Nijmegen Breakage Syndrome Differential Diagnoses

  • Author: Krystyna H Chrzanowska, MD, PhD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Jan 25, 2012
 
 

Differential Diagnoses

Proceed to Workup
 
 
Contributor Information and Disclosures
Author

Krystyna H Chrzanowska, MD, PhD  Head of Genetic Counseling Unit, Associate Professor, Department of Medical Genetics, Children's Memorial Health Institute, Warsaw, Poland

Disclosure: Nothing to disclose.

Coauthor(s)

Camila K Janniger, MD  Clinical Professor of Dermatology, Clinical Associate Professor of Pediatrics, Chief of Pediatric Dermatology, University of Medicine and Dentistry of New Jersey-New Jersey Medical School

Camila K Janniger, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Specialty Editor Board

Noah S Scheinfeld, MD, JD, FAAD  Assistant Clinical Professor, Department of Dermatology, Columbia University College of Physicians and Surgeons; Consulting Staff, Department of Dermatology, St Luke's Roosevelt Hospital Center, Beth Israel Medical Center, and New York Eye and Ear Infirmary; Private Practice

Noah S Scheinfeld, MD, JD, FAAD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Optigenex Consulting fee Independent contractor

David F Butler, MD  Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic, Northside Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Robert A Schwartz, MD, MPH  Professor and Head, Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, University of Medicine and Dentistry of New Jersey-New Jersey Medical School

Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, and Sigma Xi

Disclosure: Nothing to disclose.

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD  Director, Ackerman Academy of Dermatopathology, New York

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

The authors and editors of eMedicine gratefully acknowledge the contributions of previous Chief Editor, William D. James, MD, to the development and writing of this article.

References

  1. Weemaes CM, Hustinx TW, Scheres JM, van Munster PJ, Bakkeren JA, Taalman RD. A new chromosomal instability disorder: the Nijmegen breakage syndrome. Acta Paediatr Scand. Jul 1981;70(4):557-64. [Medline].

  2. Seemanova E, Passarge E, Beneskova D, Houstek J, Kasal P, Sevcikova M. Familial microcephaly with normal intelligence, immunodeficiency, and risk for lymphoreticular malignancies: a new autosomal recessive disorder. Am J Med Genet. Apr 1985;20(4):639-48. [Medline].

  3. Taalman RD, Hustinx TW, Weemaes CM, et al. Further delineation of the Nijmegen breakage syndrome. Am J Med Genet. Mar 1989;32(3):425-31. [Medline].

  4. Chrzanowska KH, Kleijer WJ, Krajewska-Walasek M, et al. Eleven Polish patients with microcephaly, immunodeficiency, and chromosomal instability: the Nijmegen breakage syndrome. Am J Med Genet. Jul 3 1995;57(3):462-71. [Medline].

  5. Matsuura S, Weemaes C, Smeets D, et al. Genetic mapping using microcell-mediated chromosome transfer suggests a locus for Nijmegen breakage syndrome at chromosome 8q21-24. Am J Hum Genet. Jun 1997;60(6):1487-94. [Medline].

  6. Jaspers NG, Taalman RD, Baan C. Patients with an inherited syndrome characterized by immunodeficiency, microcephaly, and chromosomal instability: genetic relationship to ataxia telangiectasia. Am J Hum Genet. Jan 1988;42(1):66-73. [Medline].

  7. Wegner RD, Metzger M, Hanefeld F, et al. A new chromosomal instability disorder confirmed by complementation studies. Clin Genet. Jan 1988;33(1):20-32. [Medline].

  8. Stumm M, Gatti RA, Reis A, et al. The ataxia-telangiectasia-variant genes 1 and 2 are distinct from the ataxia-telangiectasia gene on chromosome 11q23.1. Am J Hum Genet. Oct 1995;57(4):960-2. [Medline].

  9. Chrzanowska K, Stumm M, Bialecka M, et al. Linkage studies exclude the AT-V gene(s) from the translocation breakpoints in an AT-V patient. Clin Genet. May 1997;51(5):309-13. [Medline].

