What are the IBMFS disorders?
Diamond-Blackfan Anemia (DBA)
DBA patients have only low red cell counts
(anemia).
The rest of their blood cells (the
platelets
and the
white cells) are normal. ~25% of DBA patients have physical abnormalities,
often involving malformations of the thumbs. Most patients are diagnosed
within the first year of life. Detecting a
mutation
in a known DBA
gene
confirms the diagnosis. However, failure to find a mutation in a
DBA gene does not eliminate the diagnosis of DBA. This is because
the genes which have been identified so far explain less than half
of the disease occurrences. Currently, DBA is diagnosed
by clinical findings after exclusion of other known causes of pure
red cell
anemia.
Males and females are affected equally.
- What are the major findings on physical examination?
- Short stature
- Abnormal thumbs
- What is the age at diagnosis?
- Anytime from birth to 60 years of age.
- 90% are less than 1 year old when the diagnosis is made.
- What is the pattern of bone marrow failure?
- Pure
anemia
(low red blood cell count, often with large red
cells)
- Normal
platelet
count usually (Platelets are the cells in the blood which help
the blood to clot)
- Normal
white
cells usually (White cells help the body fight off infection)
- What specific kinds of cancer
develop?
- Leukemia
(cancer of the blood and bone marrow)
- Sarcomas (cancer arising in bone, fat, cartilage, tendons
or connective tissue)
- How is DBA specifically diagnosed?
- Patients with DBA usually have an increase in a specific red
cell
enzyme
called adenosine deaminase (ADA).
- Mutation analysis (genetic testing)
- Laboratories can now identify the genetic "error"
(or
mutation)
in some patients.
- There are more than 3 different
genes
responsible for DBA:
RPS19, RPS24, RPS17 and others.
- The disease is inherited
in an
autosomal
dominant fashion. This means that illness may occur
if a person has only one copy of the abnormal (mutant) gene.
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