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{{Hereditary spherocytosis}}
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==Overview==
==Overview==
The [[hereditary spherocytosis]] is a [[Family|familial]] [[Hemolysis|hemolytic]] [[Disorder (medicine)|disorder]] with high [[Heterogeneous|heterogeneity]]. [[Clinical]] features range from [[asymptomatic]] to [[fulminant]] [[hemolytic anemia]]. [[History and Physical examination|History]] and [[Symptom|symptoms]] of [[hereditary spherocytosis]] include: [[Jaundice|yellowing of skin]], [[fatigue]], [[irritability]], [[weakness]], [[Dyspnea|shortness of breath]], [[anemia]], [[hemolysis]], [[thrombocytopenia]] and [[hyperbilirubinemia]]. [[Gallstones|Pigment gallstones]] may be found in young [[Child|children]], but [[incidence]] of [[Gallstone disease|gallstones]] increases markedly with [[Ageing|age]], however [[jaundice]] is more prominent in [[newborns]].


==History==
==History==
* As in any other chronic hemolytic states, the signs and symptoms of hereditary spherocytosis (HS) include mild [[pallor]], intermittent [[jaundice]], and [[splenomegaly]]. However, signs and symptoms are highly variable. [[Anemia]] or [[hyperbilirubinemia]] may be of such magnitude as to require [[exchange transfusion]] in the neonatal period. The disorder also may escape clinical recognition altogether. [[Anemia]] usually is mild to moderate, but is sometimes very severe and sometimes not present.
* [[Hereditary spherocytosis]] is a [[familial]] [[Hemolysis|hemolytic]] [[Disorder (medicine)|disorder]] with marked [[heterogeneity]].<ref>{{Cite journal
 
| author = [[Yuki Tateno]], [[Ryoji Suzuki]] & [[Yukihiro Kitamura]]
* Children diagnosed early in life usually have a severe form of [[Hereditary spherocytosis|HS]] that results in their early presentation. [[Jaundice]] is likely to be most prominent in newborns. The magnitude of [[hyperbilirubinemia]] may be such that [[exchange transfusion]] is required. Approximately 30-50% of adults with [[Hereditary spherocytosis|HS]] had a history of [[jaundice]] during the first week of life. Recognition of HS as a potential cause of neonatal [[anemia]] and [[hyperbilirubinemia]] and institution of prompt treatment may reduce the risk of bilirubin-induced neurologic dysfunction in these patients.
| title = Previously undiagnosed hereditary spherocytosis in a patient with jaundice and pyelonephritis: a case report
 
| journal = [[Journal of medical case reports]]
* Beyond the [[neonatal]] period, [[jaundice]] rarely is intense. [[Icterus]] is intermittent and may be triggered by [[fatigue]], cold exposure, emotional distress, or pregnancy. An increase in scleral icterus and a darker urine color commonly are observed in children with nonspecific viral infections. Adults who remain undiagnosed usually have a very mild form, and their HS remains undetected until challenged by an environmental stressor.
| volume = 10
 
| issue = 1
* Gallstones of the pigment type, resulting from excess unconjugated bilirubin in bile, may be found in very young children, but the incidence of gallstones increases markedly with age. In patients with mild HS, cholelithiasis may be the first sign of an underlying red cell disorder.
| pages = 337
 
