Case series of Fanconi anemia in Hevi pediatric hospital-Duhok

Authors

  • Adnan A.S. Al-Doski Department of Pathology, College of Medicine, University of Duhok, Duhok, Iraq

DOI:

https://doi.org/10.15218/zjms.2018.028

Keywords:

Fanconi anemia, Hevi pediatric hospital, Duhok city

Abstract

Background and objective: Fanconi anemia is a rare inherited autosomal recessive disease characterized by chromosomal instability, progressive bone marrow failure, congenital malformations, and a high propensity of malignancies. Fanconi anemia is a genetically and phenotypically heterogeneous disorder defined by cellular hypersensitivity to DNA cross-linking agents. This study aimed to review retrospectively medical history, genetics, clinical course, blood test results, complications and social issues of Fanconi anemia patients.

Methods: All the patients with Fanconi anemia included in the study had been diagnosed between August 2008 and August 2016 in the Hevi pediatric teaching hospital, Duhok, Kurdistan-Iraq. The cases identified initially, which fulfilled clinical, peripheral blood and bone marrow examination (aspirate and biopsy) and confirmed by the cytogenic study as criteria of inherited hypoplastic anemia. Other causes of aplastic marrow were excluded.

Results: The study includes 30 Fanconi anemia cases,the median age at diagnosis was 7.5 years (range 1.5-15); At diagnosis the most blood parameters were reduced hemoglobin (63%), reduced platelets (57%) followed reduced leukocytes (53%) and 9 (30%) cases, all three peripheral blood count elements were reduced. Moderate aplastic anemiawas predominant, and common symptom (20 cases, 66.7%) washemorrhagic diathesis at presentation.Common physical abnormalities were skin pigmentation (70%), short stature (66.7%), thumb deformity (56.7%),and (53.3%) of the patients had small faces and eyes. Up to 33.3% of all Fanconi anemia patients exhibit none of the physical findings.

Conclusion: Fanconi anemia is a rare genetic disease in Duhok area;most patients were of moderate aplastic anemia, the bleeding tendency was the chief complaint of presentation.The diagnosis of Fanconi anemia in the early stage is important to select special management.

Metrics

Metrics Loading ...

References

Alter BP. Inherited bone marrow failure syndromes. In: Nathan DG, Orkin SH, Ginsburg D, Look AT, eds. Nathan and Oski’s Hematology of Infancy and Childhood. 6thed. Philadelphia, PA: Saunders; 2003. P. 280–365.

MacMillan ML, DeFor TE, Young JA, Dusenbery KE, Blazar BR, Slungaard A, et al. Alternative donor hematopoietic cell transplantation for Fanconi anemia. Blood 2015; 125(24):3798–804.

Lobitz S, Velleuer E. Guido Fanconi (1892-1979): a jack of all trades. Nat Rev Cancer 2006; 6(11): 893–8.

Wang AT, Smogorzewska A. SnapShot: Fanconi anemia and associated proteins. Cell 2015; 160(1-2): 354 e1.

Joenje H, Patel KJ. The emerging genetic and molecular basis of Fanconi anemia. Nat Rev Genet 2001; 2(6):446–57.

Tischkowitz MD, Hodgson SV. Fanconi anemia. J Med Genet 2003; 40:1–10.

Alter BP. Fanconi's anemia and malignancies. Am J Hematol 1996; 53:99–110.

Vogelstein B, Kinzler KW. The Genetic Basis of Human Cancer. In: Vogelstein B, Kinzler KW, Auerbach AD, Buchwald M, Joenje H; Fanconi anemia. 2nded. New York: McGraw-Hill; 2002. P. 317–32.

Camitta BM, Thomas ED, Nathan DG, Santos G, Gordon Smith EC, Gale RP, et al. Severe aplastic anemia: a prospective study of the effect of early marrow transplantation on acute mortality. Blood 1976; 48:63–9.

Bacigalupo A, Hows JM, Gordon Smith EC, Gluckman E, Van Lint MT, Congiu M, et al. Bone marrow transplantation (BMT) versus immunosuppression for the treatment of severe aplastic anemia (SAA): a report of the EBMT SAA Working Party. Br J Haematol 1988; 70:177–82.

