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Shwachman–Diamond syndrome

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Abstract

Shwachman–Diamond syndrome (SDS) is a rare autosomal recessive disorder with exocrine pancreatic insufficiency, bone marrow failure and skeletal abnormalities. Patients frequently present failure to thrive, susceptibility to infections and short stature. A persistent or intermittent neutropenia occurs in 88–100% of patients. Bone marrow biopsy usually reveals a hypoplastic specimen with varying degrees of hypoplasia and fat infiltration. Some patients may develop myeloblastic syndrome and acute myeloblastic leukemia. The genetic defect in SDS has been identified in 2002. The osteoporosis is increased in patients with SDS, and also, bone malformations are included among the primary characteristics of the syndrome. The severity and location change with age and sexes. The typical characteristics include the following: secondary ossification centers delayed appearance, metaphysis enlargement and irregularity (very common in childhood, particularly in coastal and femur), growth cartilage progressive thinning and irregularity (possibly asymmetric growth), generalized osteopenia with cortical thinning. We describe a clinical case regarding an SDS patient with severe bone abnormalities and treated surgically for corrective osteotomy. The persistent or intermittent neutropenia that characterized this disease and the consequent risk of infection is a contraindication for short stature correction and limbs lengthening.

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Conflict of interest

I, the undersigned Carlo Dall’Oca, declare that I have not received any financial support or other economic participation for conducting the study in question. I also declare that neither I, nor my family, nor other professionals close to me have ever received any profits or other forms of benefits for conducting this study. I declare to not have received funding or support from any institutions or associations in return for publication of the study or part of it in databases, magazines or other media.

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Authors and Affiliations

  1. Department of Surgery, Orthopaedic and Traumatology Clinic, University of Verona, G.B. Rossi Hospital, Piazzale Scuro 10, 37134, Verona, Italy

    C. Dall’Oca, M. Bondi, M. Merlini, M. Cipolli, F. Lavini & P. Bartolozzi

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  1. C. Dall’Oca
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  2. M. Bondi
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  3. M. Merlini
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Correspondence to C. Dall’Oca.

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Dall’Oca, C., Bondi, M., Merlini, M. et al. Shwachman–Diamond syndrome. Musculoskelet Surg 96, 81–88 (2012). https://doi.org/10.1007/s12306-011-0174-z

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