Pseudoxanthoma elasticum

Pseudoxanthoma elasticum (PXE), also known as Grönblad–Strandberg syndrome, is a systemic condition characterised by the degeneration of elastic fibres. It has multiorgan manifestations.

Its prevalence is estimated to be around 1 in 25,000 9

Patients may present with a characteristic xanthomatous papular rash and retinal angioid streaks. The clinical spectrum is wide and can include

  • abnormal tissue mineralisation in various organs (e.g. liver, kidneys, spleen, breast, and testes)
  • angiomatous malformations: can result in gastrointestinal haemorrhage
  • aneurysmal dilatation
    • can potentially involve any vessel (intracranial 5, renal 4)
    • if in the mesentery: can result in gastrointestinal haemorrhage
  • narrowing and/or occlusion of visceral or peripheral arteries
  • cerebrovascular events: can be ischaemic or haemorrhagic 6
  • optic disc drusen 7

It is characterised by ectopic mineralisation with subsequent fragmentation of elastic fibres of connective tissues, including skin, vascular walls, and the eyes.

The presence of fragmented basophilic elastic fibres in the upper and middle reticular dermis and calcification of elastic fibres are considered characteristic histological findings.

It is largely known to have an autosomal recessive inheritance although an autosomal dominant inheritance has been proposed in some occasional cases 9.

It was first described in 1881by D Rigal 8.

The first complete description of the syndrome was by Swedish ophthalmologist Ester E (Elisabeth) Grönblad (1898-1942) 13,14 and Swedish dermatologist James V (Victor) Strandberg (1883-1942) 13

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Article information

rID: 34097
System: Vascular
Section: Syndromes
Synonyms or Alternate Spellings:
  • Pseudoxanthoma elasticum (PXE)
  • Gronblad–Strandberg syndrome

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