Jammed joints and constricted heart: The science of tribology and missing lubricin. A case report on camptodactyly-arthropathy-coxa vara-pericarditis syndrome

An autosomal recessively inherited noninflammatory arthropathy known as camptodactyly, arthropathy, coxa vara, and pericarditis (CACP) syndrome was discovered in 1999. It is distinguished by synoviocyte hyperplasia and subcapsular fibrosis of the synovial capsule, which results in a shortage of lubr...

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Main Authors: Krishnan Ganapathy Subramaniam, Satish Mohanty, Dhruva Sharma, Komal Tamildasan, Narahari Srinath Reddy
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2024-10-01
Series:Annals of Pediatric Cardiology
Subjects:
Online Access:https://journals.lww.com/10.4103/apc.apc_18_24
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author Krishnan Ganapathy Subramaniam
Satish Mohanty
Dhruva Sharma
Komal Tamildasan
Narahari Srinath Reddy
author_facet Krishnan Ganapathy Subramaniam
Satish Mohanty
Dhruva Sharma
Komal Tamildasan
Narahari Srinath Reddy
author_sort Krishnan Ganapathy Subramaniam
collection DOAJ
description An autosomal recessively inherited noninflammatory arthropathy known as camptodactyly, arthropathy, coxa vara, and pericarditis (CACP) syndrome was discovered in 1999. It is distinguished by synoviocyte hyperplasia and subcapsular fibrosis of the synovial capsule, which results in a shortage of lubricin production. The resulting lack of joint lubrication induces increased mechanical stress, causing progressive deformities that become evident with weight-bearing and heightened joint activity. Animal models with a lubricin gene knock-out display similar traits, underscoring the impact of mechanical stress on disrupting type II collagen on the articular surface. The gradual development of pericarditis and constriction often results in misdiagnosis as juvenile rheumatoid arthritis with cardiac involvement, but the defining feature remains the noninflammatory nature of the disease. Early recognition is pivotal, as interventions such as pericardiectomy and recombinant human lubricin hold promise for altering the disease’s natural course. In our familial case of CACP, two siblings exhibited distinct phenotypic variations – one with fibrosis-dominant features and pericardial constriction and the other displaying synovial hyperplasia without pericardial involvement.
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issn 0974-2069
0974-5149
language English
publishDate 2024-10-01
publisher Wolters Kluwer Medknow Publications
record_format Article
series Annals of Pediatric Cardiology
spelling doaj-art-2487f33469c84735b26ca08e326ff5212025-08-20T02:17:58ZengWolters Kluwer Medknow PublicationsAnnals of Pediatric Cardiology0974-20690974-51492024-10-0117322122310.4103/apc.apc_18_24Jammed joints and constricted heart: The science of tribology and missing lubricin. A case report on camptodactyly-arthropathy-coxa vara-pericarditis syndromeKrishnan Ganapathy SubramaniamSatish MohantyDhruva SharmaKomal TamildasanNarahari Srinath ReddyAn autosomal recessively inherited noninflammatory arthropathy known as camptodactyly, arthropathy, coxa vara, and pericarditis (CACP) syndrome was discovered in 1999. It is distinguished by synoviocyte hyperplasia and subcapsular fibrosis of the synovial capsule, which results in a shortage of lubricin production. The resulting lack of joint lubrication induces increased mechanical stress, causing progressive deformities that become evident with weight-bearing and heightened joint activity. Animal models with a lubricin gene knock-out display similar traits, underscoring the impact of mechanical stress on disrupting type II collagen on the articular surface. The gradual development of pericarditis and constriction often results in misdiagnosis as juvenile rheumatoid arthritis with cardiac involvement, but the defining feature remains the noninflammatory nature of the disease. Early recognition is pivotal, as interventions such as pericardiectomy and recombinant human lubricin hold promise for altering the disease’s natural course. In our familial case of CACP, two siblings exhibited distinct phenotypic variations – one with fibrosis-dominant features and pericardial constriction and the other displaying synovial hyperplasia without pericardial involvement.https://journals.lww.com/10.4103/apc.apc_18_24camptodactylyarthropathycoxa varapericarditis syndromeconstrictive pericarditislubricin deficiencypericardiectomy
spellingShingle Krishnan Ganapathy Subramaniam
Satish Mohanty
Dhruva Sharma
Komal Tamildasan
Narahari Srinath Reddy
Jammed joints and constricted heart: The science of tribology and missing lubricin. A case report on camptodactyly-arthropathy-coxa vara-pericarditis syndrome
Annals of Pediatric Cardiology
camptodactyly
arthropathy
coxa vara
pericarditis syndrome
constrictive pericarditis
lubricin deficiency
pericardiectomy
title Jammed joints and constricted heart: The science of tribology and missing lubricin. A case report on camptodactyly-arthropathy-coxa vara-pericarditis syndrome
title_full Jammed joints and constricted heart: The science of tribology and missing lubricin. A case report on camptodactyly-arthropathy-coxa vara-pericarditis syndrome
title_fullStr Jammed joints and constricted heart: The science of tribology and missing lubricin. A case report on camptodactyly-arthropathy-coxa vara-pericarditis syndrome
title_full_unstemmed Jammed joints and constricted heart: The science of tribology and missing lubricin. A case report on camptodactyly-arthropathy-coxa vara-pericarditis syndrome
title_short Jammed joints and constricted heart: The science of tribology and missing lubricin. A case report on camptodactyly-arthropathy-coxa vara-pericarditis syndrome
title_sort jammed joints and constricted heart the science of tribology and missing lubricin a case report on camptodactyly arthropathy coxa vara pericarditis syndrome
topic camptodactyly
arthropathy
coxa vara
pericarditis syndrome
constrictive pericarditis
lubricin deficiency
pericardiectomy
url https://journals.lww.com/10.4103/apc.apc_18_24
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