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Fiesco-Roa MÓ, García-de Teresa B, Leal-Anaya P, van ‘t Hek R, Wegman-Ostrosky T, Frías S, Rodríguez A. Fanconi anemia and dyskeratosis congenita/telomere biology disorders: Two inherited bone marrow failure syndromes with genomic instability. Front Oncol 2022; 12:949435. [PMID: 36091172 PMCID: PMC9453478 DOI: 10.3389/fonc.2022.949435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 08/01/2022] [Indexed: 11/13/2022] Open
Abstract
Inherited bone marrow failure syndromes (IBMFS) are a complex and heterogeneous group of genetic diseases. To date, at least 13 IBMFS have been characterized. Their pathophysiology is associated with germline pathogenic variants in genes that affect hematopoiesis. A couple of these diseases also have genomic instability, Fanconi anemia due to DNA damage repair deficiency and dyskeratosis congenita/telomere biology disorders as a result of an alteration in telomere maintenance. Patients can have extramedullary manifestations, including cancer and functional or structural physical abnormalities. Furthermore, the phenotypic spectrum varies from cryptic features to patients with significantly evident manifestations. These diseases require a high index of suspicion and should be considered in any patient with abnormal hematopoiesis, even if extramedullary manifestations are not evident. This review describes the disrupted cellular processes that lead to the affected maintenance of the genome structure, contrasting the dysmorphological and oncological phenotypes of Fanconi anemia and dyskeratosis congenita/telomere biology disorders. Through a dysmorphological analysis, we describe the phenotypic features that allow to make the differential diagnosis and the early identification of patients, even before the onset of hematological or oncological manifestations. From the oncological perspective, we analyzed the spectrum and risks of cancers in patients and carriers.
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Affiliation(s)
- Moisés Ó. Fiesco-Roa
- Laboratorio de Citogenética, Instituto Nacional de Pediatría, Ciudad de México, Mexico
- Maestría y Doctorado en Ciencias Médicas, Universidad Nacional Autónoma de México (UNAM), Ciudad Universitaria, Ciudad de México, Mexico
| | | | - Paula Leal-Anaya
- Departamento de Genética Humana, Instituto Nacional de Pediatría, Ciudad de México, Mexico
| | - Renée van ‘t Hek
- Facultad de Medicina, Universidad Nacional Autoínoma de Meíxico (UNAM), Ciudad Universitaria, Ciudad de México, Mexico
| | - Talia Wegman-Ostrosky
- Subdirección de Investigación Básica, Instituto Nacional de Cancerología, Ciudad de México, Mexico
| | - Sara Frías
- Laboratorio de Citogenética, Instituto Nacional de Pediatría, Ciudad de México, Mexico
- Departamento de Medicina Genómica y Toxicología Ambiental, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México (UNAM), Ciudad de México, Mexico
- *Correspondence: Alfredo Rodríguez, ; Sara Frías,
| | - Alfredo Rodríguez
- Departamento de Medicina Genómica y Toxicología Ambiental, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México (UNAM), Ciudad de México, Mexico
- Unidad de Genética de la Nutrición, Instituto Nacional de Pediatría, Ciudad de México, Mexico
- *Correspondence: Alfredo Rodríguez, ; Sara Frías,
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Wang NW, Georgara N, Khan HS. Shwachman-Diamond Syndrome With Congenital Myogenic Ptosis: Case Report of a Rare Association? J Pediatr Hematol Oncol 2022; 44:345-346. [PMID: 35482443 DOI: 10.1097/mph.0000000000002469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 03/13/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Shwachman-Diamond syndrome (SDS) is a multisystem disorder characterized by exocrine pancreatic insufficiency and bone marrow failure. There is considerable variation in the phenotypes of SDS. We present a case of an infant presenting with SDS and left-sided ptosis. OBSERVATION We report a case of an infant who presented with 2 episodes of severe sepsis and cytopenia, without overt symptoms of exocrine pancreatic deficiency or skeletal abnormalities. Persistent left-sided ptosis was noted in both presentations. Genetic testing confirmed the diagnosis of SDS. The left-sided ptosis was diagnosed as congenital myogenic ptosis. CONCLUSION The association of ptosis and other congenital bone marrow failure syndromes is well established, but this is the first description of SDS with ptosis. This association may expand our understanding of SDS phenotypes if similar cases are reported in the future.
