Fanconi Anemia in a pediatric patient

Main Article Content

Anne Karoline Pires de Jesus
https://orcid.org/0000-0002-8852-0785
Carolina Lipi Cerdeira
https://orcid.org/0000-0002-4731-6745
Flavia de Lima Franco
https://orcid.org/0000-0002-5498-8419
Gustavo Fonseca Lemos Calixto
https://orcid.org/0000-0003-3481-7011
Rafael Del Valle da Silva
https://orcid.org/0000-0001-9971-3710
Alessandra dos Santos Danziger Silverio
https://orcid.org/0000-0002-9513-1331

Abstract

Fanconi Anemia (FA) is a rare genetic autosomal-recessive disorder characterized by progressive spinal depression, morphological alterations such as café-au-lait spots, absence of fingers, genital atrophy, hypogonadism, short stature, susceptibility to myelodysplastic events, among others. We report a 10-year-old patient who sought medical care for evaluation of phimosis and bilateral retractile testis. There was an absence of the first right finger, café-au-lait spots, and syndromic facies, in addition to thrombocytopenia and abdominal pain. The chromosomal fragility test confirmed the clinical suspicion of FA. The investigation is complex and clinical evidence is essential for confirmation. The most appropriate treatment is bone marrow transplantation, which may lead to resolving hematological symptoms, as was the case in question.



Article Details

How to Cite
1.
Pires de Jesus AK, Cerdeira CL, Franco F de L, Calixto GFL, Silva RDV da, Silverio A dos SD. Fanconi Anemia in a pediatric patient. Health Sci J [Internet]. 2021Dec.28 [cited 2024May4];11(4):108-11. Available from: https://portalrcs.hcitajuba.org.br/index.php/rcsfmit_zero/article/view/1192
Section
CASE REPORT
Author Biographies

Anne Karoline Pires de Jesus, José do Rosário Vellano University (Unifenas)

Fourth-year medical student at the José do Rosário Vellano University. Alfenas, Minas Gerais, Brazil.

Carolina Lipi Cerdeira, José do Rosário Vellano University (Unifenas)

Fifth-year medical student at the José do Rosário Vellano University. Alfenas, Minas Gerais, Brazil.

Flavia de Lima Franco, José do Rosário Vellano University (Unifenas)

Fifth-year medical student at the José do Rosário Vellano University. Alfenas, Minas Gerais, Brazil.

Gustavo Fonseca Lemos Calixto, José do Rosário Vellano University

Sixth-year medical student at the José do Rosário Vellano University. Alfenas, Minas Gerais, Brazil.

Rafael Del Valle da Silva, José do Rosário Vellano University (Unifenas)

Sixth-year medical student at the Jose do Rosário Vellano University. Alfenas, Minas Gerais, Brazil.

Alessandra dos Santos Danziger Silverio, José do Rosário Vellano University (Unifenas)

Degree in Industrial Pharmacy from Jose do Rosário Vellano University (Unifenas) (1995), Qualification in Pharmacy-Clinical and Toxicological Analysis from Unifenas (1995) and Master's in Morphological Sciences from Unifenas (2001). PhD in Sciences Federal University of Lavras (UFLA). Professor at Unifenas. Alfenas, Minas Gerais, Brazil.

References

1. Soulier J. Fanconi anemia. Hematology Am Soc Hematol Educ Program. 2011:492-7. https://doi.org/10.1182/asheducation-2011.1.492 PMid:22160080
2. Geiselhart A, Lier A, Walter D, Milsom MD. Disrupted signaling through the Fanconi Anemia pathway leads to dysfunctional hematopoietic stem cell biology: underlying mechanisms and potential therapeutic strategies. Anemia. 2012;2012:265790. https://doi.org/10.1155/2012/265790 PMid:22675615 PMCid:PMC3366203
3. Oostra AB, Nieuwint AWM, Joenje H, de Winter JP. Diagnosis of fanconi anemia: chromosomal breakage analysis. Anemia. 2012;2012:238731. https://doi.org/10.1155/2012/238731 PMid:22693659 PMCid:PMC3368163
4. Beltrame MP. Recuperação imune em pacientes com Anemia de Fanconi após transplante de Medula Óssea Alogênico [Doctorate Thesis in Health Sciences] Curitiba: UFPR; 2013. Avaiable from: https://www.acervodigital.ufpr.br/handle/1884/35108
5. Mehta PA, Ebens C. Fanconi anemia. GeneReviews® [Internet]. 2002 [updated 2021 Jun 3; cited 2021 Nov 21]. Avaiable from: https://www.ncbi.nlm.nih.gov/sites/books/NBK1401/
6. Auerbach AD. Fanconi anemia and its diagnosis. Mut Res. 2009;668(1-2):4-10. https://doi.org/10.1016/j.mrfmmm.2009.01.013 PMid:19622403 PMCid:PMC2742943
7. Petryk A, Shankar RK, Giri N, Hollenberg AN, Rutter MM, Nathan B, et al. Endocrine disorders in Fanconi anemia: recommendations for screening and treatment. J Clin Endocrinol Metab. 2015;100(3):803-11. https://doi.org/10.1210/jc.2014-4357 PMid:25575015 PMCid:PMC4333044
8. Younghoon Kee, D'Andrea AD. Molecular pathogenesis and clinical management of Fanconi anemia. J Clin Invest. 2012;122(11):3799-806. https://doi.org/10.1172/JCI58321 PMid:23114602 PMCid:PMC3484428
9. Ferreira D. Análise da literatura sobre Anemia de Fanconi: Aspectos clínicos e laboratoriais. [Pós-graduação em Hematologia e Banco de Sangue]. São Jose do Rio Preto: Academia de Ciência e Tecnologia; 2020 [cited 2021 Nov 21]. Avaiable from: https://bit.ly/3CBd4Co
10. Abreu F; Evaluation of chromosomal abnormalities frequency in patients suspected with Fanconi Anemia in spontaneous and induced with diepoxybutane lymphocyte cultures; Rev Ciênc Méd Biol. 2013 [cited 2021 Nov 21];12(3):318-23. Avaiable from: https://bit.ly/3qYRZ2u
11. Anur P, Friedman DN, Sklar C, Oeffinger K, Castiel M, Kearney J, et al. Late effects in patients with Fanconi anemia following allogeneic hematopoietic stem cell transplantation from alternative donors. Bone Marrow Transplant. 2016;51(7):938-44. https://doi.org/10.1038/bmt.2016.32 PMid:26999465 PMCid:PMC4968886
12. Ferri F. Oncologia e Hematologia: recomendações atualizadas de diagnóstico e tratamento. 1a ed. Elsevier: Amsterdã;2019.
13. MacMillan ML, Wagner JE. Haematopoietic cell transplantation for Fanconi anemia - when and how? Br J Haematol, 2010;149(1):14-21. https://doi.org/10.1111/j.1365-2141.2010.08078.x PMid:20136826
14. Funke VAM, Moreira MCR, Vigorito AC. Acute and chronic Graft-versus-host disease after hematopoietic stem cell transplantation. Rev Assoc Med Bras (1992). 2016;62 Suppl 1:44-50. https://doi.org/10.1590/1806-9282.62.suppl1.44 PMid:27982319
15. Souza PFA. Doença do enxerto versus hospedeiro: fisiopatologia e implicações clínicas. [Trabalho de Conclusão de Curso - Graduação em Biomedicina] Brasília: UNICEUB; 2019 [cited 2021 Nov 21]. Avaiable from: https://bit.ly/3oQffNo