A anemia sideroblástica ligada ao X corresponde a uma forma constitucional de anemia microcítica e hipocrómica de gravidade variável. Clinicamente caracteriza-se por manifestações de anemia e sobrecarga de ferro, e esta pode responder favoravelmente à terapêutica com piridoxina e ácido fólico.
Introdução
O que você precisa saber de cara
A anemia sideroblástica ligada ao X corresponde a uma forma constitucional de anemia microcítica e hipocrômica de gravidade variável. Clinicamente caracteriza-se por manifestações de anemia e sobrecarga de ferro, e esta pode responder favoravelmente à terapia com piridoxina e ácido fólico.
Escala de raridade
<1/50kMuito rara
1/20kRara
1/10kPouco freq.
1/5kIncomum
1/2k
Encontrou um erro ou informação desatualizada? Sugira uma correção →
Entender a doença
Do básico ao detalhe, leia no seu ritmo
Preparando trilha educativa...
Sinais e sintomas
O que aparece no corpo e com que frequência cada sintoma acontece
Partes do corpo afetadas
+ 7 sintomas em outras categorias
Características mais comuns
Os sintomas variam de pessoa para pessoa. Abaixo estão as 18 características clínicas mais associadas, ordenadas por frequência.
Linha do tempo da pesquisa
Encontrou um erro ou informação desatualizada? Sugira uma correção →
Genética e causas
O que está alterado no DNA e como passa nas famílias
Genes associados
1 gene identificado com associação a esta condição. Padrão de herança: X-linked recessive.
Catalyzes the pyridoxal 5'-phosphate (PLP)-dependent condensation of succinyl-CoA and glycine to form aminolevulinic acid (ALA), with CoA and CO2 as by-products (PubMed:14643893, PubMed:21252495, PubMed:21309041, PubMed:21653323, PubMed:32499479, PubMed:34492704). Contributes significantly to heme formation during erythropoiesis (PubMed:2050125) Catalyzes the pyridoxal 5'-phosphate (PLP)-dependent condensation of succinyl-CoA and glycine to form aminolevulinic acid (ALA), with CoA and CO2 as by-
Mitochondrion inner membrane
Anemia, sideroblastic, 1
A form of sideroblastic anemia that shows a variable hematologic response to pharmacologic doses of pyridoxine. Sideroblastic anemia is characterized by anemia of varying severity, hypochromic peripheral erythrocytes, systemic iron overload secondary to chronic ineffective erythropoiesis, and the presence of bone marrow ringed sideroblasts. Sideroblasts are characterized by iron-loaded mitochondria clustered around the nucleus.
Variantes genéticas (ClinVar)
207 variantes patogênicas registradas no ClinVar.
Classificação de variantes (ClinVar)
Distribuição de 102 variantes classificadas pelo ClinVar.
Diagnóstico
Os sinais que médicos procuram e os exames que confirmam
Tratamento e manejo
Remédios, cuidados de apoio e o que precisa acompanhar
Onde tratar no SUS
Hospitais de referência no Brasil e o protocolo oficial do SUS (PCDT)
🇧🇷 Atendimento SUS — Anemia sideroblástica ligada ao X
Selecione um estado ou use sua localização para ver resultados.
Dados de DATASUS/CNES, SBGM, ABNeuro e Ministério da Saúde. Sempre confirme a disponibilidade diretamente com o estabelecimento.
Pesquisa ativa
Ensaios clínicos abertos e novidades científicas recentes
Pesquisa e ensaios clínicos
Nenhum ensaio clínico registrado para esta condição.
Publicações mais relevantes
X-Linked Sideroblastic Anemia Caused by ALAS2 Intron 1 Mutation Successfully Treated by Allogenic Hematopoietic Stem Cell Transplant.
X-Linked Sideroblastic Anemia Induced by a Novel ALAS2 Nonsense Mutation: A Case Report and Literature Review.
