Presentation
Congenital dyserythropoietic anemia type I (CDA1) can present in utero with hydrops fetalis, but more often it presents in childhood or adulthood with moderate macrocytic anemia, jaundice, and progressive iron-overload. [ncbi.nlm.nih.gov]
Patients often present with anemia, jaundice, and variable splenomegaly. Most cases of CDA II are diagnosed at a young age; some patients, however, may remain unrecognized until late adulthood. [scholars.northwestern.edu]
Immune System
- Splenomegaly
Congenital dyserythropoietic anemia type II (CDA II) is the most common form of CDA (see this term) characterized by anemia, jaundice and splenomegaly and often leading to liver iron overload and gallstones. [monarchinitiative.org]
Patients often present with anemia, jaundice, and variable splenomegaly. Most cases of CDA II are diagnosed at a young age; some patients, however, may remain unrecognized until late adulthood. [scholars.northwestern.edu]
CDA I patients have a moderate macrocytic anemia with frequent splenomegaly and occasional hepatomegaly. [orpha.net]
Neonatal manifestations (anemia, early jaundice, and/or splenomegaly) and bone abnormalities were present in 11 of the 12 and 6 of the 12 patients, respectively. CDA I was initially misdiagnosed in four children. [ncbi.nlm.nih.gov]
Entire Body System
- Anemia
II, SEC23B-CDG, CDA II, Hereditary Erythroblastic Multinuclearity With Positive Acidified-Serum Test, CDAN2, Dyserythropoietic Anemia, Congenital, Type 2, ANEMIA, CONGENITAL DYSERYTHROPOIETIC, TYPE II; CDAN2, Congenital dyserythropoietic anemia type [monarchinitiative.org]
We report a case of CDA II diagnosed in a 48-year-old woman with a longstanding history of anemia of unknown etiology.", keywords = "Anemia, Congenital dyserythropoietic anemia type II (CDA II), Dyserythropoiesis, Hereditary erythroblastic multinuclearity [scholars.northwestern.edu]
[…] onset of severe anemia resulting in cardiac failure and relatively mild dyserythropoietic features on bone marrow aspiration in contrast to severity of anemia. [journals.lww.com]
Entry H00917 Disease Name Congenital dyserythropoietic anemias (CDAs) Description Congenital dyserythropoietic anemias (CDAs) are rare hereditary disorders characterized by ineffective erythropoiesis and by distinct morphological abnormalities of erythroblasts [genome.jp]
TY - JOUR T1 - Congenital dyserythropoietic anemia type I with ringed sideroblasts. [unboundmedicine.com]
- Splenectomy
Splenectomy produced an increased hemoglobin (P <.001) and a reduced bilirubin level (P =.007) in comparison with values before splenectomy. Preliminary data indicate that iron overload occurs irrespective of the hemochromatosis genotype. [ncbi.nlm.nih.gov]
Thirty percent of the patients had splenectomy when last observed. From our analysis, splenectomy is sometimes of benefit because anemia improves and hemolysis decreases. [doi.org]
Splenectomy, performed in 22 cases, led to moderate increases in hemoglobin values and eliminated the need for transfusions but did not prevent further iron loading. [bloodjournal.hematologylibrary.org]
- Pallor
Age at onset of pallor ranged from birth to 9 years. Blood transfusion requirements varied from nil to monthly. This is the first report of CDA type I from India. [ncbi.nlm.nih.gov]
On the other hand chronic blood loss is characterized by pallor out of proportion to distress and possibly signs of congestive cardiac failure, including hepatomegaly. [oncologynurseadvisor.com]
Symptoms & Diagnosis The most common symptoms of CDA include: Fatigue Lack of energy Jaundice Pale skin (pallor) Enlarged spleen or liver Formation of gallstones Skeletal abnormalities, including missing fingers and toes CDA is diagnosed with: Blood tests [danafarberbostonchildrens.org]
Physical signs include pallor, signs of a hyperkinetic circulation (tachycardia, wide pulse pressure with capillary pulsation, cardiac murmurs), signs of congestive cardiac failure, and hemorrhages and exudates in the retina. [clinicalgate.com]
