Congenital hypoplastic anemia
Diamond-Blackfan anemia (DBA) (previously known as congenital hypoplastic anemia) is the primary congenital form of pure red cell aplasia. It is a rare sporadic genetic form of anemia that typically presents in the first few years of life, and usually only affects cells of the erythroid lineage . Although, neutropenia and thrombocytopenia may occasionally be found . The disorder is also associated with an increased risk of acute myeloid leukemia and osteogenic sarcoma .
Clinical presentation
Congenital malformations are often observed :
- craniofacial: microcephaly, micrognathia, hypertelorism, microtia, cleft lip and palate
- eyes: congenital cataract, glaucoma, strabismus, amblyopia
- neck: small webbed neck
- cardiac: atrial septal defect, ventricular septal defect
- genitourinary: horseshoe kidney, hypospadias, absent kidney
- upper limb: absent thumb, hypoplastic thumbs, triphalangeal thumb
As patients age, they may develop findings from iron overload due to the chronic need for transfusions.
Pathology
Genetics
Diamond-Blackfan anemia displays an autosomal dominant inheritance with incomplete penetrance . A large number of genetic mutations, especially ribosomal proteins, but also of other key proteins in the early development of the erythroid cell line, resulting in Diamond-Blackfan anemia. This group of affected genes is now collectively known as the DBA-associated genes . Mutations of the ribosomal protein S19 (RPS19) gene are the cause of Diamond-Blackfan anemia in approximately 25% of patients .
History and etymology
Diamond-Blackfan anemia was described in 1938 by Louis K Diamond (1902-1999), the "founding father of American pediatric hematology" , and Kenneth D Blackfan (1883-1941), an American pediatrician . The first cases of the condition were actually described in 1936 by another American pediatrician, Hugh W Joseph , who worked at Johns Hopkins, in Baltimore, Maryland.
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