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Familial isolated congenital asplenia(ICAS)

MedGen UID:
151935
Concept ID:
C0685889
Congenital Abnormality
Synonyms: ASPLENIA, FAMILIAL; Asplenia, isolated congenital; HYPOSPLENIA, ISOLATED CONGENITAL
SNOMED CT: Congenital hypoplasia of spleen (93292008); Congenital microsplenia (93292008); Congenital small spleen (93292008); Hypoplasia of spleen (205735005)
Modes of inheritance:
Autosomal dominant inheritance
MedGen UID:
141047
Concept ID:
C0443147
Intellectual Product
Source: Orphanet
A mode of inheritance that is observed for traits related to a gene encoded on one of the autosomes (i.e., the human chromosomes 1-22) in which a trait manifests in heterozygotes. In the context of medical genetics, an autosomal dominant disorder is caused when a single copy of the mutant allele is present. Males and females are affected equally, and can both transmit the disorder with a risk of 50% for each child of inheriting the mutant allele.
 
Gene (location): RPSA (3p22.1)
 
Monarch Initiative: MONDO:0010066
OMIM®: 271400
Orphanet: ORPHA101351

Definition

Isolated congenital asplenia (ICAS) is a rare cause of primary immunodeficiency. Most affected individuals die of severe bacterial infections in early childhood. Isolated asplenia is distinct from asplenia associated with other complex visceral defects, notably heterotaxy syndromes such as Ivemark syndrome (208530) (summary by Mahlaoui et al., 2011). [from OMIM]

Additional description

From MedlinePlus Genetics
Isolated congenital asplenia is a condition in which affected individuals are missing their spleen (asplenia) but have no other developmental abnormalities. While most individuals with this condition have no spleen at all, some people have a very small, nonfunctional spleen (hyposplenism).

The spleen plays an important role in the immune system. This organ is part of the lymphatic system, which produces and transports fluids and immune cells throughout the body. The spleen produces certain immune system cells called phagocytes that help remove bacteria from the blood in order to prevent infections. The spleen also stores particular blood cells that fight foreign invaders until they are needed and filters old blood cells for removal. Because people with isolated congenital asplenia lack these immune functions, they are highly susceptible to bacterial infections.

People with isolated congenital asplenia are prone to developing severe, recurrent infections. Infections most commonly affect the whole body (sepsis), the membrane covering the brain and spinal cord (meningitis), or the ears (otitis media). Infections are most often caused by the Streptococcus pneumoniae bacteria.

Without preventative care and proper treatment, the frequent infections caused by isolated congenital asplenia can be life-threatening.  https://medlineplus.gov/genetics/condition/isolated-congenital-asplenia

Clinical features

From HPO
Howell-Jolly bodies
MedGen UID:
5644
Concept ID:
C0020058
Acquired Abnormality
Howell-Jolly bodies are small, intra-erythrocytic remnants of erythrocyte nuclei. These inclusions are solitary in each erythrocyte and strongly basophilic. These are often confused with overlying platelets, but can be distinguished by the presence of a halo around overlying platelets.
Thrombocytosis
MedGen UID:
163397
Concept ID:
C0836924
Disease or Syndrome
Increased numbers of platelets in the peripheral blood.
Asplenia
MedGen UID:
108652
Concept ID:
C0600031
Congenital Abnormality
Absence (aplasia) of the spleen.

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVFamilial isolated congenital asplenia

Recent clinical studies

Etiology

Butel-Simoes GI, Jones P, Wood EM, Spelman D, Woolley IJ, Ojaimi S
Ann Hematol 2022 Jul;101(7):1421-1434. Epub 2022 Apr 22 doi: 10.1007/s00277-022-04765-3. PMID: 35451619
Farrell SA, Sodhi S, Marshall CR, Guerin A, Slavotinek A, Paton T, Chong K, Sirkin WL, Scherer SW, Bérubé-Simard FA, Pilon N
Am J Med Genet A 2017 Nov;173(11):3070-3074. Epub 2017 Sep 12 doi: 10.1002/ajmg.a.38354. PMID: 28898547
Mahlaoui N, Minard-Colin V, Picard C, Bolze A, Ku CL, Tournilhac O, Gilbert-Dussardier B, Pautard B, Durand P, Devictor D, Lachassinne E, Guillois B, Morin M, Gouraud F, Valensi F, Fischer A, Puel A, Abel L, Bonnet D, Casanova JL
J Pediatr 2011 Jan;158(1):142-8, 148.e1. Epub 2010 Sep 16 doi: 10.1016/j.jpeds.2010.07.027. PMID: 20846672
Halbertsma FJ, Neeleman C, Weemaes CM, van Deuren M
Acta Paediatr 2005 Mar;94(3):369-71. doi: 10.1111/j.1651-2227.2005.tb03082.x. PMID: 16028659
Gilbert B, Menetrey C, Belin V, Brosset P, de Lumley L, Fisher A
Eur J Pediatr 2002 Jul;161(7):368-72. Epub 2002 Jun 4 doi: 10.1007/s00431-002-0965-1. PMID: 12111187