Akiko S. Treatment of hematologic abnormalities in Fanconi Anemia. In: Eiler ME, D Frohnmayer, JD, L Frohnmayer, MSW, Kim Larsen, and Joyce Owen. Fanconi Anemia: Guidelines for Diagnosis and Management. 4thed.Oregon, Fanconi Anemia Research Fund, Inc.; 2014. P. 49–74.

Kurdistan Region Statistics Office, Kurdistan Regional Government. The map of the estimated population of Duhok governorate in districts level 2015. 2015. (Accessed August 13, 2016, at http://krg.org/articles/detail.asp? lngnr=12&smap=03010300&rnr= 140&anr=23911).

Alter BP. Clinical features of Fanconi’s anemia. In: Young NS, Alter BP, eds. Aplastic anemia: acquired and inherited. Philadelphia: Saunders; 1994. P. 275–308.

Auerbach AD, Allen RG. Leukemia and preleukemia in Fanconi anemia patients. A review of the literature and report of the International Fanconi Anemia Registry. Cancer Genet Cytogenet 1991; 51:1–12.

Butturini A, Gale RP, Verlander PC, Adler-Brecher B, Gillio AP, Auerbach AD. Hematologic abnormalities in Fanconi anemia: an International Fanconi Anemia Registry study. Blood 1994; 84:1650–5.

Garaycoechea JI, Patel KG. Why does bone marrow fail in Fanconi anemia? Blood 2014; 123(1):26–34.

Khatib Z, Wilimas J, Wang W. Outcome of moderate aplastic anemia in children. Am J Pediatr Hematol Oncol 1994; 16:80–5.

Eiler ME, Frohnmayer D, Frohnmayer L, Larsen K, Owen J. Fanconi Anemia: Guidelines for Diagnosis and Management. Fanconi Anemia Research Fund; Eugene, OR; 2008. 3rd Edition.

Morris LG, Sikora AG, Patel SG, Hayes RB, Ganly I. Second primary cancers after an index head and neck cancer: subset-specific trends in the era of human papilloma virus associated oropharyngeal cancer. J Clin Oncol 2011; 29(6):739–46.

Shimamura A, Atler BP. Pathophysiology and management of inherited bone marrow failure syndromes. Blood Rev 2010; 24:101–22.

Auerbach AD. Fanconi anemia and its diagnosis. Mutat Res 2009; 668:4–10.

Auerbach AD, Rogatko A,Schroeder-Kurth TM. International Fanconi Anemia Registry: relation of clinical symptoms to diepoxybutane sensitivity. Blood 1989; 73:391–6.

Verlandder PC, Davis JG, Auerbach AD. Diagnosis of Fanconi anemia in patients without congenital malformations: an International Fanconi Anemia Registry study. Am J Med Genet 1997; 68:58–61.

Koc A, Pronk JC, Alikasifoglu M, Joenje H, Altay C. Variable pathogenicity of exon 43del (FAA) in four Fanconi anemia patients within a consanguineous family. Br J Haematol 1999; 104:127–30.

Giampietro PF, Verlander PC, Davis JG, Auerbach AD. Diagnosis of Fanconi anemia in patients without congenital malformations: an International Fanconi Anemia Registry study. Am J Med Genet 1997; 68:58–61.

Gupta V, Kumar A, Saini I, Ajid KS.Cytogenetic profile of aplastic anemia in Indian children. Indian J Med Res 2013; 137(3):502–6.

Al Suliman AM, Al Qadaiub K. A 15-year-old girl with pancytopenia and congenital defects. Ann Saudi Med 2009; 29(4):319.

Downloads

Published

2018-08-16

How to Cite

Al-Doski, A. A. (2018). Case series of Fanconi anemia in Hevi pediatric hospital-Duhok. Zanco Journal of Medical Sciences (Zanco J Med Sci), 22(2), 208–216. https://doi.org/10.15218/zjms.2018.028

Issue

Section

Original Articles