To clarify the clinical manifestations of X-linked sideroblastic anemia (XLSA) and the mutational profiles of the aminolevulinate synthase 2 (ALAS2) gene, thereby optimizing treatment and prognosis. The proband, a 16-year-old male student, presented with microcytic hypochromic anemia, with hemoglobin (Hb) 55 g/L, red cell distribution width (RDW) 22.5%, mean corpuscular hemoglobin concentration (MCHC) 314 g/L, mean corpuscular hemoglobin (MCH) 23.9 pg, and mean corpuscular volume (MCV) 76.1 fL. Next-generation sequencing followed by Sanger sequencing of his family identified a de novo heterozygous nonsense mutation in ALAS2 (c.224C>A); this identification led to the final diagnosis of XLSA with a novel ALAS2 mutation. Incorporating genetic analyses into diagnostic algorithms can improve the precision of XLSA diagnosis and support personalized treatment strategies for patients and families. Our findings expand the mutational spectrum of ALAS2 and highlight that integrating next-generation sequencing (NGS) with Sanger validation into diagnostic workflows can significantly improve the diagnostic accuracy of XLSA.
X-linked sideroblastic anemia in females.
X-linked sideroblastic anemia (XLSA) in female carriers of 5-aminolevulinic acid synthase 2 mutations is not uncommon. We describe unique features and genotype/phenotype correlations in females with XLSA and evaluate the contributions of X-chromosome skewing and clonal hematopoiesis, emphasizing the importance of distinguishing it from myelodysplastic syndromes with ring sideroblasts.
SLC25A38 is required for mitochondrial pyridoxal 5'-phosphate (PLP) accumulation.
Many essential proteins require pyridoxal 5'-phosphate, the active form of vitamin B6, as a cofactor for their activity. These include enzymes important for amino acid metabolism, one-carbon metabolism, polyamine synthesis, erythropoiesis, and neurotransmitter metabolism. A third of all mammalian pyridoxal 5'-phosphate-dependent enzymes are localized in the mitochondria; however, the molecular machinery involved in the regulation of mitochondrial pyridoxal 5'-phosphate levels in mammals remains unknown. In this study, we used a genome-wide CRISPR interference screen in erythroleukemia cells and organellar metabolomics to identify the mitochondrial inner membrane protein SLC25A38 as a regulator of mitochondrial pyridoxal 5'-phosphate. Loss of SLC25A38 causes depletion of mitochondrial, but not cellular, pyridoxal 5'-phosphate, and impairs cellular proliferation under both physiological and low vitamin B6 conditions. Metabolic changes associated with SLC25A38 loss suggest impaired mitochondrial pyridoxal 5'-phosphate-dependent enzymatic reactions, including serine to glycine conversion catalyzed by serine hydroxymethyltransferase-2 as well as ornithine aminotransferase. The proliferation defect of SLC25A38-null K562 cells in physiological and low vitamin B6 media can be explained by the loss of serine hydroxymethyltransferase-2-dependent production of one-carbon units and downstream de novo nucleotide synthesis. Our work points to a role for SLC25A38 in mitochondrial pyridoxal 5'-phosphate accumulation and provides insights into the pathology of congenital sideroblastic anemia.
An erythroid-specific lentiviral vector improves anemia and iron metabolism in a new model of XLSA.
