivitis related to type I plasminogen deficiency is relatively common in the Turkish population, however, mutations are heterogeneous and a common founder is unlikely.
Department of Paediatric Infectious Diseases, University of Ankara Medical School, 06100, Dikimevi Ankara, Turkey. erginciftci@doctor.com.
Ergin
E
Çiftçi
Department of Paediatric Infectious Diseases, University of Ankara Medical School, 06100, Dikimevi Ankara, Turkey.
Erdal
E
Ince
Department of Paediatric Infectious Diseases, University of Ankara Medical School, 06100, Dikimevi Ankara, Turkey.
Nejat
N
Akar
Department of Paediatric Infectious Diseases, University of Ankara Medical School, 06100, Dikimevi Ankara, Turkey.
Ülker
Ü
Dogru
Department of Paediatrics, University of Leipzig, Leipzig, Germany.
Katrin
K
Tefs
Department of Paediatrics, University of Leipzig, Leipzig, Germany.
Volker
V
Schuster
D002872:Chromosome Deletion; D003231:Conjunctivitis / Q000209:etiology* / Q000235:genetics; D004252:DNA Mutational Analysis; D016368:Frameshift Mutation; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology*; D007231:Infant, Newborn; D008297:Male; D010958:Plasminogen / Q000172:deficiency*
D010958:Plasminogen