Variable clinical presentation of shwachman-diamond syndrome: Update from the North American shwachman-diamond syndrome registry

Kasiani C. Myers, Audrey Anna Bolyard, Barbara Otto, Trisha E. Wong, Amanda T. Jones, Richard E. Harris, Stella M. Davies, David C. Dale, Akiko Shimamura

Research output: Contribution to journalArticle

65 Scopus citations

Abstract

Objectives To investigate the range of clinical presentations for Shwachman-Diamond syndrome (SDS) with the long-term goal of improving diagnosis. Study design We reviewed the North American Shwachman-Diamond Syndrome Registry. Genetic reports of biallelic Shwachman-Bodian-Diamond syndrome mutations confirming the diagnosis of SDS were available for 37 patients. Results Neutropenia was the most common hematologic abnormality at presentation (30/37, 81%); however, only 51% (19/37) of patients presented with the classic combination of neutropenia and steatorrhea. Absence of pancreatic lipomatosis on ultrasound or computed tomography scan, normal fecal elastase levels, and normal skeletal survey do not rule out the diagnosis of SDS. SDS was diagnosed in 2 asymptomatic siblings of SDS probands. Twenty-four of 37 patients (65%) had congenital anomalies. Conclusion Our cohort reveals a broad range of clinical presentation for SDS. Clues to the underlying diagnosis of SDS included cytopenias with a hypocellular marrow, congenital anomalies, family history, and myelodysplasia with clonal abnormalities frequently found in SDS. Reliance on classic clinical criteria for SDS would miss or delay diagnosis of a significant subset of patients with SDS.

Original languageEnglish (US)
Pages (from-to)866-870
Number of pages5
JournalJournal of Pediatrics
Volume164
Issue number4
DOIs
StatePublished - Apr 2014

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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    Myers, K. C., Bolyard, A. A., Otto, B., Wong, T. E., Jones, A. T., Harris, R. E., Davies, S. M., Dale, D. C., & Shimamura, A. (2014). Variable clinical presentation of shwachman-diamond syndrome: Update from the North American shwachman-diamond syndrome registry. Journal of Pediatrics, 164(4), 866-870. https://doi.org/10.1016/j.jpeds.2013.11.039