35 PERINATAL LETHAL FORM OF HYPOPHOSPHATASIA

Hypophosphatasia is a rare and lethal metabolic bone disease characterised by low or absent serum and tissue-alkaline phosphatase activities resulting in insufficient bone mineralisation. Hypophosphatasia has been reported throughout the world and affects all races; however, it is especially prevalent in Manitoba, Canada, where about one in 25 individuals is a carrier and 1: 2.500 newborns manifest severe disease. Six forms of hypophosphatasia have been identified. The perinatal (lethal), infantile, childhood and adult types are distinguished from one another by the age at which clinical manifestations and bone lesions are recognised. Patients with dental manifestations but no skeletal disease are considered to have odontohypophosphatasia. Pseudohypophosphatasia is a rare variant of hypophosphatasia characterised by normal serum alkalinephosphatase (ALP) activity (1). The severe infantile form of hypophosphatasia is autosomal-recessively inherited and is lethal in the neonatal period (2). We report a neonate with congenital hypophosphatasia in which prenatal diagnosis could not be carried out, in spite of the termination of the mother’s former pregnancy because of abnormal skeletal development