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Affiliation(s)
| | - Natalia Georgara
- Department of Pediatrics, Hull University Teaching Hospitals, NHS Trust, Hull, UK
| | - Haji S Khan
- Department of Pediatrics, Hull University Teaching Hospitals, NHS Trust, Hull, UK
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Graf CM, Nichele S, Siviero RB, Loth G, Trennepohl JP, Zinher MT, Grandinetti A, Pilonetto DV, Pasquini R, Ramos Moreira AT, Bonfim C. Ocular Manifestations in Patients with Fanconi Anemia: A Single-Center Experience Including 106 Patients. J Pediatr 2022; 242:228-234.e1. [PMID: 34774576 DOI: 10.1016/j.jpeds.2021.11.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 11/02/2021] [Accepted: 11/04/2021] [Indexed: 01/15/2023]
Abstract
OBJECTIVES To describe the prevalence of acquired ocular manifestations in patients with Fanconi anemia (FA) and to describe and correlate the congenital ocular malformations with the genetic subtypes of the disease. STUDY DESIGN This is a cross-sectional observational study of 106 consecutive patients with confirmed diagnosis of FA who were followed at the Hematopoietic Stem Cell Transplantation (HSCT) Service at the Federal University of Paraná, Curitiba, Parana, Brazil. Participants underwent a complete ophthalmologic evaluation and 84 patients underwent ocular ultrasound examination. This study was conducted between November 2014 and August 2017. RESULTS The patients ranged in age from 6 months to 43 years of age. Microphthalmia was the most common congenital ocular abnormality (95.2%). A decrease in anthropometric measurements was observed, including palpebral fissure length (78/103 patients [76.5%]), microcornea (48/103 patients [46.6%]), and ptosis (31/103 patients [30.1%]). We identified a new ophthalmic condition in 15 patients with FA, that is, epiretinal tissue on the optic disc. The genetic subtype was identified in 78 patients (79.6%), the FA-A subtype was most prevalent (50%). The most common acquired ocular manifestation (non-graft-versus-host disease [GVHD] related) in patients who did not undergo HSCT (n = 44) was limbal neovascularization (13.6%), whereas in patients who underwent HSCT (n = 62), the GVHD-related manifestation was ocular GVHD (51.6%). The most frequent symptom of ocular GVHD was keratoconjunctivitis sicca (29%). CONCLUSIONS Several ocular manifestations were identified in patients with FA.
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Affiliation(s)
- Christie Michelle Graf
- Ophthalmic Reference Center, Hospital De Clinicas, Federal University of Parana, Curitiba, Brazil.
| | - Samantha Nichele
- Bone Marrow Transplantation Service, Hospital De Clinicas, Federal University of Parana, Curitiba, Brazil
| | | | - Gisele Loth
- Bone Marrow Transplantation Service, Hospital De Clinicas, Federal University of Parana, Curitiba, Brazil
| | - Joanna Paula Trennepohl
- Bone Marrow Transplantation Service, Hospital De Clinicas, Federal University of Parana, Curitiba, Brazil
| | - Mariana Tosato Zinher
- Ophthalmic Reference Center, Hospital De Clinicas, Federal University of Parana, Curitiba, Brazil
| | | | | | - Ricardo Pasquini
- Bone Marrow Transplantation Service, Hospital De Clinicas, Federal University of Parana, Curitiba, Brazil
| | - Ana Tereza Ramos Moreira
- Ophthalmic Reference Center, Hospital De Clinicas, Federal University of Parana, Curitiba, Brazil
| | - Carmem Bonfim
- Bone Marrow Transplantation Service, Hospital De Clinicas, Federal University of Parana, Curitiba, Brazil
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Chauhan BK, Medsinge A, Scanga HL, Chu CT, Nischal KK. Transcriptome from opaque cornea of Fanconi anemia patient uncovers fibrosis and two connected players. Mol Genet Metab Rep 2021; 26:100712. [PMID: 33552906 PMCID: PMC7846932 DOI: 10.1016/j.ymgmr.2021.100712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 01/15/2021] [Accepted: 01/16/2021] [Indexed: 11/28/2022] Open
Abstract
Congenital corneal opacities (CCO) are a group of blinding corneal disorders, where the underlying molecular mechanisms are poorly understood. Phenotyping through specialized imaging and histopathology analysis, together with assessment of key transcriptomic changes (including glycosaminoglycan metabolic enzymes) in cornea(s) with CCO from a case of Fanconi anemia is the approach taken in this study to identify causal mechanisms. Based on our findings, we propose a novel mechanism and two key players contributing to CCO.