X-linked sideroblastic anemia (XLSA) is a congenital anemia caused by mutations in ALAS2, a gene responsible for heme synthesis. Treatments are limited to pyridoxine supplements and blood transfusions, offering no definitive cure except for allogeneic hematopoietic stem cell transplantation, only accessible to a subset of patients. The absence of a suitable animal model has hindered the development of gene therapy research for this disease. We engineered a conditional Alas2-knockout (KO) mouse model using tamoxifen administration or treatment with lipid nanoparticles carrying Cre-mRNA and conjugated to an anti-CD117 antibody. Alas2-KOBM animals displayed a severe anemic phenotype characterized by ineffective erythropoiesis (IE), leading to low numbers of red blood cells, hemoglobin, and hematocrit. In particular, erythropoiesis in these animals showed expansion of polychromatic erythroid cells, characterized by reduced oxidative phosphorylation, mitochondria's function, and activity of key tricarboxylic acid cycle enzymes. In contrast, glycolysis was increased in the unsuccessful attempt to extend cell survival despite mitochondrial dysfunction. The IE was associated with marked splenomegaly and low hepcidin levels, leading to iron accumulation in the liver, spleen, and bone marrow and the formation of ring sideroblasts. To investigate the potential of a gene therapy approach for XLSA, we developed a lentiviral vector (X-ALAS2-LV) to direct ALAS2 expression in erythroid cells. Infusion of bone marrow (BM) cells with 0.6 to 1.4 copies of the X-ALAS2-LV in Alas2-KOBM mice improved complete blood cell levels, tissue iron accumulation, and survival rates. These findings suggest our vector could be curative in patients with XLSA.
Publicações recentes
Cooley's Legacy Endures-Elliptocytes in X-Linked Sideroblastic Anemia due to Aminolevulinate Synthase 2 Mutations.
Successful Outcome of Haploidentical Hematopoietic Stem Cell Transplantation in X-Linked Sideroblastic Anemia.
X-Linked Sideroblastic Anemia Caused by ALAS2 Intron 1 Mutation Successfully Treated by Allogenic Hematopoietic Stem Cell Transplant.
X-Linked Sideroblastic Anemia Induced by a Novel ALAS2 Nonsense Mutation: A Case Report and Literature Review.
[Emerging perspectives on sideroblastic anemia].
📚 EuropePMC59 artigos no totalmostrando 82
X-Linked Sideroblastic Anemia Caused by ALAS2 Intron 1 Mutation Successfully Treated by Allogenic Hematopoietic Stem Cell Transplant.
Pediatric blood & cancerX-Linked Sideroblastic Anemia Induced by a Novel ALAS2 Nonsense Mutation: A Case Report and Literature Review.
Annals of clinical and laboratory science[Emerging perspectives on sideroblastic anemia].
[Rinsho ketsueki] The Japanese journal of clinical hematologyThe role of genetic testing in accurate diagnosis of X-linked sideroblastic anemia: novel ALAS2 mutations and the impact of X-chromosome inactivation.
Scientific reportsCase report: A novel 11-bp deletion in exon 11 causing a frameshift in the C-terminal of the ALAS2 gene leading to X-linked sideroblastic anemia-a family study.
Frontiers in medicineX-linked sideroblastic anemia in females.
BloodSLC25A38 is required for mitochondrial pyridoxal 5'-phosphate (PLP) accumulation.
Nature communicationsAn erythroid-specific lentiviral vector improves anemia and iron metabolism in a new model of XLSA.
Blood[Pathophysiology of sideroblastic anemia].
[Rinsho ketsueki] The Japanese journal of clinical hematologyNon-syndromic congenital sideroblastic anaemia; phenotype, and genotype of 15 Indian patients.
Annals of hematologyMurine models of erythroid 5ALA synthesis disorders and their conditional synthetic lethal dependency on pyridoxine.
BloodElucidating the Role of Human ALAS2 C-terminal Mutations Resulting in Loss of Function and Disease.
BiochemistryDeconvoluting the Complexity of Congenital Sideroblastic Anemias through Genetic and Functional Profiling.
The Journal of molecular diagnostics : JMDLuspatercept for the treatment of congenital sideroblastic anemia: Two case reports.
Current research in translational medicineErythropoiesis-hepcidin-iron axis in patients with X-linked sideroblastic anaemia: An explorative biomarker study.
British journal of haematologyLuspatercept as Potential Treatment for Congenital Sideroblastic Anemia.
The New England journal of medicineThree siblings with variable degrees of neuromuscular involvement and congenital sideroblastic anemia: A peculiar phenotype and a surprise genotypic explanation.
Annals of human geneticsSevere Microcytic Anemia Caused by Complex Hereditary Spherocytosis and X-Linked Sideroblastic Anemia with Mutations in SPTB and ALAS2 Genes.
