Diamond-Blackfan anemia history and symptoms: Difference between revisions

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Classic DBA: Symptoms of [[anemia]] include fatigue, weakness, and an abnormally pale appearance ([[pallor]]). The symptomatic onset of Diamond black-fan anemia becomes apparent during the first year of life. Approximately half of DBA cases have [[Congenital]] malformations, in particular [[craniofacial]], upper-limb, heart, and genitourinary malformations.
Classic DBA: Symptoms of [[anemia]] include fatigue, weakness, and an abnormally pale appearance ([[pallor]]). The symptomatic onset of Diamond black-fan anemia becomes apparent during the first year of life. Approximately half of DBA cases have [[Congenital]] malformations, in particular [[craniofacial]], upper-limb, heart, and genitourinary malformations.
Non-classic DBA: presents with mild or absent anemia with only subtle indications of erythroid abnormalities such as macrocytosis, elevated ADA, and/or elevated HbF concentration Have mild anemia beginning later in childhood or in adulthood, while others have some of the physical features but no bone marrow problems. Minimal or no evidence of congenital anomalies or short stature.
Non-classic DBA: presents with mild or absent anemia with only subtle indications of erythroid abnormalities such as macrocytosis, elevated ADA, and/or elevated HbF concentration Have mild anemia beginning later in childhood or in adulthood, while others have some of the physical features but no bone marrow problems. Minimal or no evidence of congenital anomalies or short stature.
==Diagnosis==
*Diagnosing DBA is usually hard due to its partial phenotypes and the wide inconsistency of clinical expressions. the International Clinical Consensus Conference stated diagnostic and supporting criteria for the diagnosis of DBA.<ref name="pmid18671700">{{cite journal |vauthors=Vlachos A, Ball S, Dahl N, Alter BP, Sheth S, Ramenghi U, Meerpohl J, Karlsson S, Liu JM, Leblanc T, Paley C, Kang EM, Leder EJ, Atsidaftos E, Shimamura A, Bessler M, Glader B, Lipton JM |title=Diagnosing and treating Diamond Blackfan anaemia: results of an international clinical consensus conference |journal=Br. J. Haematol. |volume=142 |issue=6 |pages=859–76 |date=September 2008 |pmid=18671700 |pmc=2654478 |doi=10.1111/j.1365-2141.2008.07269.x |url=}}</ref>
*'''Diagnostic criteria'''
**Normochromic, often [[macrocytic anemia]] developing in the first year of life
**Profound [[reticulocytopenia]]
**Normocellular bone marrow with selective deficiency of [[erythroid]] precursors
**Normal or slightly reduced [[leukocyte]] count
**Normal or slightly increased [[platelet]] count
*'''Major supporting criteria'''
**Gene mutation described in ‘‘classical’’ DBA
**Positive family history
*'''Minor supporting criteria'''
**Elevated erythrocyte [[adenosine deaminase]] activity
**Congenital anomalies described in ‘‘classical’’ DBA
**Elevated HbF
**No evidence of another inherited bone marrow failure syndrome
__NOTOC__
<br />
{| class="wikitable"
|+
|'''Classical DBA'''
All diagnostic criteria are met
'''Probable DBA'''
3 Diagnostic criteria + positive family history
OR
2 Diagnostic criteria + 3 minor criteria
OR
3 Minor criteria + positive family history
'''Non-classical DBA'''
DBA associated gene mutation without sufficient diagnostic criteria
|}


==Diamond-Blackfan anemia history and symptoms==
==Diamond-Blackfan anemia history and symptoms==

Revision as of 00:13, 18 September 2020

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Overview

Classic DBA: Symptoms of anemia include fatigue, weakness, and an abnormally pale appearance (pallor). The symptomatic onset of Diamond black-fan anemia becomes apparent during the first year of life. Approximately half of DBA cases have Congenital malformations, in particular craniofacial, upper-limb, heart, and genitourinary malformations. Non-classic DBA: presents with mild or absent anemia with only subtle indications of erythroid abnormalities such as macrocytosis, elevated ADA, and/or elevated HbF concentration Have mild anemia beginning later in childhood or in adulthood, while others have some of the physical features but no bone marrow problems. Minimal or no evidence of congenital anomalies or short stature.

Diagnosis

  • Diagnosing DBA is usually hard due to its partial phenotypes and the wide inconsistency of clinical expressions. the International Clinical Consensus Conference stated diagnostic and supporting criteria for the diagnosis of DBA.[1]
  • Diagnostic criteria
  • Major supporting criteria
    • Gene mutation described in ‘‘classical’’ DBA
    • Positive family history
  • Minor supporting criteria
    • Elevated erythrocyte adenosine deaminase activity
    • Congenital anomalies described in ‘‘classical’’ DBA
    • Elevated HbF
    • No evidence of another inherited bone marrow failure syndrome


Classical DBA

All diagnostic criteria are met


Probable DBA

3 Diagnostic criteria + positive family history

OR

2 Diagnostic criteria + 3 minor criteria

OR

3 Minor criteria + positive family history


Non-classical DBA

DBA associated gene mutation without sufficient diagnostic criteria

Diamond-Blackfan anemia history and symptoms

History The symptomatic onset of Diamond black-fan anemia becomes apparent during the first year of life. A positive family history of DBA is suggestive of DBA. The most common symptoms of DBA include

  • Symptoms of anemia include pallor, irritability, failure to thrive, sleepiness, poor appetite, and weakness[2]

Symptoms

The severity of Diamond-Blackfan anemia may vary, even within the same family.

Classic DBA: The symptomatic onset of Diamond black-fan anemia becomes apparent during the first year of life

  • Symptoms of anemia include fatigue, weakness, and an abnormally pale appearance (pallor).
  • Approximately half of DBA cases have Congenital malformations, in particular craniofacial, upper-limb, heart, and genitourinary malformations:(observed in ~30%-50%):
    • Microcephaly
    • low frontal hairline
    • Wide-set eyes (hypertelorism)
    • Droopy eyelids (ptosis)
    • Broad, flat bridge of the nose
    • Small, low-set ears
    • Small lower jaw (micrognathia)
    • Cleft palate
    • Cleft lip
    • Short, webbed neck
    • Smaller and higher shoulder blades than usual
    • Malformed or absent thumbs
    • All diagnostic criteria are met.
  • Non-classic DBA:
    • presents with mild or absent anemia with only subtle indications of erythroid abnormalities such as macrocytosis, elevated ADA, and/or elevated HbF concentration

Have mild anemia beginning later in childhood or in adulthood, while others have some of the physical features but no bone marrow problems. Minimal or no evidence of congenital anomalies or short stature.

References

  1. Vlachos A, Ball S, Dahl N, Alter BP, Sheth S, Ramenghi U, Meerpohl J, Karlsson S, Liu JM, Leblanc T, Paley C, Kang EM, Leder EJ, Atsidaftos E, Shimamura A, Bessler M, Glader B, Lipton JM (September 2008). "Diagnosing and treating Diamond Blackfan anaemia: results of an international clinical consensus conference". Br. J. Haematol. 142 (6): 859–76. doi:10.1111/j.1365-2141.2008.07269.x. PMC 2654478. PMID 18671700.
  2. Da Costa L, Narla A, Mohandas N (2018). "An update on the pathogenesis and diagnosis of Diamond-Blackfan anemia". F1000Res. 7. doi:10.12688/f1000research.15542.1. PMC 6117846. PMID 30228860.