J Korean Orthop Assoc.  2009 Aug;44(4):486-489.

Carpal Tunnel Syndrome in Children with Hypogammaglobulinemia: Case Report

• Lee SJ
• Kang MS

Abstract

Carpal tunnel syndrome occurs infrequently in children. Genetic disorders and systemic disease of carpal tunnel syndrome may be the predisposing factors for carpal tunnel syndrome in children. Immunoglobulins (Ig) play a major role in adaptive immunity, and the loss of certain species of immunoglobulin is known to increase the risk of certain types of infection. Patients with hypogammaglobulinemia have an increased risk of cellulitis, arthritis and osteomyelitis. We describe the management of bilateral carpal tunnel syndrome in children with hypogammaglobulinemia.

Keyword

Carpal tunnel syndrome; Children; Hypogammaglobulinemia

MeSH Terms

Adaptive Immunity
Agammaglobulinemia
Arthritis
Carpal Tunnel Syndrome
Cellulitis
Child
Humans
Immunoglobulins
Osteomyelitis
Immunoglobulins

Figure

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  Fig. 1 Axial T1-weighted magnetic resonance image and axial T2-weighted magnetic resonance image demonstrate extensive synovitis in flexor and extensor tendon sheath, radiocarpal, intercarpal and carpometacarpal joint (excluding distal radioulnar compartment).

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  Fig. 2 Photographs (A) and (B) show a hypertrophic change of flexor tendon sheath and flattening of median nerve.

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  Fig. 3 Photographs show a microscopic finding of left wrist fat, synovium and transverse carpal ligament. (A) Left wrist fat: the adiopose tissue at the left wrist revealed diffuse septal fibrosis and (B) Synovium: the ligament shows increased fibrosis and degeneration. (C) Transverse carpal ligament: There are proliferation and activation of the stromal and cells of the synovium with mild infiltrate of chronic inflammatory cells.

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