Ghosal hematodiaphyseal dysplasia (GHDD) diagnosis and treatment: case report

Objective: Ghosal hematodiaphyseal dysplasia syndrome (GHDD) is a rare authosomal ressesive disorder characterized by increased bone density and regenerative corticosteroid-sensitive anemia.We describe GHDD in an 11-year old Azerbaijani boy with refractory anemia,mild thrombocytopenia and radiologic...

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Main Authors: Gular MAMMADOVA, Samira HASANOVA, Konul BAGHIROVA, Avesta ALLAHVERDIYEVA, Narmin EYVAZOVA, Adam NAJAFLI, Kamala MAMMADOVA, Afag NASIBOVA, Valeh HUSEYNOV
Format: Article
Language:English
Published: Elsevier 2022-10-01
Series:Hematology, Transfusion and Cell Therapy
Online Access:http://www.sciencedirect.com/science/article/pii/S2531137922013505
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author Gular MAMMADOVA
Samira HASANOVA
Konul BAGHIROVA
Avesta ALLAHVERDIYEVA
Narmin EYVAZOVA
Adam NAJAFLI
Kamala MAMMADOVA
Afag NASIBOVA
Valeh HUSEYNOV
author_facet Gular MAMMADOVA
Samira HASANOVA
Konul BAGHIROVA
Avesta ALLAHVERDIYEVA
Narmin EYVAZOVA
Adam NAJAFLI
Kamala MAMMADOVA
Afag NASIBOVA
Valeh HUSEYNOV
author_sort Gular MAMMADOVA
collection DOAJ
description Objective: Ghosal hematodiaphyseal dysplasia syndrome (GHDD) is a rare authosomal ressesive disorder characterized by increased bone density and regenerative corticosteroid-sensitive anemia.We describe GHDD in an 11-year old Azerbaijani boy with refractory anemia,mild thrombocytopenia and radiological metadiaphyseal dysplasia.The diagnosis was made based on clinical and laboratory examinations and genetic analysis.We have observed a significant improvement of anemia after administration of steroids. Case report: An 11-year-old boy with long-standing anemia, complained of fatigue,delayed physical development,and limited range of motion in the joint.Physical examination did not reveal LAP and hepatosplenomegaly.Among the dysmorphic craniofacial changes mentioned in the literature, has a tower-shaped skull,micrognotia,drooping ears,a long and wide philtrum,and a thin upper lip.Skeletal X-ray imaging showed fibrotic changes and varying degrees of osteopenia in the metaphysis of the long tubular bones. Methodology: The blood count: Hb 7.0 g/dl,HCT 24.5%,reticulocytes 5.6%,MCV 78fL,MCHC 28.6 g/dl,WBC count 6860/mm3,platelets 165000/mm3,ESR 75 mm/h,anisocytosis in erythrocytes and platelets were observed in a peripheral blood smear.Hemoglobin electrophoresis,iron studies,vitamin B12 and folic acid were normal.Coombs test was negative.Bone marrow examination showed hypoplasia in erythroid and megakaryocytic series and dysgranulocytopoiesis. Results: After detection of exon 12 ((p.Gly473Trp),rs149988492,CM215867) in the genetic panel analysis of anemia,steroid treatment at a dose of 1 mg/kg/day was started and anemia improved at 1-month follow-up (Hb level 6.8 g/dL to 11.9 g/dL),but mild thrombocytopenia was noted to persist.The clinically insignificant CRP elevation normalized during the treatment. Conclusion: GHDD should be considered in patients with clinical and radiographic evidence of diaphyseal dysplasia as well as hematological abnormalities. In addition, bone dysplasia should be investigated in treatment-resistant hematological pathologies of unknown origin. Although GHDD is rare, clinicians should be informed that it responds well to steroid therapy.