- Family History of Anemia
We present a patient with CDA type 1 who had severe anemia develop during the fetal period resulting in cardiac failure and death. CASE REPORT The patient was born to nonconsanguineous, healthy parents without a family history of anemia. [journals.lww.com]
What features of the presentation will guide me toward possible causes and next treatment steps: A careful history and examination is essential, paying particular attention to obstetric and family history, ethnicity, examination for pallor with or without [oncologynurseadvisor.com]
Cardiovascular
- Tachycardia
Symptoms of anemia include fatigue, failure to thrive in infants, headache, dizziness, leg cramps, tachycardia and insomnia. Erythropoiesis is always dysfunctional, as revealed by cellular anomalies and erythroid hyperplasia. [orpha.net]
Symptoms for both types include: Chest pain Fast heartbeat, or tachycardia Headaches Trouble breathing Weakness and fatigue Treatment for sideroblastic anemia depends on the cause. [webmd.com]
Acute blood loss at the time of delivery may be characterized by minimal pallor that worsens over the first 24 hours, with rapid, shallow or gasping respiration, tachycardia, and shock with low blood pressure. [oncologynurseadvisor.com]
- Thrombosis
It shows how to accurately identify cells, simplifies hemostasis and thrombosis concepts, and covers normal hematopoiesis through diseases of erythroid, myeloid, lymphoid, and megakaryocytic origins. [books.google.es]
Portal vein thrombosis occurred in 2 patients after splenectomy and also in some cases of CDA I. 49 In contrast to a CDA II-like variant with negative B criteria, 50 - 52 prominent peripheral postsplenectomy erythroblastosis was absent. [doi.org]
Liver, Gall & Pancreas
- Jaundice
Congenital dyserythropoietic anemia type II (CDA II) is the most common form of CDA (see this term) characterized by anemia, jaundice and splenomegaly and often leading to liver iron overload and gallstones. [monarchinitiative.org]
Patients often present with anemia, jaundice, and variable splenomegaly. Most cases of CDA II are diagnosed at a young age; some patients, however, may remain unrecognized until late adulthood. [scholars.northwestern.edu]
Neonatal/diagnosis Jaundice, Neonatal/etiology Jaundice, Neonatal/therapy Microscopy, Electron Phototherapy Pregnancy [ncbi.nlm.nih.gov]
- Hepatosplenomegaly
Most affected individuals do not have hepatosplenomegaly, and iron does not build up in tissues and organs. In adulthood, abnormalities of a specialized tissue at the back of the eye (the retina) can cause vision impairment. [ncbi.nlm.nih.gov]
The resulting shortage of healthy red blood cells leads to the characteristic signs and symptoms of anemia, as well as complications including hepatosplenomegaly and an abnormal buildup of iron. [ghr.nlm.nih.gov]
Musculoskeletal
- Osteoporosis
Main complications were due to anemia and ineffective erythropoiesis [osteoporosis (8/9, 89%), cholelithiasis (21/30, 70%), pulmonary arterial hypertension (PAH) (6/25, 24%)] and iron overload [hypothyroidism (9/24, 38%), and diabetes mellitus (6/32, [ncbi.nlm.nih.gov]
Pathogenesis and management of osteoporosis in thalassemia. Pediatr Endocrinol Rev. 2008;6(1):86-93. Roy NB, Pavord S. Management of other inherited red cell disorders in pregnancy. In: Pavord S, Hunt B, eds. The Obstetric Hematology Maual. [medigraphic.com]
Urogenital
- Cesarean Section
MeSH terms MeSH terms Anemia, Dyserythropoietic, Congenital/diagnosis* Anemia, Dyserythropoietic, Congenital/therapy Biopsy, Needle Bone Marrow/pathology Cesarean Section Diagnosis, Differential Erythroid Precursor Cells/pathology Exchange Transfusion [ncbi.nlm.nih.gov]
The fetus required four intrauterine transfusions and was delivered at 34 weeks 6 days via cesarean section due to history of previous cesarean. Exam revealed a phenotypically normal female with APGARs of 9/9 and a birth weight of 2130 grams. [bloodjournal.org]