Journal of clinical medicineAllogenic Hematopoietic Stem Cell Transplant in Iranian Patients With Congenital Sideroblastic Anemia: A Single-Center Experience.
Experimental and clinical transplantation : official journal of the Middle East Society for Organ TransplantationIron Metabolism in the Disorders of Heme Biosynthesis.
Metabolites[Differential diagnosis of inherited bone marrow failure syndromes in erythrocyte disorders].
[Rinsho ketsueki] The Japanese journal of clinical hematologyCongenital sideroblastic anemia model due to ALAS2 mutation is susceptible to ferroptosis.
Scientific reportsStructural basis for dysregulation of aminolevulinic acid synthase in human disease.
The Journal of biological chemistryCryo-EM structure of AMP-PNP-bound human mitochondrial ATP-binding cassette transporter ABCB7.
Journal of structural biologyX-linked sideroblastic anaemia in a female fetus: a case report and a literature review.
BMC medical genomics36-year-old male with X-linked congenital sideroblastic anemia presenting as chronic microcytic anemia with iron overload.
International journal of laboratory hematologyAzacitidine is a potential therapeutic drug for pyridoxine-refractory female X-linked sideroblastic anemia.
Blood advancesA synonymous coding variant that alters ALAS2 splicing and causes X-linked sideroblastic anemia.
Pediatric blood & cancerThe First Case Report of X-Linked Sideroblastic Anemia With Ataxia of Chinese Origin and Literature Review.
Frontiers in pediatricsDifferentiating iron-loading anemias using a newly developed and analytically validated ELISA for human serum erythroferrone.
PloS oneHighly efficient gene editing and single cell analysis of hematopoietic stem/progenitor cells from X-linked sideroblastic anemia patients.
Signal transduction and targeted therapyA hemizygous p.R204Q mutation in the ALAS2 gene underlies X-linked sideroblastic anemia in an adult Chinese Han man.
BMC medical genomicsExpression, purification and microscopic characterization of human ATP-binding cassette sub-family B member 7 protein.
Protein expression and purificationA Novel ALAS2 Missense Mutation in Two Brothers With Iron Overload and Associated Alterations in Serum Hepcidin/Erythroferrone Levels.
Frontiers in physiologyEvolution of the human mitochondrial ABCB7 [2Fe-2S](GS)4 cluster exporter and the molecular mechanism of an E433K disease-causing mutation.
Archives of biochemistry and biophysicsClinical characterization and hematopoietic stem cell transplant outcomes for congenital sideroblastic anemia caused by a novel pathogenic variant in SLC25A38.
Pediatric blood & cancerNovel frameshift variant (c.409dupG) in SLC25A38 is a common cause of congenital sideroblastic anaemia in the Indian subcontinent.
Journal of clinical pathologyHereditary Ataxia: A Focus on Heme Metabolism and Fe-S Cluster Biogenesis.
International journal of molecular sciencesNovel mutations in the ALAS2 gene from patients with X-linked sideroblastic anemia.
International journal of laboratory hematologyIdentification of a novel heterozygous ALAS2 mutation in a young Chinese female with X-linked sideroblastic anemia.
Annals of hematology[A case report of X-linked sideroblastic anemia with novel ALAS2 gene mutation].
Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhiReticulocyte Hemoglobin Equivalent (Ret-He) Combined with Red Blood Cell Distribution Width Has a Differentially Diagnostic Value for Thalassemias.
HemoglobinGenotype/phenotype correlations of childhood-onset congenital sideroblastic anaemia in a European cohort.
British journal of haematologyHeme biosynthesis and the porphyrias.
Molecular genetics and metabolismDimeric ferrochelatase bridges ABCB7 and ABCB10 homodimers in an architecturally defined molecular complex required for heme biosynthesis.
HaematologicaRegulation and tissue-specific expression of δ-aminolevulinic acid synthases in non-syndromic sideroblastic anemias and porphyrias.
