title: Paediatric pseudoxanthoma elasticum with cardiovascular involvement.
abstract: BACKGROUND
  Pseudoxanthoma elasticum (PXE) is characterized by aberrant mineralization of connective tissues, causing considerable morbidity and mortality. The disease is typically of late onset, the skin manifestations first being noted in the teens or later. Another aberrant mineralization disorder, generalized arterial calcification of infancy (GACI), is present at birth and can demonstrate a phenotypic overlap with PXE.
  
  
  OBJECTIVE
  A patient with PXE was noted to have skin findings as early as at 6 years of age, with cardiovascular involvement. The purpose of this study was to examine the genetic basis of this phenotypic presentation in the spectrum of PXE/GACI.
  
  
  METHODS
  The patient's genotype was studied by sequencing ABCC6 and ENPP1, genes known to be associated with PXE and/or GACI.
  
  
  RESULTS
  Screening of the ABCC6 gene revealed two pathogenetic mutations, p.R1141X and g.del23-29. Analysis of the ENPP1 gene failed to demonstrate the presence of mutations.
  
  
  CONCLUSIONS
  This study demonstrates the presence of cutaneous findings of PXE in an 8-year-old paediatric patient, with cardiovascular involvement, illustrating the phenotypic spectrum of PXE.
authors.affiliation: Department of Dermatology and Cutaneous Biology, Jefferson Medical College and Jefferson Institute of Molecular Medicine, Thomas Jefferson University, 233 South 10th Street, Suite 450 BLSB, Philadelphia, PA, 19107, U.S.A.
authors.forename: Q
authors.initials: Q
authors.lastname: Li
authors.forename: J
authors.initials: J
authors.lastname: Baker
authors.forename: J
authors.initials: J
authors.lastname: Kowalczyk
authors.forename: Q
authors.initials: Q
authors.lastname: Jiang
authors.forename: J
authors.initials: J
authors.lastname: Uitto
authors.forename: L
authors.initials: L
authors.lastname: Schachner
mesh_terms: D002648:Child; D004252:DNA Mutational Analysis; D005260:Female; D006801:Humans; D027425:ATP-Binding Cassette, Sub-Family C Proteins / Q000235:genetics*; D009154:Mutation / Q000235:genetics*; D010727:Phosphoric Diester Hydrolases / Q000235:genetics*; D011561:Pseudoxanthoma Elasticum / Q000150:complications / Q000235:genetics*; D011755:Pyrophosphatases / Q000235:genetics*; D061205:Vascular Calcification / Q000150:complications* / Q000235:genetics
chemical_list: D027425:ATP-Binding Cassette, Sub-Family C Proteins; D010727:Phosphoric Diester Hydrolases; D011755:Pyrophosphatases; C102029:ABCC6 protein, human; C065962:ectonucleotide pyrophosphatase phosphodiesterase 1