Causes of acute bleeding such as rupture of the umbilical cord may be associated with precipitous deliveries, and the cord may bleed from vascular abnormalities, inflammation or incision during cesarean section; velamentous insertion of the cord can also [oncologynurseadvisor.com]
Workup
A convenient way to organize and think through the workup of an anemic infant would be: 1. [oncologynurseadvisor.com]
These assays are routinely performed in the diagnostic workup of DAT-negative hemolytic anemia. It is unknown if flow cytometry with EMA and monoclonal antibodies against CD55 and CD59 can be used to identify samples from CDA III patients. [omicsonline.org]
In 2 exceptional cases, long-standing moderate anemia was investigated in the workup of an unrelated disorder, and the correct diagnosis was recognized at 62 and 78 years, respectively. [doi.org]
Serum
- Macrocytic Anemia
This report describes a case of congenital dyserythropoietic anemia (CDA) type I diagnosed in a 22-year-old woman with a two year history of macrocytic anemia. [ncbi.nlm.nih.gov]
Three types are described: type I [MIM224120], macrocytic, megaloblastic anemia with erythroblastic internuclear chromatin bridges; type II, [MIM*224100], normoblastic anemia with multinucleated erythroblasts; type III, macrocytic anemia with erythroblastic [medical-dictionary.thefreedictionary.com]
- Macrocytosis
Herein is described the case of a young woman presenting with iron overload and macrocytosis. The initial diagnosis was hereditary hemochromatosis. [ncbi.nlm.nih.gov]
The disorder is characterized by mild anemia, macrocytosis in the peripheral blood, and giant multinucleated erythroblasts (containing up to 12 nuclei) in the bone marrow. [rarediseases.info.nih.gov]
Ineffective erythropoiesis results in an anemia of variable severity associated with a mild macrocytosis, a normal, or at most slightly elevated, absolute reticulocyte count, a moderate increase in unglycosylated (indirect) bilirubin, a low haptoglobin [accessmedicine.mhmedical.com]
- Microcytic Anemia
anemia syndrome ; see these terms), acquired dyserythropoiesis (myelodysplastic syndrome, acute erythroid leukemia), hemolytic anemias (hereditary spherocytosis) or microcytic anemias (thalassemias and iron deficiency anemias). [rarediseases.info.nih.gov]
For example, in microcytic anemias, a normal RDW is generally seen in thalassemias whereas in iron deficiency it is mildly elevated. [clinicalgate.com]
[…] and microcytic (decreased mean cell volume) anemia with target cells and basophilic stippling on his peripheral blood film. [slideshare.net]
neutropenia); X-linked sideroblastic anemia, due to ALAS2 mutation (hypochromic microcytic anemia that develops within a few months of birth); and congenital dyserythropoietic anemia (CDA) type I, characterized by anemia and early jaundice, variable [oncologynurseadvisor.com]
However, the latter two are associated with microcytic anemia. [ncbi.nlm.nih.gov]
- Hemoglobin Decreased
Cord blood hemoglobin (Hb) at birth in full term infants is 16-17g/dL, does not decrease appreciably during the first week of life, and then declines slowly to a physiological nadir of 11g/dL by 8-12 weeks. [oncologynurseadvisor.com]
- Reticulocytes Increased
On this treatment, hemoglobin and reticulocytes increased and transfusions became unnecessary. In keeping with a few previous reports, interferon alpha2b proved to be effective in congenital dyserythropoietic anemia, type 1. [ncbi.nlm.nih.gov]
Treatment
Response to the treatment was monitored using the blood count and reticulocyte count. The patient was age 14 when interferon treatment was started. [ncbi.nlm.nih.gov]
You can help by adding to it. ( December 2017 ) Treatment [ edit ] Treatment consists of frequent blood transfusions and chelation therapy. Potential cures include bone marrow transplantation and gene therapy. [en.wikipedia.org]
Prognosis
