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Beta-thalassemia-X-linked thrombocytopenia syndrome(XLTT)

MedGen UID:
326415
Concept ID:
C1839161
Disease or Syndrome
Synonyms: THROMBOCYTOPENIA WITH BETA-THALASSEMIA, X-LINKED; Thrombocytopenia, platelet dysfunction, hemolysis, and imbalanced globin synthesis
SNOMED CT: Beta thalassemia X-linked thrombocytopenia syndrome (718196002)
Modes of inheritance:
X-linked recessive inheritance
MedGen UID:
375779
Concept ID:
C1845977
Finding
Source: Orphanet
A mode of inheritance that is observed for recessive traits related to a gene encoded on the X chromosome. In the context of medical genetics, X-linked recessive disorders manifest in males (who have one copy of the X chromosome and are thus hemizygotes), but generally not in female heterozygotes who have one mutant and one normal allele.
 
Gene (location): GATA1 (Xp11.23)
 
Monarch Initiative: MONDO:0010745
OMIM®: 314050
Orphanet: ORPHA231393

Disease characteristics

Excerpted from the GeneReview: GATA1-Related Cytopenia
GATA1-related cytopenia is characterized by thrombocytopenia and/or anemia ranging from mild to severe. Thrombocytopenia typically presents in infancy as a bleeding disorder with easy bruising and mucosal bleeding (e.g., epistaxis). Anemia ranges from minimal (mild dyserythropoiesis) to severe (hydrops fetalis requiring in utero transfusion). At the extreme end of the clinical spectrum, severe hemorrhage and/or erythrocyte transfusion dependence are lifelong; at the milder end, anemia and the risk for bleeding may decrease spontaneously with age. One or more of the following may also be present: neutropenia, splenomegaly, cryptorchidism, hypospadias, and rarely additional clinical features of Diamond-Blackfan anemia. Heterozygous females may have mild-to-moderate symptoms such as menorrhagia. Rarely, GATA1-related cytopenia can progress to myelodysplastic syndrome or aplastic anemia. [from GeneReviews]
Authors:
Kaoru Takasaki  |  Melissa A Kacena  |  Wendy H Raskind, et. al.   view full author information

Additional description

From OMIM
XLTT is an X-linked recessive hematologic disorder characterized by variable thrombocytopenia, hemolytic anemia, splenomegaly, and abnormalities in hemoglobin chain synthesis (summary by Ciovacco et al., 2008 and Millikan et al., 2011).  http://www.omim.org/entry/314050

Clinical features

From HPO
Hemolytic anemia
MedGen UID:
1916
Concept ID:
C0002878
Disease or Syndrome
A type of anemia caused by premature destruction of red blood cells (hemolysis).
Epistaxis
MedGen UID:
4996
Concept ID:
C0014591
Pathologic Function
Epistaxis, or nosebleed, refers to a hemorrhage localized in the nose.
Thrombocytopenia
MedGen UID:
52737
Concept ID:
C0040034
Disease or Syndrome
A reduction in the number of circulating thrombocytes.
Prolonged bleeding time
MedGen UID:
56231
Concept ID:
C0151529
Finding
Prolongation of the time taken for a standardized skin cut of fixed depth and length to stop bleeding.
Reticulocytosis
MedGen UID:
60089
Concept ID:
C0206160
Finding
An elevation in the number of reticulocytes (immature erythrocytes) in the peripheral blood circulation.
Increased RBC distribution width
MedGen UID:
1630967
Concept ID:
C0948014
Finding
Red blood cell distribution width (RDW) is a simple parameter of the standard full blood count and a measure of heterogeneity in the size of circulating erythrocytes. It is provided by automated hematology analyzers and it reflects the range of the red cell size. It is calculated by dividing the standard deviation of erythrocyte volume by the mean corpuscular volume (MCV) and multiplied by 100 to convert to a percentage.
Increased mean platelet volume
MedGen UID:
853131
Concept ID:
C1096367
Finding
Average platelet volume above the upper limit of the normal reference interval.
Reduced platelet alpha granules
MedGen UID:
1789060
Concept ID:
C5539664
Finding
A reduced number of platelet alpha granules.
Splenomegaly
MedGen UID:
52469
Concept ID:
C0038002
Finding
Abnormal increased size of the spleen.
Petechiae
MedGen UID:
10680
Concept ID:
C0031256
Disease or Syndrome
Petechiae are pinpoint-sized reddish/purple spots, resembling a rash, that appear just under the skin or a mucous membrane when capillaries have ruptured and some superficial bleeding into the skin has happened. This term refers to an abnormally increased susceptibility to developing petechiae.
Bruising susceptibility
MedGen UID:
140849
Concept ID:
C0423798
Finding
An ecchymosis (bruise) refers to the skin discoloration caused by the escape of blood into the tissues from ruptured blood vessels. This term refers to an abnormally increased susceptibility to bruising. The corresponding phenotypic abnormality is generally elicited on medical history as a report of frequent ecchymoses or bruising without adequate trauma.