  10. Saar K, Chrzanowska KH, Stumm M, et al. The gene for the ataxia-telangiectasia variant, Nijmegen breakage syndrome, maps to a 1-cM interval on chromosome 8q21. Am J Hum Genet. Mar 1997;60(3):605-10. [Medline].

  11. Cerosaletti KM, Lange E, Stringham HM, et al. Fine localization of the Nijmegen breakage syndrome gene to 8q21: evidence for a common founder haplotype. Am J Hum Genet. Jul 1998;63(1):125-34. [Medline].

  12. Carney JP, Maser RS, Olivares H, et al. The hMre11/hRad50 protein complex and Nijmegen breakage syndrome: linkage of double-strand break repair to the cellular DNA damage response. Cell. May 1 1998;93(3):477-86. [Medline].

  13. Varon R, Dutrannoy V, Weikert G, et al. Mild Nijmegen breakage syndrome phenotype due to alternative splicing. Hum Mol Genet. Mar 1 2006;15(5):679-89. [Medline].

  14. Varon R, Vissinga C, Platzer M, et al. Nibrin, a novel DNA double-strand break repair protein, is mutated in Nijmegen breakage syndrome. Cell. May 1 1998;93(3):467-76. [Medline].

  15. Kanaar R, Wyman C. DNA repair by the MRN complex: break it to make it. Cell. Oct 3 2008;135(1):14-6. [Medline].

  16. Matsumoto Y, Miyamoto T, Sakamoto H, Izumi H, Nakazawa Y, Ogi T, et al. Two unrelated patients with MRE11A mutations and Nijmegen breakage syndrome-like severe microcephaly. DNA Repair (Amst). Mar 7 2011;10(3):314-21. [Medline].

  17. Zhang Y, Zhou J, Lim CU. The role of NBS1 in DNA double strand break repair, telomere stability, and cell cycle checkpoint control. Cell Res. Jan 2006;16(1):45-54. [Medline].

  18. Pluth JM, Yamazaki V, Cooper BA, Rydberg BE, Kirchgessner CU, Cooper PK. DNA double-strand break and chromosomal rejoining defects with misrejoining in Nijmegen breakage syndrome cells. DNA Repair (Amst). Jan 1 2008;7(1):108-18. [Medline].

  19. Lähdesmäki A, Taylor AM, Chrzanowska KH, Pan-Hammarström Q. Delineation of the role of the Mre11 complex in class switch recombination. J Biol Chem. Apr 16 2004;279(16):16479-87. [Medline].

  20. Kracker S, Bergmann Y, Demuth I, et al. Nibrin functions in Ig class-switch recombination. Proc Natl Acad Sci U S A. Feb 1 2005;102(5):1584-9. [Medline].

  21. Reina-San-Martin B, Nussenzweig MC, Nussenzweig A, Difilippantonio S. Genomic instability, endoreduplication, and diminished Ig class-switch recombination in B cells lacking Nbs1. Proc Natl Acad Sci U S A. Feb 1 2005;102(5):1590-5. [Medline].

  22. Demuth I, Digweed M. The clinical manifestation of a defective response to DNA double-strand breaks as exemplified by Nijmegen breakage syndrome. Oncogene. Dec 10 2007;26(56):7792-8. [Medline].

  23. Wegner RD, German JJ, Chrzanowska KH, Digweed M, Stumm M. Chromosomal instability syndromes other than ataxia-telangiectasia. In: HD Ochs, CIE Smith, JM Puck. Primary Immunodeficiency Diseases. A Molecular and Genetic Approach. Second. New York, NY: Oxford University Press; 2007:427-453.

  24. Wilda M, Demuth I, Concannon P, Sperling K, Hameister H. Expression pattern of the Nijmegen breakage syndrome gene, Nbs1, during murine development. Hum Mol Genet. Jul 22 2000;9(12):1739-44. [Medline].

  25. Demuth I, Frappart PO, Hildebrand G, et al. An inducible null mutant murine model of Nijmegen breakage syndrome proves the essential function of NBS1 in chromosomal stability and cell viability. Hum Mol Genet. Oct 15 2004;13(20):2385-97. [Medline].

