Carpal Tunnel Syndrome in Children with Hypogammaglobulinemia - Case Report -

Seoung-Joon Lee; Min-Seok Kang

doi:10.4055/jkoa.2009.44.4.486

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Lee and Kang: Carpal Tunnel Syndrome in Children with Hypogammaglobulinemia - Case Report -

Case Report

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2009; 44(4): 486-489.

Published online: 21 July 2009

DOI: https://doi.org/10.4055/jkoa.2009.44.4.486

Carpal Tunnel Syndrome in Children with Hypogammaglobulinemia - Case Report -

Seoung-Joon Lee, M.D., Min-Seok Kang, M.D.

Department of Orthopedic Surgery, Konkuk University Hospital, Seoul, Korea.

Correspondence to Seoung-Joon Lee, M.D. Department of Orthopaedic Surgery, Konkuk University School of Medicine, 1, Hwayang-dong, Gwangjin-gu, Seoul 143-701, Korea. Tel: +82.2-2030-7360, Fax: +82.2-2030-7369, lsjmd@kuh.ac.kr

Received 9 September 2008 Accepted 20 June 2009

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.

Keywords: Carpal tunnel syndrome, Children, Hypogammaglobulinemia

Figures and Tables

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).

Fig. 2

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

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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