Hereditary spherocytosis classification: Difference between revisions

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==Classification==
==Classification==
* HS classified on basis of underlying defect and pattern of inheritance. <ref name="pmid3105174">{{cite journal| author=Duboucher C, Milhau S, Bouissou H| title=Isolated amyloidosis of the atrioventricular valves. A study of one case, curiously associated with diffuse storage of plant wax paraffin. | journal=Virchows Arch A Pathol Anat Histopathol | year= 1987 | volume= 410 | issue= 6 | pages= 541-5 | pmid=3105174 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3105174  }}</ref>
* Hereditary Spherocytosis classified on basis of underlying defect in protein and also on the basis of severity of hemolysis.
* Classification of hereditary spherocytosis on the basis of clinical severity.<ref name="Bolton-Maggs2004">{{cite journal|last1=Bolton-Maggs|first1=P H B|title=Hereditary spherocytosis; new guidelines|journal=Archives of Disease in Childhood|volume=89|issue=9|year=2004|pages=809–812|issn=0003-9888|doi=10.1136/adc.2003.034587}}</ref>{{cite web |url=http://www.ncbi.nlm.nih.gov/books/NBK1116/ |title=GeneReviews® - NCBI Bookshelf |format= |work= |accessdate=}}<ref name="pmid3105174">{{cite journal| author=Duboucher C, Milhau S, Bouissou H| title=Isolated amyloidosis of the atrioventricular valves. A study of one case, curiously associated with diffuse storage of plant wax paraffin. | journal=Virchows Arch A Pathol Anat Histopathol | year= 1987 | volume= 410 | issue= 6 | pages= 541-5 | pmid=3105174 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3105174  }}</ref><ref name="pmid10629586">{{cite journal| author=Beauchamp-Nicoud A, Morle L, Lutz HU, Stammler P, Agulles O, Petermann-Khder R et al.| title=Heavy transfusions and presence of an anti-protein 4.2 antibody in 4. 2(-) hereditary spherocytosis (949delG). | journal=Haematologica | year= 2000 | volume= 85 | issue= 1 | pages= 19-24 | pmid=10629586 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10629586  }}</ref>
 
{| class="wikitable"
{| class="wikitable"
| colspan="1" rowspan="2" |SPH1
|+
| colspan="1" rowspan="2" |''ANK1''
! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF|Locus}}
| colspan="1" rowspan="2" |Ankyrin-1
! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF|Gene}}
| colspan="1" rowspan="1" |AD
! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF|Protein}}
| colspan="1" rowspan="1" |Mild -moderate
! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF|Inheritance}}
| colspan="1" rowspan="1" |
! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF|Severity}}
! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF|Comment}}
|-
|-
| colspan="1" rowspan="1" |AR
| SPH1
| colspan="1" rowspan="1" |Moderately severe -severe
| ANK1
| colspan="1" rowspan="1" |Often transfusion dependent
| Ankyrin-1
| AD/AR
| mild-moderate/moderately severe-severe
| often transfusion dependant
|-
|-
| colspan="1" rowspan="2" |SPH2
| SPH2
| colspan="1" rowspan="2" |''SPTB''
| SPTB
| colspan="1" rowspan="2" |Spectrin beta chain, erythrocytic
| Spectrin beta chain,erythrocytic
| colspan="1" rowspan="1" |AD
| AD/AR
| colspan="1" rowspan="1" |Mild -moderate
| mild-moderate/severe
| colspan="1" rowspan="1" |
| 1 fatal infantile case described
|-
|-
| colspan="1" rowspan="1" |AR
| SPH3
| colspan="1" rowspan="1" |Severe
| SPTA1
| colspan="1" rowspan="1" |1 fatal infantile case described
| Spectrin alpha chain,erythrocytic1
| AR
| severe
| transfusion dependant
|-
|-
| colspan="1" rowspan="1" |SPH3
| SPH4
| colspan="1" rowspan="1" |''SPTA1''
| SLC4A1
| colspan="1" rowspan="1" |Spectrin alpha chain, erythrocytic 1
| Band3(anion transport protein)
| colspan="1" rowspan="1" |AR
| AD
| colspan="1" rowspan="1" |Severe
| mild-moderate
| colspan="1" rowspan="1" |Transfusion dependent
| certain SLC4A1 variants cause disease only when biallelic
|-
|-
| colspan="1" rowspan="1" |SPH4
| SPH5
| colspan="1" rowspan="1" |''SLC4A1''
| EPB42
| colspan="1" rowspan="1" |Band 3 (anion transport protein)
| Protein 4.2
| colspan="1" rowspan="1" |AD
| AR
| colspan="1" rowspan="1" |Mild -moderate
| mild-moderate
| colspan="1" rowspan="1" |Certain ''SLC4A1'' pathogenic variants cause disease only when biallelic.
| 1 moderately severe case described
|-
| colspan="1" rowspan="1" |SPH5
| colspan="1" rowspan="1" |''EPB42''
| colspan="1" rowspan="1" |Protein 4.2 2
| colspan="1" rowspan="1" |AR
| colspan="1" rowspan="1" |Mild -moderate 3
| colspan="1" rowspan="1" |1 moderately severe case described
|}
|}
* HS also classified on basis of severity as mentioned on the below table.<ref name="pmid10629586">{{cite journal| author=Beauchamp-Nicoud A, Morle L, Lutz HU, Stammler P, Agulles O, Petermann-Khder R et al.| title=Heavy transfusions and presence of an anti-protein 4.2 antibody in 4. 2(-) hereditary spherocytosis (949delG). | journal=Haematologica | year= 2000 | volume= 85 | issue= 1 | pages= 19-24 | pmid=10629586 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10629586  }}</ref>
{| class="wikitable"
{| class="wikitable"
|+
! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF|Classification}}
! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF|Mild}}
! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF|Moderate}}
! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF|Severe}}
|-
|-
! colspan="1" rowspan="1" |Severity
! Hemoglobin (g/dl)
! colspan="1" rowspan="1" |Hgb (g/dL)
| 110-150
! colspan="1" rowspan="1" |Reticulocytes (%)
| 80-120
! colspan="1" rowspan="1" |Splenectomy
| 60-80
|-
| colspan="1" rowspan="1" |'''Mild'''
| colspan="1" rowspan="1" |11-15
| colspan="1" rowspan="1" |3-8
| colspan="1" rowspan="1" |Not necessary
|-
| colspan="1" rowspan="1" |'''Moderate'''
| colspan="1" rowspan="1" |8-11.5
| colspan="1" rowspan="1" |>8
| colspan="1" rowspan="1" |Consider if activity level & quality of life are decreased
|-
|-
| colspan="1" rowspan="1" |'''Moderately severe'''
! Reticulocyte count (%)
| colspan="1" rowspan="1" |6-8
| 3-6
| colspan="1" rowspan="1" |≥10
| >6
| colspan="1" rowspan="1" |Indicated at age >5 yrs
| >10
|-
|-
| colspan="1" rowspan="1" |'''Severe'''
! Bilirubin (ug/l)
| colspan="1" rowspan="1" |<6
| 17-34
| colspan="1" rowspan="1" |≥10
| >34
| colspan="1" rowspan="1" |Indicated at age >3 yrs
| >51
|-
|-
| colspan="1" rowspan="1" |'''Normal 1'''
! Splenectomy
| colspan="1" rowspan="1" |11.7-15.7 (adult females) 13.3-17.7 (adult males)
| usually not required
| colspan="1" rowspan="1" |0.5-1.5 2
| indicated during school age, usually before puberty
| necessary - delay until 6 years of age if possible
|}
|}