  26. Difilippantonio S, Celeste A, Fernandez-Capetillo O, et al. Role of Nbs1 in the activation of the Atm kinase revealed in humanized mouse models. Nat Cell Biol. Jul 2005;7(7):675-85. [Medline].

  27. Wang JY. Cancer. New link in a web of human genes. Nature. May 25 2000;405(6785):404-5. [Medline].

  28. Williams RS, Williams JS, Tainer JA. Mre11-Rad50-Nbs1 is a keystone complex connecting DNA repair machinery, double-strand break signaling, and the chromatin template. Biochem Cell Biol. Aug 2007;85(4):509-20. [Medline].

  29. Czornak K, Chughtai S, Chrzanowska KH. Mystery of DNA repair: the role of the MRN complex and ATM kinase in DNA damage repair. J Appl Genet. 2008;49(4):383-96. [Medline].

  30. O'Driscoll M, Cerosaletti KM, Girard PM, et al. DNA ligase IV mutations identified in patients exhibiting developmental delay and immunodeficiency. Mol Cell. Dec 2001;8(6):1175-85. [Medline].

  31. Ben-Omran TI, Cerosaletti K, Concannon P, Weitzman S, Nezarati MM. A patient with mutations in DNA Ligase IV: clinical features and overlap with Nijmegen breakage syndrome. Am J Med Genet A. Sep 1 2005;137A(3):283-7. [Medline].

  32. Waltes R, Kalb R, Gatei M, et al. Human RAD50 deficiency in a Nijmegen breakage syndrome-like disorder. Am J Hum Genet. May 2009;84(5):605-16. [Medline].

  33. Hiel JA, Weemaes CM, van Engelen BG, et al. Nijmegen breakage syndrome in a Dutch patient not resulting from a defect in NBS1. J Med Genet. Jun 2001;38(6):E19. [Medline].

  34. Maraschio P, Spadoni E, Tanzarella C, et al. Genetic heterogeneity for a Nijmegen breakage-like syndrome. Clin Genet. Apr 2003;63(4):283-90. [Medline].

  35. Berardinelli F, di Masi A, Salvatore M, et al. A case report of a patient with microcephaly, facial dysmorphism, chromosomal radiosensitivity and telomere length alterations closely resembling "Nijmegen breakage syndrome" phenotype. Eur J Med Genet. May-Jun 2007;50(3):176-87. [Medline].

  36. Varon R, Seemanova E, Chrzanowska K, et al. Clinical ascertainment of Nijmegen breakage syndrome (NBS) and prevalence of the major mutation, 657del5, in three Slav populations. Eur J Hum Genet. Nov 2000;8(11):900-2. [Medline].

  37. van der Burgt I, Chrzanowska KH, Smeets D, Weemaes C. Nijmegen breakage syndrome. J Med Genet. Feb 1996;33(2):153-6. [Medline].

  38. Nijmegen breakage syndrome. The International Nijmegen Breakage Syndrome Study Group. Arch Dis Child. May 2000;82(5):400-6. [Medline].

  39. Resnick IB, Kondratenko I, Togoev O, et al. Nijmegen breakage syndrome: clinical characteristics and mutation analysis in eight unrelated Russian families. J Pediatr. Mar 2002;140(3):355-61. [Medline].

  40. Van de Kaa CA, Weemaes CM, Wesseling P, Schaafsma HE, Haraldsson A, De Weger RA. Postmortem findings in the Nijmegen breakage syndrome. Pediatr Pathol. Sep-Oct 1994;14(5):787-96. [Medline].

  41. Chrzanowska KH, Romer T, Krajewska-Walasek M. Evidence for a high rate of gonadal failure in female patients with Nijmegen breakage syndrome. Eur J Hum Genet. 2000;8 (Suppl. 1):73.

  42. Chrzanowska KH, Szarras-Czapnik M, Gajdulewicz M, Kalina MA, Gajtko-Metera M, Walewska-Wolf M, et al. High prevalence of primary ovarian insufficiency in girls and young women with Nijmegen breakage syndrome: evidence from a longitudinal study. J Clin Endocrinol Metab. Jul 2010;95(7):3133-40. [Medline].

