II. Epidemiology

  1. Incidence: 1 in 60,000 to 300,000 births
  2. Diagnosis often not identified until age 2-7 years
  3. Higher Prevalence in Ashkenazi Jews (Carriers: 1 in 89)

III. Pathophysiology

IV. Signs

  1. Patchy brown Hyperpigmentation
  2. Cafe Au Lait spots
  3. Short Stature
  4. Microcephaly
  5. Hypogonadism
  6. Strabismus
  7. Renal hypoplasia
  8. Microphthalmia
  9. Mental Retardation
  10. Extra-digits or absence of digits
  11. Purpura

V. Labs

  1. Complete Blood Count
    1. Pancytopenia
  2. Chromosomal Breakage with exposure to deiepoxybutane

VI. Management

  1. Corticosteroids
  2. Maintenance androgen therapy

VII. Complications

  1. Malignancy (esp. Acute Myelogenous Leukemia)
  2. Bone Marrow Failure (often by 7 years of age)

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