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVBeta-thalassemia-X-linked thrombocytopenia syndrome
Follow this link to review classifications for Beta-thalassemia-X-linked thrombocytopenia syndrome in Orphanet.

Professional guidelines

PubMed

Sekeres MA, Taylor J
JAMA 2022 Sep 6;328(9):872-880. doi: 10.1001/jama.2022.14578. PMID: 36066514
Yoshiji H, Nagoshi S, Akahane T, Asaoka Y, Ueno Y, Ogawa K, Kawaguchi T, Kurosaki M, Sakaida I, Shimizu M, Taniai M, Terai S, Nishikawa H, Hiasa Y, Hidaka H, Miwa H, Chayama K, Enomoto N, Shimosegawa T, Takehara T, Koike K
J Gastroenterol 2021 Jul;56(7):593-619. Epub 2021 Jul 7 doi: 10.1007/s00535-021-01788-x. PMID: 34231046Free PMC Article
Fanouriakis A, Tziolos N, Bertsias G, Boumpas DT
Ann Rheum Dis 2021 Jan;80(1):14-25. Epub 2020 Oct 13 doi: 10.1136/annrheumdis-2020-218272. PMID: 33051219

Recent clinical studies

Etiology

Crickx E, Mahévas M, Michel M, Godeau B
Clin Interv Aging 2023;18:115-130. Epub 2023 Jan 26 doi: 10.2147/CIA.S369574. PMID: 36726813Free PMC Article
Michael M, Bagga A, Sartain SE, Smith RJH
Lancet 2022 Nov 12;400(10364):1722-1740. Epub 2022 Oct 19 doi: 10.1016/S0140-6736(22)01202-8. PMID: 36272423
Pishko AM, Levine LD, Cines DB
Blood Rev 2020 Mar;40:100638. Epub 2019 Nov 6 doi: 10.1016/j.blre.2019.100638. PMID: 31757523
Rivers E, Worth A, Thrasher AJ, Burns SO
Br J Haematol 2019 May;185(4):647-655. Epub 2019 Mar 12 doi: 10.1111/bjh.15831. PMID: 30864154Free PMC Article
Cines DB, Levine LD
Blood 2017 Nov 23;130(21):2271-2277. Epub 2017 Jun 21 doi: 10.1182/blood-2017-05-781971. PMID: 28637667Free PMC Article

Diagnosis

Michel M
Hematol Oncol Clin North Am 2022 Apr;36(2):381-392. Epub 2022 Mar 11 doi: 10.1016/j.hoc.2021.12.004. PMID: 35282950
Pishko AM, Levine LD, Cines DB
Blood Rev 2020 Mar;40:100638. Epub 2019 Nov 6 doi: 10.1016/j.blre.2019.100638. PMID: 31757523
Guo Q, Lou Y, Liu L, Luo P
Ther Apher Dial 2020 Aug;24(4):352-360. Epub 2019 Dec 2 doi: 10.1111/1744-9987.13448. PMID: 31661590
Swain F, Bird R
Platelets 2020;31(3):285-290. Epub 2019 Jul 3 doi: 10.1080/09537104.2019.1637835. PMID: 31269407
Rivers E, Worth A, Thrasher AJ, Burns SO
Br J Haematol 2019 May;185(4):647-655. Epub 2019 Mar 12 doi: 10.1111/bjh.15831. PMID: 30864154Free PMC Article

Therapy

Fattizzo B, Marchetti M, Michel M, Cantoni S, Frederiksen H, Giordano G, Glenthøj A, González-López TJ, Murakhovskaya I, Napolitano M, Mingot ME, Arguello M, Patriarca A, Raso S, Vianelli N, Barcellini W
Lancet Haematol 2024 Aug;11(8):e617-e628. Epub 2024 Jul 2 doi: 10.1016/S2352-3026(24)00144-3. PMID: 38968944
Morice PM, Leary A, Dolladille C, Chrétien B, Poulain L, González-Martín A, Moore K, O'Reilly EM, Ray-Coquard I, Alexandre J
Lancet Haematol 2021 Feb;8(2):e122-e134. Epub 2020 Dec 18 doi: 10.1016/S2352-3026(20)30360-4. PMID: 33347814
Guo Q, Lou Y, Liu L, Luo P
Ther Apher Dial 2020 Aug;24(4):352-360. Epub 2019 Dec 2 doi: 10.1111/1744-9987.13448. PMID: 31661590
Velo-García A, Castro SG, Isenberg DA
J Autoimmun 2016 Nov;74:139-160. Epub 2016 Jul 25 doi: 10.1016/j.jaut.2016.07.001. PMID: 27461045
Lovecchio F
Clin Toxicol (Phila) 2014 Jul;52(6):579-83. Epub 2014 May 20 doi: 10.3109/15563650.2014.917181. PMID: 24844576