  43. Gregorek H, Chrzanowska KH, Michalkiewicz J, Syczewska M, Madalinski K. Heterogeneity of humoral immune abnormalities in children with Nijmegen breakage syndrome: an 8-year follow-up study in a single centre. Clin Exp Immunol. Nov 2002;130(2):319-24. [Medline].

  44. Gladkowska-Dura M, Dzierzanowska-Fangrat K, Dura WT, et al. Unique morphological spectrum of lymphomas in Nijmegen breakage syndrome (NBS) patients with high frequency of consecutive lymphoma formation. J Pathol. Nov 2008;216(3):337-44. [Medline].

  45. Chrzanowska KH, Digweed M, Sperling K, Seemanova E. DNA-repair deficiency and cancer: Lessons from lymphoma. In: H. Allgayer, H. Rehder, S. Fulda. Hereditary tumors. From genes to clinical consequences. Weinheim Germany: WILEY-VH; 2009:377-391.

  46. Pastorczak A, Stolarska M, Trelinska J, Zawitkowska J, Kowalczyk J, Mlynarski W. Nijmegen breakage syndrome (NBS) as a risk factor for CNS involvement in childhood acute lymphoblastic leukemia. Pediatr Blood Cancer. Jul 15 2011;57(1):160-2. [Medline].

  47. Michallet AS, Lesca G, Radford-Weiss I, Delarue R, Varet B, Buzyn A. T-cell prolymphocytic leukemia with autoimmune manifestations in Nijmegen breakage syndrome. Ann Hematol. Aug 2003;82(8):515-7. [Medline].

  48. Bakhshi S, Cerosaletti KM, Concannon P, et al. Medulloblastoma with adverse reaction to radiation therapy in nijmegen breakage syndrome. J Pediatr Hematol Oncol. Mar 2003;25(3):248-51. [Medline].

  49. Distel L, Neubauer S, Varon R, Holter W, Grabenbauer G. Fatal toxicity following radio- and chemotherapy of medulloblastoma in a child with unrecognized Nijmegen breakage syndrome. Med Pediatr Oncol. Jul 2003;41(1):44-8. [Medline].

  50. Der Kaloustian VM, Kleijer W, Booth A, et al. Possible new variant of Nijmegen breakage syndrome. Am J Med Genet. Oct 2 1996;65(1):21-6. [Medline].

  51. Tekin M, Akcayoz D, Ucar C, Gulen H, Akar N. 657del5 mutation of the Nijmegen breakage syndrome gene (NBS1) in the Turkish population. Hum Biol. Jun 2005;77(3):393-7. [Medline].

  52. Meyer S, Kingston H, Taylor AM, et al. Rhabdomyosarcoma in Nijmegen breakage syndrome: strong association with perianal primary site. Cancer Genet Cytogenet. Oct 15 2004;154(2):169-74. [Medline].

  53. Yoo J, Wolgamot G, Torgerson TR, Sidbury R. Cutaneous noncaseating granulomas associated with Nijmegen breakage syndrome. Arch Dermatol. Mar 2008;144(3):418-9. [Medline].

  54. Bekiesinska-Figatowska M, Chrzanowska KH, Sikorska J, et al. Cranial MRI in the Nijmegen breakage syndrome. Neuroradiology. Jan 2000;42(1):43-7. [Medline].

  55. Chrzanowska KH, Stumm M, Bekiesiska-Figatowska M, et al. Atypical clinical picture of the Nijmegen breakage syndrome associated with developmental abnormalities of the brain. J Med Genet. Jan 2001;38(1):E3. [Medline].

  56. Maraschio P, Danesino C, Antoccia A, et al. A novel mutation and novel features in Nijmegen breakage syndrome. J Med Genet. Feb 2001;38(2):113-7. [Medline].

  57. Seemanova E, Sperling K, Neitzel H, et al. Nijmegen breakage syndrome (NBS) with neurological abnormalities and without chromosomal instability. J Med Genet. Mar 2006;43(3):218-24. [Medline].

