PMC7348629_01
Pedigree of the patient. The arrow indicates the proband. The normal range of
alkaline phosphatase (ALP) for adults is 115-359 (U/L). Underlining of a number
indicates that the ALP is decreased. Asterisk (*) indicates that there was a change in
serum ALP during the perinatal period; 150 during lactation for the first child; 98
during pregnancy for the second child (this case); 106 at the end of the lactation for
the second child.
cpe-29-115-g001.jpg
PMC7348629_01_cpe-29-115-g001.jpg
fig_001
Her family history revealed bone fractures in her parents, paternal aunt, and paternal grandfather as well as low serum ALP levels in her parents and paternal aunt (Fig. 1).
Dental X-ray showed alveolar bone absorption in the regions of the deciduous
mandibular central incisors. The arrows indicate the absorption of the alveolar bone,
whereas the arrow shafts indicate the normal thickness of the alveolar bone (a). The
arrowheads indicate the exfoliation of the deciduous mandibular incisors (b). a:
before the exfoliation; b: after the exfoliation.
cpe-29-115-g002.jpg
PMC7348629_02_cpe-29-115-g002.jpg
fig_002
However, exfoliation of two deciduous teeth that were already mobile was triggered by catching a cold 2 mo after starting ERT (Fig. 2b).
PMC7348629_02
Dental X-ray showed alveolar bone absorption in the regions of the deciduous
mandibular central incisors. The arrows indicate the absorption of the alveolar bone,
whereas the arrow shafts indicate the normal thickness of the alveolar bone (a). The
arrowheads indicate the exfoliation of the deciduous mandibular incisors (b). a:
before the exfoliation; b: after the exfoliation.
cpe-29-115-g002.jpg
PMC7348629_02_cpe-29-115-g002.jpg
fig_002
However, exfoliation of two deciduous teeth that were already mobile was triggered by catching a cold 2 mo after starting ERT (Fig. 2b).
The exfoliated teeth with the root. a: right deciduous mandibular central incisor; b:
left deciduous mandibular central incisor.
cpe-29-115-g003.jpg
PMC7348629_02_cpe-29-115-g003.jpg
fig_003
The roots of the teeth remained attached to the lost teeth (Fig. 3a, 3b), which is often seen in HPP.