Prognosis

Boyer O, Niaudet P
Pediatr Clin North Am 2022 Dec;69(6):1181-1197. Epub 2022 Oct 29 doi: 10.1016/j.pcl.2022.07.006. PMID: 36880929
Greinacher A, Thiele T, Warkentin TE, Weisser K, Kyrle PA, Eichinger S
N Engl J Med 2021 Jun 3;384(22):2092-2101. Epub 2021 Apr 9 doi: 10.1056/NEJMoa2104840. PMID: 33835769Free PMC Article
Bayer G, von Tokarski F, Thoreau B, Bauvois A, Barbet C, Cloarec S, Mérieau E, Lachot S, Garot D, Bernard L, Gyan E, Perrotin F, Pouplard C, Maillot F, Gatault P, Sautenet B, Rusch E, Buchler M, Vigneau C, Fakhouri F, Halimi JM
Clin J Am Soc Nephrol 2019 Apr 5;14(4):557-566. Epub 2019 Mar 12 doi: 10.2215/CJN.11470918. PMID: 30862697Free PMC Article
Igawa T, Sato Y
Hematol Oncol Clin North Am 2018 Feb;32(1):107-118. doi: 10.1016/j.hoc.2017.09.009. PMID: 29157612
Sihler KC, Napolitano LM
Chest 2010 Jan;137(1):209-20. doi: 10.1378/chest.09-0252. PMID: 20051407

Clinical prediction guides

Platzbecker U, Santini V, Fenaux P, Sekeres MA, Savona MR, Madanat YF, Díez-Campelo M, Valcárcel D, Illmer T, Jonášová A, Bělohlávková P, Sherman LJ, Berry T, Dougherty S, Shah S, Xia Q, Sun L, Wan Y, Huang F, Ikin A, Navada S, Feller F, Komrokji RS, Zeidan AM
Lancet 2024 Jan 20;403(10423):249-260. Epub 2023 Dec 1 doi: 10.1016/S0140-6736(23)01724-5. PMID: 38048786
Manrique-Caballero CL, Peerapornratana S, Formeck C, Del Rio-Pertuz G, Gomez Danies H, Kellum JA
Crit Care Clin 2020 Apr;36(2):333-356. Epub 2020 Jan 31 doi: 10.1016/j.ccc.2019.11.004. PMID: 32172817
Gupta M, Feinberg BB, Burwick RM
Pregnancy Hypertens 2018 Apr;12:29-34. Epub 2018 Feb 16 doi: 10.1016/j.preghy.2018.02.007. PMID: 29674195
Velo-García A, Castro SG, Isenberg DA
J Autoimmun 2016 Nov;74:139-160. Epub 2016 Jul 25 doi: 10.1016/j.jaut.2016.07.001. PMID: 27461045
Sihler KC, Napolitano LM
Chest 2010 Jan;137(1):209-20. doi: 10.1378/chest.09-0252. PMID: 20051407

Recent systematic reviews

Aziz H, Brown ZJ, Baghdadi A, Kamel IR, Pawlik TM
J Gastrointest Surg 2022 Sep;26(9):1998-2007. Epub 2022 Jun 15 doi: 10.1007/s11605-022-05382-1. PMID: 35705835
Carson JL, Stanworth SJ, Dennis JA, Trivella M, Roubinian N, Fergusson DA, Triulzi D, Dorée C, Hébert PC
Cochrane Database Syst Rev 2021 Dec 21;12(12):CD002042. doi: 10.1002/14651858.CD002042.pub5. PMID: 34932836Free PMC Article
Terpos E, Ntanasis-Stathopoulos I, Elalamy I, Kastritis E, Sergentanis TN, Politou M, Psaltopoulou T, Gerotziafas G, Dimopoulos MA
Am J Hematol 2020 Jul;95(7):834-847. Epub 2020 May 23 doi: 10.1002/ajh.25829. PMID: 32282949Free PMC Article
Kaegi C, Wuest B, Schreiner J, Steiner UC, Vultaggio A, Matucci A, Crowley C, Boyman O
Front Immunol 2019;10:1990. Epub 2019 Sep 6 doi: 10.3389/fimmu.2019.01990. PMID: 31555262Free PMC Article
Al-Nouri ZL, Reese JA, Terrell DR, Vesely SK, George JN
Blood 2015 Jan 22;125(4):616-8. Epub 2014 Nov 20 doi: 10.1182/blood-2014-11-611335. PMID: 25414441Free PMC Article

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