  58. Gennery AR, Slatter MA, Bhattacharya A, et al. The clinical and biological overlap between Nijmegen Breakage Syndrome and Fanconi anemia. Clin Immunol. Nov 2004;113(2):214-9. [Medline].

  59. New HV, Cale CM, Tischkowitz M, et al. Nijmegen breakage syndrome diagnosed as Fanconi anaemia. Pediatr Blood Cancer. May 2005;44(5):494-9. [Medline].

  60. Varon R, Muer A, Wagner K, et al. Nijmegen breakage syndrome (NBS) due to maternal isodisomy of chromosome 8. Am J Med Genet A. Jan 1 2007;143(1):92-4. [Medline].

  61. Michalkiewicz J, Barth C, Chrzanowska K, et al. Abnormalities in the T and NK lymphocyte phenotype in patients with Nijmegen breakage syndrome. Clin Exp Immunol. Dec 2003;134(3):482-90. [Medline].

  62. Seemanova E, Sperling K, Neitzel H, et al. Nijmegen breakage syndrome (NBS) with neurological abnormalities and without chromosomal instability. J Med Genet. Mar 2006;43(3):218-24. [Medline].

  63. Lammens M, Hiel JA, Gabreels FJ, van Engelen BG, van den Heuvel LP, Weemaes CM. Nijmegen breakage syndrome: a neuropathological study. Neuropediatrics. Aug 2003;34(4):189-93. [Medline].

  64. Seidemann K, Henze G, Beck JD, et al. Non-Hodgkin's lymphoma in pediatric patients with chromosomal breakage syndromes (AT and NBS): experience from the BFM trials. Ann Oncol. 2000;11 Suppl 1:141-5. [Medline].

  65. Dumic M, Radman I, Krnic N, et al. Successful treatment of diffuse large B-cell non-hodgkin lymphoma with modified CHOP (cyclophosphamide/doxorubicin/vincristine/prednisone) chemotherapy and rituximab in a patient with Nijmegen syndrome. Clin Lymphoma Myeloma. Nov 2007;7(9):590-3. [Medline].

  66. Dembowska-Baginska B, Perek D, Brozyna A, et al. Non-Hodgkin lymphoma (NHL) in children with Nijmegen Breakage syndrome (NBS). Pediatr Blood Cancer. Feb 2009;52(2):186-90. [Medline].

  67. Jovanovic A, Minic P, Scekic-Guc M, et al. Successful treatment of hodgkin lymphoma in nijmegen breakage syndrome. J Pediatr Hematol Oncol. Jan 2009;31(1):49-52. [Medline].

  68. Barth E, Demori E, Pecile V, Zanazzo GA, Malorgio C, Tamaro P. Anthracyclines in Nijmegen breakage syndrome. Med Pediatr Oncol. Feb 2003;40(2):122-4. [Medline].

  69. Seemanova E, Jarolim P, Seeman P, et al. Cancer risk of heterozygotes with the NBN founder mutation. J Natl Cancer Inst. Dec 19 2007;99(24):1875-80. [Medline].

  70. di Masi A, Antoccia A. NBS1 Heterozygosity and Cancer Risk. Curr Genomics. Jun 2008;9(4):275-81. [Medline].

  71. Hibner E, Wendorff J, Ircha G, Piotrowicz M, Zeman K. Cavernous sinus thrombophlebitis in Nijmegen breakage syndrome. Pediatr Neurol. Jul 2002;27(1):62-4. [Medline].

  72. Howlett NG, Scuric Z, D'Andrea AD, Schiestl RH. Impaired DNA double strand break repair in cells from Nijmegen breakage syndrome patients. DNA Repair (Amst). Feb 3 2006;5(2):251-7. [Medline].

  73. Kruger L, Demuth I, Neitzel H, et al. Cancer incidence in Nijmegen breakage syndrome is modulated by the amount of a variant NBS protein. Carcinogenesis. Jan 2007;28(1):107-11. [Medline].

  74. Moreno Perez D, Garcia Martin FJ, Vazquez Lopez R, et al. [Nijmegen breakage syndrome associated with pulmonary lymphoma]. An Esp Pediatr. Dec 2002;57(6):574-7. [Medline].

