Evaluation of hair structural abnormalities in children with different neurological diseases

Turk J Pediatr. 2022;64(6):1086-1105. doi: 10.24953/turkjped.2022.221.

Abstract

Background: Hair microscopy is a fast and effortless diagnostic method for many diseases affecting hair in daily practice. Many diseases can present with hair shaft disorders in pediatric neurology practice.

Methods: Children with pathological hair findings were included in our study. Microscopic evaluation of the hair was performed under light microscopy. The clinical findings, pathological hair shaft findings, laboratory tests, and final diagnosis of the patients were evaluated.

Results: In our study, 16 patients with rare pathological hair findings were identified. Of these 16 patients, nine were diagnosed with giant axonal neuropathy, three with Griscelli syndrome, two with Menkes disease, and two with autosomal recessive woolly hair disease. In hair inspection, curly and tangled hair in patients with giant axonal neuropathy; silvery blond hair in patients with Griscelli syndrome; sparse, coarse, and light-colored hair in patients with Menkes disease; and hypotrichosis in patients with autosomal recessive woolly hair were remarkable findings. Dystrophic hair was detected in most of the patients on light microscopy. In addition, signs of trichorrhexis nodosa, tricoptylosis, and pili torti were found. In particular, pigment deposition in the hair shaft of two patients diagnosed with Griscelli syndrome and pili torti findings in two patients with Menkes disease were the most important findings suggestingthe diagnosis.

Conclusions: Detection of hair findings in the physical examination and performing light microscopic evaluation facilitates the diagnosis of rare diseases accompanied by hair findings. A hair examination should be performed as a part of physical and neurological examinationson eachpatient regardless of thecomplaint.

Keywords: Griscelli syndrome; Menkes disease; child; giant axonal neuropathy; hair microscopy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Amino Acid Metabolism, Inborn Errors*
  • Child
  • Giant Axonal Neuropathy*
  • Hair
  • Hair Diseases* / diagnosis
  • Hair Diseases* / pathology
  • Humans
  • Menkes Kinky Hair Syndrome* / diagnosis
  • Menkes Kinky Hair Syndrome* / pathology
  • Nervous System Diseases* / diagnosis
  • Primary Immunodeficiency Diseases*

Supplementary concepts

  • Pili Torti
  • Woolly Hair, Autosomal Recessive