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spelling doaj.art-ff90ba443129438abd3e25ee2c3aad5e2022-12-22T03:30:16ZengElsevierHematology, Transfusion and Cell Therapy2531-13792022-10-0144S22S23Ghosal hematodiaphyseal dysplasia (GHDD) diagnosis and treatment: case reportGular MAMMADOVA0Samira HASANOVA1Konul BAGHIROVA2Avesta ALLAHVERDIYEVA3Narmin EYVAZOVA4Adam NAJAFLI5Kamala MAMMADOVA6Afag NASIBOVA7Valeh HUSEYNOV8Azerbaijan National Hematology and Transfusiology CenterAzerbaijan National Hematology and Transfusiology CenterAzerbaijan National Hematology and Transfusiology CenterAzerbaijan National Hematology and Transfusiology CenterAzerbaijan National Hematology and Transfusiology CenterAzerbaijan National Hematology and Transfusiology CenterAzerbaijan National Hematology and Transfusiology CenterAzerbaijan National Hematology and Transfusiology CenterAzerbaijan National Hematology and Transfusiology Center; Azerbaijan National Hematology and Transfusiology CenterObjective: Ghosal hematodiaphyseal dysplasia syndrome (GHDD) is a rare authosomal ressesive disorder characterized by increased bone density and regenerative corticosteroid-sensitive anemia.We describe GHDD in an 11-year old Azerbaijani boy with refractory anemia,mild thrombocytopenia and radiological metadiaphyseal dysplasia.The diagnosis was made based on clinical and laboratory examinations and genetic analysis.We have observed a significant improvement of anemia after administration of steroids. Case report: An 11-year-old boy with long-standing anemia, complained of fatigue,delayed physical development,and limited range of motion in the joint.Physical examination did not reveal LAP and hepatosplenomegaly.Among the dysmorphic craniofacial changes mentioned in the literature, has a tower-shaped skull,micrognotia,drooping ears,a long and wide philtrum,and a thin upper lip.Skeletal X-ray imaging showed fibrotic changes and varying degrees of osteopenia in the metaphysis of the long tubular bones. Methodology: The blood count: Hb 7.0 g/dl,HCT 24.5%,reticulocytes 5.6%,MCV 78fL,MCHC 28.6 g/dl,WBC count 6860/mm3,platelets 165000/mm3,ESR 75 mm/h,anisocytosis in erythrocytes and platelets were observed in a peripheral blood smear.Hemoglobin electrophoresis,iron studies,vitamin B12 and folic acid were normal.Coombs test was negative.Bone marrow examination showed hypoplasia in erythroid and megakaryocytic series and dysgranulocytopoiesis. Results: After detection of exon 12 ((p.Gly473Trp),rs149988492,CM215867) in the genetic panel analysis of anemia,steroid treatment at a dose of 1 mg/kg/day was started and anemia improved at 1-month follow-up (Hb level 6.8 g/dL to 11.9 g/dL),but mild thrombocytopenia was noted to persist.The clinically insignificant CRP elevation normalized during the treatment. Conclusion: GHDD should be considered in patients with clinical and radiographic evidence of diaphyseal dysplasia as well as hematological abnormalities. In addition, bone dysplasia should be investigated in treatment-resistant hematological pathologies of unknown origin. Although GHDD is rare, clinicians should be informed that it responds well to steroid therapy.http://www.sciencedirect.com/science/article/pii/S2531137922013505
spellingShingle Gular MAMMADOVA
Samira HASANOVA
Konul BAGHIROVA
Avesta ALLAHVERDIYEVA
Narmin EYVAZOVA
Adam NAJAFLI
Kamala MAMMADOVA
Afag NASIBOVA
Valeh HUSEYNOV
Ghosal hematodiaphyseal dysplasia (GHDD) diagnosis and treatment: case report
Hematology, Transfusion and Cell Therapy
title Ghosal hematodiaphyseal dysplasia (GHDD) diagnosis and treatment: case report
title_full Ghosal hematodiaphyseal dysplasia (GHDD) diagnosis and treatment: case report
title_fullStr Ghosal hematodiaphyseal dysplasia (GHDD) diagnosis and treatment: case report
title_full_unstemmed Ghosal hematodiaphyseal dysplasia (GHDD) diagnosis and treatment: case report
title_short Ghosal hematodiaphyseal dysplasia (GHDD) diagnosis and treatment: case report
title_sort ghosal hematodiaphyseal dysplasia ghdd diagnosis and treatment case report
url http://www.sciencedirect.com/science/article/pii/S2531137922013505
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