Congenital insensitivity to pain with anhidrosis

Congenital insensitivity to pain with anhidrosis (CIPA), also known as hereditary sensory and autonomic neuropathy type IV, is a condition which affects the nervous system. The main signs of CIPA include being unable to feel pain or temperature, being unable to sweat, and intellectual disability. The sense of touch and vibration is not affected. The inability to feel pain can result in accidental self-injury and the inability to sweat can result in high fevers (hyperpyrexia) and seizures.

Other symptoms of CIPA can include thick, leathery skin on the hands, mis-shapen finger- and toenails, and patches where hair does not grow. Some people experience muscle weakness as children.

Treatment is focussed on controlling body temperature, and avoiding and treatng injury.

Quick facts about congenital insensitivity to pain with anhidrosis
Genes: NTRK1
Inheritance: Autosomal Recessive
Alternative Names: hereditary sensory and autonomic neuropathy type IV
Relevant resources for congenital insensitivity to pain with anhidrosis

A quick genetics rundown

As humans we have about 23,000 genes. These genes are like tiny instruction manuals that influence our health, growth and development. We inherit half of our genes from our biological mum and the other half from our biological dad. These genes are lined up on structures called chromosomes. Most of us have 23 pairs of chromosomes. The first 22 pairs are called autosomes and for the most part - these are the same among men and women. The 23rd pair determine our sex - two X chromosomes for a female and one X and one Y chromosome for males.

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How is congenital insensitivity to pain with anhidrosis inherited?

congenital insensitivity to pain with anhidrosis is known as an autosomal recessive condition. For autosomal recessive conditions, if a person has a variation in one copy of their gene, they are a carrier. This means that they are healthy because they also have a working copy of the gene. But, they can still pass their non-working copy to their child.

If the other parent also happens to be a carrier of the same gene, there is a 25% (1 in 4) chance that they both pass this gene variation on to their child — and as such, have a child affected by the disease.

If both parents are carriers of congenital insensitivity to pain with anhidrosis, there’s a one in four chance that their children could develop symptoms.
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What is carrier screening?

Carrier testing is like a checkup for your genes. It tests to see if you carry a gene variation that could cause a serious genetic disease in your child. Eugene offers an inclusive genetic carrier screening panel that includes congenital insensitivity to pain with anhidrosis, but there's a total 301 conditions that can be tested.

Eugene’s carrier test is a clinical grade test that can be done from the comfort of your own home — it’s just a saliva test. You're also paired with a genetic counsellor who provides mindful support and guidance every step of the way.

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Should parents screen for congenital insensitivity to pain with anhidrosis before or early in pregnancy?

The biggest benefit of screening for congenital insensitivity to pain with anhidrosis is that it can help future parents understand their reproductive risk so they can be ready and empowered to make more informed decisions. If neither partner are carriers, it provides reassurance and peace of mind that the risk of having a child with a genetic disease is low.

Since 90% of children that have a recessive genetic disease like congenital insensitivity to pain with anhidrosis had no previous family history of it, it often feels completely out of the blue for the parents. Getting screened is a way to know this risk in advance, which can help familes manage or even prevent the disease in the first place.

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