Prognosis In most cases the prognosis is good and there is no decrease in life expectancy. Quality of life may be affected in those with visual impairment. Last updated: 9/27/2013 [rarediseases.info.nih.gov]
Heimpel H et al (2006) Congenital dyserythropoietic anemia type I (CDA I): molecular genetics, clinical appearance, and prognosis based on long-term observation. Blood 107:334–340 PubMed CrossRef Google Scholar 2. [link.springer.com]
Prognosis The prognosis depends on the underlying condition and the degree of iron overload - for example: For thalassaemia major (one of the most severe forms of iron overload): Without chelation, the iron overload causes death in the teenage years or [patient.info]
Congenital dyserythropoietic anemia type II: epidemiology, clinical appearance, and prognosis based on long-term observation. Blood. 2003 Dec 15;102(13):4576-81. Epub 2003 Aug 21. Review. [ghr.nlm.nih.gov]
[…] numbers of cases and no data on the lifetime evolution of the disease. [3] Types include: Differentiating Congenital dyserythropoietic anemia from Other Diseases Epidemiology and Demographics Risk Factors Screening Natural History, Complications, and Prognosis [wikidoc.org]
Etiology
We report a case of CDA II diagnosed in a 48-year-old woman with a longstanding history of anemia of unknown etiology. [scholars.northwestern.edu]
* Hydrops Fetalis/therapy Infant Infant, Newborn Jaundice, Neonatal/diagnosis Jaundice, Neonatal/etiology Jaundice, Neonatal/therapy Microscopy, Electron Phototherapy Pregnancy [ncbi.nlm.nih.gov]
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]
Etiology Etiology of CDA is not fully defined. [orpha.net]
Epidemiology
Summary Epidemiology The prevalence is unknown. Only 4 cases have been reported to date. Clinical description Patients have been described as having severe anemia at birth that requires repeated transfusions. [orpha.net]
Heimpel H (2004) Congenital dyserythropoietic anemias: epidemiology, clinical significance, and progress in understanding their pathogenesis. Ann Hematol 83:613–621 PubMed CrossRef Google Scholar 5. [link.springer.com]
Congenital dyserythropoietic anemia type II: epidemiology, clinical appearance, and prognosis based on long-term observation. Blood. 2003 Dec 15;102(13):4576-81. Epub 2003 Aug 21. Review. [ghr.nlm.nih.gov]
Pathophysiology
Nathan and Oski’s is the only comprehensive product on the market that relates pathophysiology in such depth to hematologic and oncologic diseases affecting children. [books.google.com]
[…] prevents the blood from carrying an adequate supply of oxygen to the body's tissues, resulting in various symptoms of anemia including: tiredness (fatigue), weakness, pale skin, and other similar complications. [1] Historical Perspective Classification Pathophysiology [wikidoc.org]
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test Next-generation sequencing (NGS) is a methodology that can interrogate large regions of genomic DNA in a single assay. [mayomedicallaboratories.com]
It is simple and convenient to use a pathophysiological approach that considers the etiology from the outside-in, (i.e., hemorrhage, vascular damage, plasma factors, membrane abnormalities, metabolic conditions and hemoglobinopathies). [oncologynurseadvisor.com]
Prevention
Early recognition of CDA II is important to prevent end-organ damage secondary to iron overload, the most important complication of the disease. [scholars.northwestern.edu]
Splenectomy, performed in 22 cases, led to moderate increases in hemoglobin values and eliminated the need for transfusions but did not prevent further iron loading. [ncbi.nlm.nih.gov]
Protein coding - H3BPZ6 - 5' and 3' truncations in transcript evidence prevent annotation of the start and the end of the CDS. CDS 5' and 3' incomplete Transcript Support Level 3, when transcripts are supported by a single EST only. [asia.ensembl.org]
Tips to preventing infection: Washing hands, both yours and your visitors, is the best way to prevent the spread of infection. [oncolink.org]