| year = 2016
* A family history of HS may be present, or the patient may report a history of a family member having had a splenectomy or cholecystectomy before the fourth decade of life. A history of family members with cholelithiasis in the second or third decade of life is also a clue to the possible presence of HS.
| month = December
| doi = 10.1186/s13256-016-1144-8
| pmid = 27906107
}}</ref><ref>{{Cite journal
| author = [[Maria Christina Lopes Araujo Oliveira]], [[Rachel Aparecida Ferreira Fernandes]], [[Carolina Lins Rodrigues]], [[Daniela Aguiar Ribeiro]], [[Maria Fernanda Giovanardi]] & [[Marcos Borato Viana]]
| title = Clinical course of 63 children with hereditary spherocytosis: a retrospective study
| journal = [[Revista brasileira de hematologia e hemoterapia]]
| volume = 34
| issue = 1
| pages = 9–13
| year = 2012
| month =
| doi = 10.5581/1516-8484.20120006
| pmid = 23049376
}}</ref><ref>{{Cite journal
| author = [[Immacolata Andolfo]], [[Roberta Russo]], [[Antonella Gambale]] & [[Achille Iolascon]]
| title = New insights on hereditary erythrocyte membrane defects
| journal = [[Haematologica]]
| volume = 101
| issue = 11
| pages = 1284–1294
| year = 2016
| month = November
| doi = 10.3324/haematol.2016.142463
| pmid = 27756835
}}</ref>
* [[Clinical]] features range from [[asymptomatic]] to [[fulminant]] [[hemolytic anemia]].<ref>{{Cite journal
| author = [[Sayeeda Huq]], [[Mark A. C. Pietroni]], [[Hafizur Rahman]] & [[Mohammad Tariqul Alam]]
| title = Hereditary spherocytosis
| journal = [[Journal of health, population, and nutrition]]
| volume = 28
| issue = 1
| pages = 107–109
| year = 2010
| month = February
| pmid = 20214092
}}</ref>
* [[Child|Children]] [[Diagnosis|diagnosed]] early in life usually have a severe form of [[Hereditary spherocytosis|hereditary spherocytosis]] that results in their early presentation. [[Jaundice]] is likely to be most prominent in [[newborns]]. The magnitude of [[hyperbilirubinemia]] may be such that [[exchange transfusion]] is required. Approximately 30-50% of [[Adult|adults]] with [[Hereditary spherocytosis|hereditary spherocytosis]] had a history of [[jaundice]] during the [[Infant|first week of life]]. Recognition of [[hereditary spherocytosis]] as a potential [[Causality|cause]] of [[neonatal]] [[anemia]] and [[hyperbilirubinemia]] and institution of prompt treatment may reduce the risk of [[Kernicterus|bilirubin-induced neurologic dysfunction]] in these [[Patient|patients]].<ref name="pmid26009624">{{cite journal| author=Christensen RD, Yaish HM, Gallagher PG| title=A pediatrician's practical guide to diagnosing and treating hereditary spherocytosis in neonates. | journal=Pediatrics | year= 2015 | volume= 135 | issue= 6 | pages= 1107-14 | pmid=26009624 | doi=10.1542/peds.2014-3516 | pmc=4444801 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26009624  }}</ref>
* Beyond the [[neonatal]] period, [[jaundice]] rarely is intense. [[Icterus]] is intermittent and may be triggered by [[fatigue]], cold exposure, emotional distress, or [[pregnancy]]. An increase in [[Sclera|scleral]] [[icterus]] and a darker [[urine]] color commonly are observed in [[Child|children]] with nonspecific [[Virus|viral infections]]. [[Adult|Adults]] who remain undiagnosed usually have a very mild form, and their [[hereditary spherocytosis]] remains undetected until challenged by an environmental stressor.
* [[Gallstones]] of the pigment type, resulting from excess [[unconjugated bilirubin]] in [[bile]], may be found in very young [[Child|children]], but the [[incidence]] of [[Gallstone|gallstones]] increases markedly with [[Ageing|age]]. In patients with mild [[Hereditary spherocytosis|hereditary spherocytosis]], [[cholelithiasis]] may be the first [[Medical sign|sign]] of an underlying [[Red blood cell|red cell]] [[Disorder (medicine)|disorder]].


==Symptoms==
==Symptoms==
Symptoms of hereditary spherocytosis include:
* [[Symptom|Symptoms]] and history of [[hereditary spherocytosis]] include:
* Yellowing of the skin and eyes (jaundice)
** [[hemolysis]]
* Pale coloring (pallor)
** [[anemia]]
* Fatigue
** [[jaundice]]
* Irritability
** [[weakness]]
* Shortness of breath
** [[irritability]]
* Weakness
** [[Dyspnea|shortness of breath]]
** [[pallor]]
** [[thrombocytopenia]]
** [[pyelonephritis]]
** [[hyperbilirubinemia]]


==References==
==References==

Latest revision as of 02:18, 19 December 2018

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Overview

The hereditary spherocytosis is a familial hemolytic disorder with high heterogeneity. Clinical features range from asymptomatic to fulminant hemolytic anemia. History and symptoms of hereditary spherocytosis include: yellowing of skin, fatigue, irritability, weakness, shortness of breath, anemia, hemolysis, thrombocytopenia and hyperbilirubinemia. Pigment gallstones may be found in young children, but incidence of gallstones increases markedly with age, however jaundice is more prominent in newborns.

History

Symptoms

References

  1. Yuki Tateno, Ryoji Suzuki & Yukihiro Kitamura (2016). "Previously undiagnosed hereditary spherocytosis in a patient with jaundice and pyelonephritis: a case report". Journal of medical case reports. 10 (1): 337. doi:10.1186/s13256-016-1144-8. PMID 27906107. Unknown parameter |month= ignored (help)
  2. Maria Christina Lopes Araujo Oliveira, Rachel Aparecida Ferreira Fernandes, Carolina Lins Rodrigues, Daniela Aguiar Ribeiro, Maria Fernanda Giovanardi & Marcos Borato Viana (2012). "Clinical course of 63 children with hereditary spherocytosis: a retrospective study". Revista brasileira de hematologia e hemoterapia. 34 (1): 9–13. doi:10.5581/1516-8484.20120006. PMID 23049376.
  3. Immacolata Andolfo, Roberta Russo, Antonella Gambale & Achille Iolascon (2016). "New insights on hereditary erythrocyte membrane defects". Haematologica. 101 (11): 1284–1294. doi:10.3324/haematol.2016.142463. PMID 27756835. Unknown parameter |month= ignored (help)
  4. Sayeeda Huq, Mark A. C. Pietroni, Hafizur Rahman & Mohammad Tariqul Alam (2010). "Hereditary spherocytosis". Journal of health, population, and nutrition. 28 (1): 107–109. PMID 20214092. Unknown parameter |month= ignored (help)
  5. Christensen RD, Yaish HM, Gallagher PG (2015). "A pediatrician's practical guide to diagnosing and treating hereditary spherocytosis in neonates". Pediatrics. 135 (6): 1107–14. doi:10.1542/peds.2014-3516. PMC 4444801. PMID 26009624.

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