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Common clinical findings in Fanconi anemia

Common clinical findings in Fanconi anemia
Anomaly Frequency (percent)
Any physical abnormality 60 to 75%
Skin  Generalized hyperpigmentation; hypopigmented areas; large freckles, café-au-lait spots 40 to 60%
Short stature, delicate features 40 to 60%
Upper limbs  Absent or hypoplastic thumb, supernumerary, bifid, clinodactyly 35 to 50%
Gonads  Hypogenitalia, undescended/absent testes, hypospadias; bicornuate or malpositioned uterus

25% (males)

<5% (females)

Head  Microcephaly or hydrocephaly; birdlike face, mid-face hypoplasia, Sprengel's deformity of neck 20 to 25%
Eyes  Microphthalmia, ptosis, epicanthal folds, strabismus 20 to 40%
Kidney  Abnormal, ectopic, horseshoe, hypoplastic, or absent kidney; hydronephrosis 20 to 30%
Ears  Deafness (usually conductive); low set ears, abnormal shape, narrow canal 10 to 20%
Developmental delay 10%
Cardiopulmonary anomalies  Congenital heart disease (patent ductus arteriosus, atrial or ventricular septal defects, coarctation, situs inversus) 6%
Gastrointestinal anomalies  Atresias, imperforate anus, tracheoesophageal fistula, malrotation 5%
Refer to UpToDate for details. These frequencies were derived from studies of patients with classic presentations and may be an underestimate. Individuals with more subtle findings may be identified from genetic sequencing.
FA: Fanconi anemia.
Adapted from:
  1. Alter BP, Young NS. Bone marrow failure syndromes. In: Hematology of Infancy and Childhood, Nathan DG, Orkin SH (Eds), WB Saunders, Philadelphia 1998. p.238.
  2. Shimamura A, Alter BP. Pathophysiology and management of inherited bone marrow failure syndromes. Blood Reviews 2010; 24:101.
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