Table 1.

Clinical manifestations and care of patients with SDS

Hematologic  
Peripheral blood cytopenias CBC with differential 
 Reticulocyte count 
BMF Bone marrow aspirate and biopsy 
 Immunophenotypic analysis by flow cytometry 
 Conventional karyotype and FISH 
 Somatic myeloid NGS panel 
MDS/AML Cytoreductive therapy as clinically indicated 
 HLA-typing and evaluation for stem cell transplant as indicated 
Immune dysregulation Serum immunoglobulins (IgG, IgM, IgA, IgE) 
 Lymphocyte subsets (T-cell subsets, B cells, natural killer cells) 
Coagulopathy Prothrombin time 
Nonhematologic  
Exocrine pancreatic dysfunction Serum pancreatic isoamylase 
Fecal elastase 
Serum levels of vitamins A, D, E, and K, copper, and selenium 
 Pancreatic enzyme supplementation 
Osteopenia/osteoporosis Consultation with endocrinology as indicated 
Short stature Assessment of age-adjusted growth 
Skeletal abnormalities Consultation with orthopedics as indicated 
Cognitive delay Neurocognitive evaluation as indicated 
Neurobehavioral conditions Consultation with behavioral specialist or psychiatry as indicated 
Genetics  
Germ line genetic testing Consultation with experts in SDS genetics 
 Inherited BMF gene panelincluding SBDS, EFL1, DNAJC21, SRP54 
Hematologic  
Peripheral blood cytopenias CBC with differential 
 Reticulocyte count 
BMF Bone marrow aspirate and biopsy 
 Immunophenotypic analysis by flow cytometry 
 Conventional karyotype and FISH 
 Somatic myeloid NGS panel 
MDS/AML Cytoreductive therapy as clinically indicated 
 HLA-typing and evaluation for stem cell transplant as indicated 
Immune dysregulation Serum immunoglobulins (IgG, IgM, IgA, IgE) 
 Lymphocyte subsets (T-cell subsets, B cells, natural killer cells) 
Coagulopathy Prothrombin time 
Nonhematologic  
Exocrine pancreatic dysfunction Serum pancreatic isoamylase 
Fecal elastase 
Serum levels of vitamins A, D, E, and K, copper, and selenium 
 Pancreatic enzyme supplementation 
Osteopenia/osteoporosis Consultation with endocrinology as indicated 
Short stature Assessment of age-adjusted growth 
Skeletal abnormalities Consultation with orthopedics as indicated 
Cognitive delay Neurocognitive evaluation as indicated 
Neurobehavioral conditions Consultation with behavioral specialist or psychiatry as indicated 
Genetics  
Germ line genetic testing Consultation with experts in SDS genetics 
 Inherited BMF gene panelincluding SBDS, EFL1, DNAJC21, SRP54 

CBC, complete blood count; HLA, human leukocyte antigen.

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