Ghosal hematodiaphyseal dysplasia-a concise review including an illustrative patient.

Skeletal Radiol

Department of Radiology and Imageology, Nizams Institute of Medical Sciences, Hyderabad, 500082, India,

Published: March 2015

Ghosal hematodiaphyseal dysplasia is a rare autosomal recessive disorder characterized by metadiaphyseal dysplasia of long bones and defective hematopoiesis due to fibrosis or sclerosis of bone marrow. Approximately 15 cases of this entity have been reported in the literature so far. The diagnosis of this rare syndrome and its differentiation from other sclerosing bone disorders is important as correct diagnosis helps in treatment with corticosteroids, leading to considerable improvement in anemia and bony changes, negating the need for blood transfusions. We review the literature for this uncommon disorder and also present a similar case in a 21-year-old female who remained undiagnosed until this age because of unfamiliarity of clinicians with the condition.

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http://dx.doi.org/10.1007/s00256-014-1989-0DOI Listing

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Article Synopsis
  • Ghosal hematodiaphyseal dysplasia (GHDD) is a rare genetic disorder affecting bone development, characterized by issues like diaphyseal dysplasia of long bones and anemia that responds to steroids, caused by mutations in the TBXAS1 gene.
  • Two cases are presented: a 3-year-old boy with pallor and ecchymosis diagnosed with GHDD due to bicytopenia and bone marrow fibrosis, and a 20-month-old girl with symptoms including bloody stools and anemia, confirmed through genetic testing.
  • Early diagnosis and treatment with steroids can significantly improve patient outcomes, reducing transfusion needs and preventing further bone damage, which contributes to better growth
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Ghosal hematodiaphyseal dysplasia (GHDD) is a rare autosomal recessive disorder characterized by increased bone density involving diaphyses of long bones and defective hematopoiesis. It is due to biallelic variants in the TBXAS1 (OMIM*274180) gene, which encodes for thromboxane synthase. We present a rare case of a middle-aged woman who presented with chronic anemia and bone pain.

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Low-dose non-steroidal anti-inflammatory drugs: a promising approach for the treatment of symptomatic bone marrow failure in Ghosal hematodiaphyseal dysplasia.

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The study highlights genomic findings in a series of 13 IRIDA phenotype cases. All had microcytic hypochromic anemia with suboptimal oral iron response to two different oral iron preparations at 4-6 weeks and low-normal ferritin, low transferrin saturation, and inappropriately high hepcidin. Targeted NGS on a 26-gene iron panel revealed pathogenic TMPRSS6 variants in 5/13 (38 %) cases.

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