Molecular genetics and metabolismMolecular expression, characterization and mechanism of ALAS2 gain-of-function mutants.
Molecular medicine (Cambridge, Mass.)Generation and Molecular Characterization of Human Ring Sideroblasts: a Key Role of Ferrous Iron in Terminal Erythroid Differentiation and Ring Sideroblast Formation.
Molecular and cellular biologyGLRX5 mutations impair heme biosynthetic enzymes ALA synthase 2 and ferrochelatase in Human congenital sideroblastic anemia.
Molecular genetics and metabolismDiverse phenotype in patients with complex I deficiency due to mutations in NDUFB11.
European journal of medical genetics[Molecular pathophysiology of sideroblastic anemia].
[Rinsho ketsueki] The Japanese journal of clinical hematologyMolecular pathophysiology and genetic mutations in congenital sideroblastic anemia.
Free radical biology & medicineThe phenotypic spectrum of germline YARS2 variants: from isolated sideroblastic anemia to mitochondrial myopathy, lactic acidosis and sideroblastic anemia 2.
HaematologicaRecurrent heteroplasmy for the MT-ATP6 p.Ser148Asn (m.8969G>A) mutation in patients with syndromic congenital sideroblastic anemia of variable clinical severity.
HaematologicaAnti-Correlation between the Dynamics of the Active Site Loop and C-Terminal Tail in Relation to the Homodimer Asymmetry of the Mouse Erythroid 5-Aminolevulinate Synthase.
International journal of molecular sciencesEstablishment of a cell model of X-linked sideroblastic anemia using genome editing.
Experimental hematology[Successful treatment of X-linked sideroblastic anemia with ALAS2 R452H mutation using vitamin B6].
[Rinsho ketsueki] The Japanese journal of clinical hematologyMutation Analysis of X-linked Sideroblastic Anemia in a 12-Month-Old Boy by Massively Parallel Sequencing.
Annals of laboratory medicineNovel mutations in mitochondrial carrier family gene SLC25A38, causing congenital sideroblastic anemia in Iranian families, identified by whole exome sequencing.
Blood cells, molecules & diseasesIn vitro studies of disease-linked variants of human tRNA nucleotidyltransferase reveal decreased thermal stability and altered catalytic activity.
Biochimica et biophysica acta. Proteins and proteomicsA defined culture method enabling the establishment of ring sideroblasts from induced pluripotent cells of X-linked sideroblastic anemia.
HaematologicaAberrant tRNA processing causes an autoinflammatory syndrome responsive to TNF inhibitors.
Annals of the rheumatic diseasesA Novel g.55040074delT in ALAS2 Gene Resulting in a Monomeric Protein and Severe Sideroblastic Anemia Phenotype.
Journal of pediatric hematology/oncologyA Novel ALAS2 Mutation Resulting in Variable Phenotypes and Pyridoxine Response in a Family with X-linked Sideroblastic Anemia.
Annals of clinical and laboratory scienceX-linked Sideroblastic Anemia in a Malay Boy With ALAS2 S568G Mutation.
Journal of pediatric hematology/oncologyRenal manifestations of primary mitochondrial disorders.
Biomedical reports[Biology of sideroblastic anemia].
[Rinsho ketsueki] The Japanese journal of clinical hematologyIntron 1 GATA site enhances ALAS2 expression indispensably during erythroid differentiation.
Nucleic acids researchIsoniazid inhibits human erythroid 5-aminolevulinate synthase: Molecular mechanism and tolerance study with four X-linked protoporphyria patients.
Biochimica et biophysica acta. Molecular basis of diseaseA recurring mutation in the respiratory complex 1 protein NDUFB11 is responsible for a novel form of X-linked sideroblastic anemia.
BloodLethal ALAS2 mutation in males X-linked sideroblastic anaemia.
British journal of haematologySideroblastic anemia: functional study of two novel missense mutations in ALAS2.
Molecular genetics & genomic medicineRaab SO, Haut A, Cartwright GE, Wintrobe MM. Pyridoxine-responsive anemia. Blood. 1961;18(3):285-302.
