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JAMA Clinical Challenge | Clinician's Corner

Silvery-Gray Hair in a Newborn

Lawrence Wong, MD; Shoji Yano, MD, PhD
JAMA. 2012;308(6):617-618. doi:10.1001/jama.2012.8136.
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A term newborn, born via spontaneous vaginal delivery, had abnormally light skin and silvery hair that is dark at the roots and light at the tips (Figure 1). Both parents are of Hispanic descent and have black hair and dark skin, as do their 2 other living children. Their first child had similar silvery hair and died at 3 months of age, 1 week after developing a fever and intractable seizures. An investigation was not done for cause of death due to the rapidity of the child's decline. The mother received prenatal care, took only prenatal vitamins, and never had a spontaneous abortion. The parents' family histories are otherwise unremarkable and there is no consanguinity. The remainder of the physical examination, including the ophthalmologic and neurologic examination, is unremarkable. Laboratory results including a complete blood cell count, peripheral blood smear, white blood cell morphology, liver panel, and coagulation studies including bleeding study are normal.

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Figure 1. Neonate with silvery hair.
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Figure 2. Microscopic image of hair sample showing abnormal clumping of melanin in patient's hair (original magnification ×20).
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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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