Hereditary and Sensory Autonomic Neuropathies

We read with interest two recent papers on congenital insensitivity to pain with anhidrosis, entitled congenital insensitivity to pain and anhydrosis (cipa) syndrome; a report of 4 cases by daneshjou et all-l and congenital insensitivity to pain with anhidrosis (hsan type iv), extremely rare syndrome that can be easily missed by bone and joint surgeons: a case report by ali et ahzl. although the clinical phenotypes of the cases are compatible with diagnosis of congenital insensitivity to pain with anhidrosis (cipa), different presentations of the disease and lack of simple diagnostic tests makes cipa a tricky diagnosisltl. thus making definite diagnosis should rest on genetic studies.