Blood[Genetic diagnosis of a Chinese pedigree with X-Linked sideroblastic anemia: a case report and literature review].
Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhiDelta-aminolevulinate synthase 2 polymorphism is associated with maximal oxygen uptake after Living-high exercise-high training-low in a male Chinese population.
International journal of clinical and experimental medicineA Japanese family with X-linked sideroblastic anemia affecting females and manifesting as macrocytic anemia.
International journal of hematologyGlycine and Folate Ameliorate Models of Congenital Sideroblastic Anemia.
PLoS geneticsDiagnosis and treatment of sideroblastic anemias: from defective heme synthesis to abnormal RNA splicing.
Hematology. American Society of Hematology. Education ProgramMurine erythroid 5-aminolevulinate synthase: Adenosyl-binding site Lys221 modulates substrate binding and catalysis.
FEBS open bioCongenital sideroblastic anemia due to mutations in the mitochondrial HSP70 homologue HSPA9.
BloodMutation analysis of Chinese sporadic congenital sideroblastic anemia by targeted capture sequencing.
Journal of hematology & oncology[Update on the biology of heme synthesis in erythroid cells].
[Rinsho ketsueki] The Japanese journal of clinical hematologyAssociações
Organizações que acompanham esta doença — pra ter apoio e orientação
Ainda não temos associações cadastradas para Anemia sideroblástica ligada ao X.
É de uma associação que acompanha esta doença? Fale com a gente →
Comunidades
Grupos ativos de quem convive com esta doença aqui no Raras
Ainda não existe comunidade no Raras para Anemia sideroblástica ligada ao X
Pacientes, familiares e cuidadores se organizam em comunidades pra compartilhar experiências, fazer perguntas e se apoiar. Você pode ser o primeiro.
Tire suas dúvidas
Perguntas, dicas e experiências compartilhadas aqui na página
Participe da discussão
Faça login para postar dúvidas, compartilhar experiências e interagir com especialistas.
Fazer loginDoenças relacionadas
Doenças com sintomas parecidos — ajudam quem ainda está buscando diagnóstico
Referências e fontes
Bases de dados externas citadas neste artigo
Publicações científicas
Artigos indexados no PubMed ligados a esta doença no grafo RarasNet — título, periódico e PMID direto da fonte, sem intermediação de IA.
- X-Linked Sideroblastic Anemia Caused by ALAS2 Intron 1 Mutation Successfully Treated by Allogenic Hematopoietic Stem Cell Transplant.
- X-Linked Sideroblastic Anemia Induced by a Novel ALAS2 Nonsense Mutation: A Case Report and Literature Review.
- X-linked sideroblastic anemia in females.
- SLC25A38 is required for mitochondrial pyridoxal 5'-phosphate (PLP) accumulation.
- An erythroid-specific lentiviral vector improves anemia and iron metabolism in a new model of XLSA.
- Cooley's Legacy Endures-Elliptocytes in X-Linked Sideroblastic Anemia due to Aminolevulinate Synthase 2 Mutations.
- Successful Outcome of Haploidentical Hematopoietic Stem Cell Transplantation in X-Linked Sideroblastic Anemia.
- [Emerging perspectives on sideroblastic anemia].
Bases de dados e fontes oficiais
Identificadores e referências canônicas usadas para montar este verbete.
- ORPHA:75563(Orphanet)
- OMIM OMIM:300751(OMIM)
- MONDO:0020721(MONDO)
- GARD:9456(GARD (NIH))
- Variantes catalogadas(ClinVar)
- Busca completa no PubMed(PubMed)
- Q18553627(Wikidata)
Dados compilados pelo RarasNet a partir de fontes abertas (Orphanet, OMIM, MONDO, PubMed/EuropePMC, ClinicalTrials.gov, DATASUS, PCDT/MS). Este conteúdo é informativo e não substitui avaliação médica.
Conteúdo mantido por Agente Raras · Médicos e pesquisadores podem colaborar