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Affiliation(s)
- Bharesh K Chauhan
- UPMC Eye Center, Children's Hospital of Pittsburgh, Pittsburgh, PA 15224, USA.,Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Anagha Medsinge
- UPMC Eye Center, Children's Hospital of Pittsburgh, Pittsburgh, PA 15224, USA
| | - Hannah L Scanga
- UPMC Eye Center, Children's Hospital of Pittsburgh, Pittsburgh, PA 15224, USA
| | - Charleen T Chu
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Ken K Nischal
- UPMC Eye Center, Children's Hospital of Pittsburgh, Pittsburgh, PA 15224, USA.,Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
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Luo E, Shi B, Chen QM, Zhou XD. [Dental-craniofacial manifestation and treatment of rare diseases in China]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2019; 37:130-142. [PMID: 31168978 PMCID: PMC7030144 DOI: 10.7518/hxkq.2019.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 01/16/2019] [Indexed: 02/05/2023]
Abstract
Rare diseases are genetic, chronic, and incurable disorders with relatively low prevalence. Thus, diagnosis and management strategies for such diseases are currently limited. This situation is exacerbated by insufficient medical sources for these diseases. The National Health and Health Committee of China recently first provided a clear definition of 121 rare diseases in the Chinese population. In this study, we summarize several dental-craniofacial manifestations associated with some rare diseases to provide a reference for dentists and oral maxillofacial surgeons aiming at fast-tracking diagnosis for the management of these rare diseases.
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Affiliation(s)
- En Luo
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Bing Shi
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Qian-Ming Chen
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Xue-Dong Zhou
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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Luo E, Liu H, Zhao Q, Shi B, Chen Q. Dental-craniofacial manifestation and treatment of rare diseases. Int J Oral Sci 2019; 11:9. [PMID: 30783081 PMCID: PMC6381182 DOI: 10.1038/s41368-018-0041-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 10/22/2018] [Accepted: 10/28/2018] [Indexed: 02/05/2023] Open
Abstract
Rare diseases are usually genetic, chronic and incurable disorders with a relatively low incidence. Developments in the diagnosis and management of rare diseases have been relatively slow due to a lack of sufficient profit motivation and market to attract research by companies. However, due to the attention of government and society as well as economic development, rare diseases have been gradually become an increasing concern. As several dental-craniofacial manifestations are associated with rare diseases, we summarize them in this study to help dentists and oral maxillofacial surgeons provide an early diagnosis and subsequent management for patients with these rare diseases.
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Affiliation(s)
- En Luo
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Hanghang Liu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Qiucheng Zhao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Bing Shi
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | - Qianming Chen
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Abstract
PURPOSE To describe the ocular findings and subsequent workup of a 21-year-old woman with previously undiagnosed Fanconi anemia. METHODS Observational case report and literature review. RESULTS A 21-year-old healthy woman presented with bilateral retinal hemorrhages, telangiectasia, and severe ischemia with vascular leak. Systemic workup revealed anemia and thrombocytopenia. A diepoxybutane chromosomal breakage test confirmed the diagnosis of Fanconi anemia. CONCLUSION Ocular complications are common in patients with Fanconi anemia and may be the presenting manifestation of the disease.
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Schneider M, Chandler K, Tischkowitz M, Meyer S. Fanconi anaemia: genetics, molecular biology, and cancer - implications for clinical management in children and adults. Clin Genet 2014; 88:13-24. [DOI: 10.1111/cge.12517] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 10/06/2014] [Accepted: 10/06/2014] [Indexed: 01/30/2023]
Affiliation(s)
- M. Schneider
- Stem Cell and Leukaemia Proteomics Laboratory; University of Manchester; Manchester UK
- Manchester Academic Health Science Centre; Manchester UK
| | - K. Chandler
- Manchester Academic Health Science Centre; Manchester UK
- Department of Genetic Medicine; University of Manchester, St Mary's Hospital; Manchester UK
| | - M. Tischkowitz
- Department of Medical Genetics; University of Cambridge, Addenbrooke's Hospital; Cambridge UK
| | - S. Meyer
- Stem Cell and Leukaemia Proteomics Laboratory; University of Manchester; Manchester UK
- Manchester Academic Health Science Centre; Manchester UK
- Department of Paediatric Haematology and Oncology; Royal Manchester Children's Hospital; Manchester UK
- Department of Paediatric and Adolescent Oncology; Young Oncology Unit, The Christie NHS Foundation Trust; Manchester UK
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