Congenital dyserythropoietic anemia in children: Case series with review of literature

Abstract

Congenital dyserythropoietic anemia (CDA) are a diverse category of heritable anemia. The causative genetic abnormalities interfere with the normal developmental process of erythrocyte maturation inside the bone marrow. As a consequence, red blood cell precursors die prematurely in the marrow (ineffective erythropoiesis) and the altered mature RBCs that reach peripheral blood have reduced survival. Due to relative rarity and resemblance to other common disorders, the diagnosis is often delayed. Apart from having symptoms related to anemia and chronic hemolysis, most of these patients suffer from complications of iron overload even if not transfusion dependent. Classically, 3 major categories of CDAs have been described (I, II, III). Other described CDA variants are rare. With easier accessibility and widespread availability of genetic testing, it is possible to make molecular diagnoses for most cases. The diagnosis can be accelerated by targeted next-generation sequencing. There's no unifying theory explaining the pathogenesis behind the disease causation. In-depth understanding at the cellular level has clarified the multifactorial pathologic process. In this review, we describe the epidemiology, pathophysiology, clinical features, and management options available for CDA. We also summarize a brief report of 17 patients with CDA diagnosed and treated at our center in the last 5 years.