Medicine (Baltimore). 2019 Sep;98(39):e17337. doi: 10.1097/MD.0000000000017337.
https://www.ncbi.nlm.nih.gov/pubmed/31574871
Bochdalek hernia with Diamond-Blackfan anemia associated with RPS19 gene mutation: A case report.
Author information
1Department of Pediatrics, Chungbuk National University Hospital, Cheongju.2Department of Pediatrics, Cha Bundang Medical Center, Cha University, Seongnam, Korea.
Abstract
RATIONALE:
Diamond-Blackfan anemia (DBA) is a rare inherited marrow disorder, characterized by erythrocyte aplasia and is associated with congenital anomalies and a susceptibility to cancer. Although congenital abnormalities have been observed in ∼50% of DBA patients, the occurrence of an associated congenital diaphragmatic hernia (CDH) has rarely been reported.
PATIENT CONCERNS:
A 19-month-old male child was referred to our pediatric hematology-oncology outpatient clinic with anemic appearance. He presented to us with recurrent anemia, short stature, and developmental delay.
DIAGNOSIS:
On bone marrow examination, only erythropoietic cells were markedly decreased in number, whereas other cell lines were unaffected. An abdominal computed tomography scan revealed a Bochdalek type of CDH. A genetic analysis revealed heterozygous mutation of RPS19; therefore, he was diagnosed as having DBA with CDH.
INTERVENTIONS:
The patient received an initial packed red blood cell transfusion, followed by an administration of oral prednisone.
OUTCOMES:
The patient is maintained on oral prednisone administered at a dose of 0.3 mg/kg every alternate day and has since a hemoglobin level of >9.0 g/dL without further RBC transfusions.
LESSONS:
We learned that a Bochdalek type of CDH can manifest in a DBA patient with RPS19 gene mutation. Therefore, patients diagnosed with the latter disorder should also be screened for an early detection of potential CDHs.PMID: 31574871 DOI: 10.1097/MD.0000000000017337[Indexed for MEDLINE] Free PMC Article