  75. Muschke P, Gola H, Varon R, et al. Retrospective diagnosis and subsequent prenatal diagnosis of Nijmegen breakage syndrome. Prenat Diagn. Feb 2004;24(2):111-3. [Medline].

  76. Pasic S. Aplastic anemia in Nijmegen breakage syndrome. J Pediatr. Nov 2002;141(5):742. [Medline].

  77. Shimada H, Shimizu K, Mimaki S, et al. First case of aplastic anemia in a Japanese child with a homozygous missense mutation in the NBS1 gene (I171V) associated with genomic instability. Hum Genet. Oct 2004;115(5):372-6. [Medline].

 
Previous
Next
 
A 6-month-old infant with Nijmegen breakage syndrome. Note microcephaly, the slightly upward-slanting palpebral fissures, and small chin.
Lateral facial features with sloping forehead and receding mandible are shown in a 6-month-old infant.
Typical facial features in a 9-year-old girl with Nijmegen breakage syndrome. Note the markedly upward-slanting palpebral features.
Lateral profile. This view shows a relatively long nose and receding mandible.
Cutaneous sarcoidosis in a patient with Nijmegen breakage syndrome. Note syndactyly of the second and third toes.
Vitiligo spots in a patient with Nijmegen breakage syndrome.
Progressive vitiligo in a patient with Nijmegen breakage syndrome.
Café au lait–like spots in a patient with Nijmegen breakage syndrome.
Preaxial polydactyly of the hand in a patient with Nijmegen breakage syndrome.
MRI in a patient with Nijmegen breakage syndrome shows large cerebrospinal fluid space that communicates with the left lateral ventricle and underdevelopment of the parietal lobes. Reprinted with permission from the Journal of Medical Genetics. Copyright 2001, BMJ Publishing Group.
MRI in a patient with Nijmegen breakage syndrome. Note compression of the posterior fossa and the lack of cerebellar atrophy. Reprinted with permission from the Journal of Medical Genetics. Copyright 2001, BMJ Publishing Group.
MRI in a patient with Nijmegen breakage syndrome. Note the small frontal lobes and the narrow frontal horns of the lateral ventricles. Reprinted with permission from the Journal of Medical Genetics. Copyright 2001, BMJ Publishing Group.
MRI in a patient with Nijmegen breakage syndrome. Note the partial defect of the corpus callosum. Reprinted with permission from the Journal of Medical Genetics. Copyright 2001, BMJ Publishing Group.
Table. NBS1 Gene Pathogenic Molecular Variants
Mutation Exon Mutation Type Change in Protein Number of Families and Origin Allelic Status
643C>T6MissenseR215W1†



Czech



He*
657del5



(657_661del5)



6FrameshiftTruncated



protein (233 aa)



>90%



Slavic



founder mutation



Ho‡



(He)



681delT6FrameshiftTruncated



protein (229 aa)



1



Russian



He
698del4



(698_701del4)



6FrameshiftTruncated



protein (236 aa)



2



English



Ho



He



742insGG



(742_743insGG)



7FrameshiftTruncated



protein (251 aa)



1



Italian



Ho
835del4



(835_838del4)



7FrameshiftTruncated



protein (279 aa)



1



Italian



Ho
842insT



(842_843insT)



7FrameshiftTruncated



protein (283 aa)



1



Mexican



Ho
900del25



(900_924del25)



8FrameshiftTruncated



protein (305 aa)



1



Moroccan



Ho
976C>T8NonsenseQ326X1



Dutch



Ho
1089C>A9NonsenseY363X3



§



Pakistani



Ho
1142delC10FrameshiftTruncated



protein (402 aa)



2



Canadian



He
*He - Heterozygous (compound with 657del5).



†Monozygotic twin-brothers (compound heterozygotes) with severe disease phenotype.[62]



‡Ho - Homozygous.



§Three nuclear families in 1 large family; proband diagnosed first as having Fanconi anemia (FA).[58, 59]



Previous
Next
 
 
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.