Diagnosis

Butel-Simoes GI, Jones P, Wood EM, Spelman D, Woolley IJ, Ojaimi S
Ann Hematol 2022 Jul;101(7):1421-1434. Epub 2022 Apr 22 doi: 10.1007/s00277-022-04765-3. PMID: 35451619
Iijima S
BMC Infect Dis 2017 Dec 18;17(1):777. doi: 10.1186/s12879-017-2896-5. PMID: 29254492Free PMC Article
Wong T, Yeung J, Hildebrand KJ, Junker AK, Turvey SE
Curr Opin Allergy Clin Immunol 2013 Dec;13(6):607-13. doi: 10.1097/ACI.0000000000000010. PMID: 24126612
Mahlaoui N, Minard-Colin V, Picard C, Bolze A, Ku CL, Tournilhac O, Gilbert-Dussardier B, Pautard B, Durand P, Devictor D, Lachassinne E, Guillois B, Morin M, Gouraud F, Valensi F, Fischer A, Puel A, Abel L, Bonnet D, Casanova JL
J Pediatr 2011 Jan;158(1):142-8, 148.e1. Epub 2010 Sep 16 doi: 10.1016/j.jpeds.2010.07.027. PMID: 20846672
Ahmed SA, Zengeya S, Kini U, Pollard AJ
Eur J Pediatr 2010 Mar;169(3):315-8. Epub 2009 Jul 19 doi: 10.1007/s00431-009-1030-0. PMID: 19618213

Therapy

Butel-Simoes GI, Jones P, Wood EM, Spelman D, Woolley IJ, Ojaimi S
Ann Hematol 2022 Jul;101(7):1421-1434. Epub 2022 Apr 22 doi: 10.1007/s00277-022-04765-3. PMID: 35451619
Iijima S
BMC Infect Dis 2017 Dec 18;17(1):777. doi: 10.1186/s12879-017-2896-5. PMID: 29254492Free PMC Article
Gilbert B, Menetrey C, Belin V, Brosset P, de Lumley L, Fisher A
Eur J Pediatr 2002 Jul;161(7):368-72. Epub 2002 Jun 4 doi: 10.1007/s00431-002-0965-1. PMID: 12111187

Prognosis

Bangalore Prakash P, Kwon SC, Badheka A, Allareddy V
Clin Pediatr (Phila) 2018 May;57(5):597-599. Epub 2017 Aug 25 doi: 10.1177/0009922817727468. PMID: 28840769
Farrell SA, Sodhi S, Marshall CR, Guerin A, Slavotinek A, Paton T, Chong K, Sirkin WL, Scherer SW, Bérubé-Simard FA, Pilon N
Am J Med Genet A 2017 Nov;173(11):3070-3074. Epub 2017 Sep 12 doi: 10.1002/ajmg.a.38354. PMID: 28898547
Halbertsma FJ, Neeleman C, Weemaes CM, van Deuren M
Acta Paediatr 2005 Mar;94(3):369-71. doi: 10.1111/j.1651-2227.2005.tb03082.x. PMID: 16028659
Gilbert B, Menetrey C, Belin V, Brosset P, de Lumley L, Fisher A
Eur J Pediatr 2002 Jul;161(7):368-72. Epub 2002 Jun 4 doi: 10.1007/s00431-002-0965-1. PMID: 12111187

Clinical prediction guides

Farrell SA, Sodhi S, Marshall CR, Guerin A, Slavotinek A, Paton T, Chong K, Sirkin WL, Scherer SW, Bérubé-Simard FA, Pilon N
Am J Med Genet A 2017 Nov;173(11):3070-3074. Epub 2017 Sep 12 doi: 10.1002/ajmg.a.38354. PMID: 28898547
Halbertsma FJ, Neeleman C, Weemaes CM, van Deuren M
Acta Paediatr 2005 Mar;94(3):369-71. doi: 10.1111/j.1651-2227.2005.tb03082.x. PMID: 16028659

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