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===History and symptoms===
===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<ref name="pmid30228860">{{cite journal |vauthors=Da Costa L, Narla A, Mohandas N |title=An update on the pathogenesis and diagnosis of Diamond-Blackfan anemia |journal=F1000Res |volume=7 |issue= |pages= |date=2018 |pmid=30228860 |pmc=6117846 |doi=10.12688/f1000research.15542.1 |url=}}</ref>
'''Symptoms'''
*Symptoms of anemia (pallor, irritability, fatigue, weakness.
*[[Growth retardation]] (in about 30% )
*Congenital malformations, in particular [[craniofacial]], [[upper-limb]], heart, and [[genitourinar]]y malformations:(~30%-50%):
The severity of Diamond-Blackfan anemia may vary, even within the same family.


===Common symptoms of Classic DBA:===
===Common symptoms of Classic DBA:===

Revision as of 01:10, 26 September 2020

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Overview

Patients with classic DBA have symptoms of anemia include fatigue, weakness, and an abnormally pale appearance (pallor). The symptomatic onset of Diamond-Blackfan 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.Patients with 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, and 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

Study of Choice

  • 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][2]

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


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

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[3]

Symptoms

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

Common symptoms of Classic DBA:

Common symptoms of 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[4]

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. Adam MP, Ardinger HH, Pagon RA, Wallace SE, Bean L, Stephens K, Amemiya A. PMID 20301295. Vancouver style error: initials (help); Missing or empty |title= (help)
  3. 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.
  4. Adam MP, Ardinger HH, Pagon RA, Wallace SE, Bean L, Stephens K, Amemiya A, Clinton C, Gazda HT. PMID 20301769. Vancouver style error: initials (help); Missing or empty |title= (help)