Revision as of 14:51, 28 November 2018

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Overview

  • Hereditary Spherocytosis classified on basis of underlying defect in protein and also on the basis of severity of hemolysis.

Classification

  • Hereditary Spherocytosis classified on basis of underlying defect in protein and also on the basis of severity of hemolysis.
  • Classification of hereditary spherocytosis on the basis of clinical severity.[1]"GeneReviews® - NCBI Bookshelf".[2][3]
Locus Gene Protein Inheritance Severity Comment
SPH1 ANK1 Ankyrin-1 AD/AR mild-moderate/moderately severe-severe often transfusion dependant
SPH2 SPTB Spectrin beta chain,erythrocytic AD/AR mild-moderate/severe 1 fatal infantile case described
SPH3 SPTA1 Spectrin alpha chain,erythrocytic1 AR severe transfusion dependant
SPH4 SLC4A1 Band3(anion transport protein) AD mild-moderate certain SLC4A1 variants cause disease only when biallelic
SPH5 EPB42 Protein 4.2 AR mild-moderate 1 moderately severe case described
Classification Mild Moderate Severe
Hemoglobin (g/dl) 110-150 80-120 60-80
Reticulocyte count (%) 3-6 >6 >10
Bilirubin (ug/l) 17-34 >34 >51
Splenectomy usually not required indicated during school age, usually before puberty necessary - delay until 6 years of age if possible

References

  1. Bolton-Maggs, P H B (2004). "Hereditary spherocytosis; new guidelines". Archives of Disease in Childhood. 89 (9): 809–812. doi:10.1136/adc.2003.034587. ISSN 0003-9888.
  2. Duboucher C, Milhau S, Bouissou H (1987). "Isolated amyloidosis of the atrioventricular valves. A study of one case, curiously associated with diffuse storage of plant wax paraffin". Virchows Arch A Pathol Anat Histopathol. 410 (6): 541–5. PMID 3105174.
  3. Beauchamp-Nicoud A, Morle L, Lutz HU, Stammler P, Agulles O, Petermann-Khder R; et al. (2000). "Heavy transfusions and presence of an anti-protein 4.2 antibody in 4. 2(-) hereditary spherocytosis (949delG)". Haematologica. 85 (1): 19–24. PMID 10629586.

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