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Thrombocytopenia 12 with or without myopathy(THC12)

MedGen UID:
1861803
Concept ID:
C5935593
Disease or Syndrome
Synonym: THC12
 
Gene (location): GNE (9p13.3)
 
Monarch Initiative: MONDO:0958325
OMIM®: 620757

Definition

Thrombocytopenia-12 with or without myopathy (THC12) is an autosomal recessive disorder characterized by congenital thrombocytopenia apparent from infancy or early childhood. Most affected individuals have bleeding episodes, including petechiae, easy bruising, epistaxis, hematomas, menorrhagia, and increased bleeding after trauma or surgery, although rare patients may have thrombocytopenia without bleeding. Platelets are enlarged (macrothrombocytopenia), and there is an increase of circulating immature platelets, consistent with increased production. Patient platelets show hyposialylation due to GNE mutations, which causes increased removal of platelets from the circulation, shortened platelet lifespan, and resultant thrombocytopenia. In contrast to the thrombocytopenia, which is present since birth or early childhood, features of myopathy usually do not develop until the mid-twenties, similar to Nonaka myopathy (summary by Zhen et al., 2014, Izumi et al., 2014; Bottega et al., 2022). For a discussion of genetic heterogeneity of thrombocytopenia, see THC1 (313900). [from OMIM]

Clinical features

From HPO
Epistaxis
MedGen UID:
4996
Concept ID:
C0014591
Pathologic Function
Epistaxis, or nosebleed, refers to a hemorrhage localized in the nose.
Menorrhagia
MedGen UID:
44358
Concept ID:
C0025323
Pathologic Function
Prolonged and excessive menses at regular intervals in excess of 80 mL or lasting longer than 7 days.
Thrombocytopenia
MedGen UID:
52737
Concept ID:
C0040034
Disease or Syndrome
A reduction in the number of circulating thrombocytes.
Increased mean platelet volume
MedGen UID:
853131
Concept ID:
C1096367
Finding
Average platelet volume above the upper limit of the normal reference interval.
Spontaneous, recurrent epistaxis
MedGen UID:
816045
Concept ID:
C3809715
Finding
Increased megakaryocyte count
MedGen UID:
870733
Concept ID:
C4025187
Finding
Increased megakaryocyte number, i.e., of platelet precursor cells, present in the bone marrow.
Muscular atrophy
MedGen UID:
892680
Concept ID:
C0541794
Pathologic Function
The presence of skeletal muscular atrophy (which is also known as amyotrophy).
Anti-HLA antibody positivity
MedGen UID:
1814119
Concept ID:
C5558385
Laboratory or Test Result
The presence of autoantibodies (immunoglobulins) in the blood circulation that react against a human leukocyte antigen (HLA).
Anti-platelet antigen antibody positivity
MedGen UID:
1841771
Concept ID:
C5826899
Laboratory or Test Result
The presence of autoantibodies (immunoglobulins) in the serum that react against antigens present on the surface of thrombocytes such as the glycoproteins GPIIb/IIIa, GPIb/IX, and GPIa/IIa.
Petechiae
MedGen UID:
10680
Concept ID:
C0031256
Disease or Syndrome
Petechiae are pinpoint-sized reddish/purple spots, resembling a rash, that appear just under the skin or a mucous membrane when capillaries have ruptured and some superficial bleeding into the skin has happened. This term refers to an abnormally increased susceptibility to developing petechiae.
Bruising susceptibility
MedGen UID:
140849
Concept ID:
C0423798
Finding
An ecchymosis (bruise) refers to the skin discoloration caused by the escape of blood into the tissues from ruptured blood vessels. This term refers to an abnormally increased susceptibility to bruising. The corresponding phenotypic abnormality is generally elicited on medical history as a report of frequent ecchymoses or bruising without adequate trauma.

Professional guidelines

PubMed

Theodorou A, Komnos G, Hantes M
Arch Orthop Trauma Surg 2023 Nov;143(11):6695-6705. Epub 2023 Aug 4 doi: 10.1007/s00402-023-04998-5. PMID: 37542006Free PMC Article
Izquierdo M, Merchant RA, Morley JE, Anker SD, Aprahamian I, Arai H, Aubertin-Leheudre M, Bernabei R, Cadore EL, Cesari M, Chen LK, de Souto Barreto P, Duque G, Ferrucci L, Fielding RA, García-Hermoso A, Gutiérrez-Robledo LM, Harridge SDR, Kirk B, Kritchevsky S, Landi F, Lazarus N, Martin FC, Marzetti E, Pahor M, Ramírez-Vélez R, Rodriguez-Mañas L, Rolland Y, Ruiz JG, Theou O, Villareal DT, Waters DL, Won Won C, Woo J, Vellas B, Fiatarone Singh M
J Nutr Health Aging 2021;25(7):824-853. doi: 10.1007/s12603-021-1665-8. PMID: 34409961
Knapik JJ, Pope R
J Spec Oper Med 2020 Spring;20(1):125-140. doi: 10.55460/QXTX-A72P. PMID: 32203618

Recent clinical studies

Etiology

Silva AMS, Campos ED, Zanoteli E
Arq Neuropsiquiatr 2022 May;80(5 Suppl 1):238-248. doi: 10.1590/0004-282X-ANP-2022-S131. PMID: 35976321Free PMC Article
Vinci P, Panizon E, Tosoni LM, Cerrato C, Pellicori F, Mearelli F, Biasinutto C, Fiotti N, Di Girolamo FG, Biolo G
Int J Mol Sci 2021 Oct 28;22(21) doi: 10.3390/ijms222111687. PMID: 34769118Free PMC Article
Verdonschot JAJ, Vanhoutte EK, Claes GRF, Helderman-van den Enden ATJM, Hoeijmakers JGJ, Hellebrekers DMEI, de Haan A, Christiaans I, Lekanne Deprez RH, Boen HM, van Craenenbroeck EM, Loeys BL, Hoedemaekers YM, Marcelis C, Kempers M, Brusse E, van Waning JI, Baas AF, Dooijes D, Asselbergs FW, Barge-Schaapveld DQCM, Koopman P, van den Wijngaard A, Heymans SRB, Krapels IPC, Brunner HG
Hum Mutat 2020 Jun;41(6):1091-1111. Epub 2020 Mar 20 doi: 10.1002/humu.24004. PMID: 32112656Free PMC Article
Mohassel P, Mammen AL
J Neuromuscul Dis 2018;5(1):11-20. doi: 10.3233/JND-170282. PMID: 29480216Free PMC Article
Tomaszewski M, Stępień KM, Tomaszewska J, Czuczwar SJ
Pharmacol Rep 2011;63(4):859-66. doi: 10.1016/s1734-1140(11)70601-6. PMID: 22001973

Diagnosis

Tarnopolsky MA
Continuum (Minneap Minn) 2022 Dec 1;28(6):1752-1777. doi: 10.1212/CON.0000000000001182. PMID: 36537979
Silva AMS, Campos ED, Zanoteli E
Arq Neuropsiquiatr 2022 May;80(5 Suppl 1):238-248. doi: 10.1590/0004-282X-ANP-2022-S131. PMID: 35976321Free PMC Article
Lawal TA, Todd JJ, Meilleur KG
Neurotherapeutics 2018 Oct;15(4):885-899. doi: 10.1007/s13311-018-00677-1. PMID: 30406384Free PMC Article
Pasnoor M, Barohn RJ, Dimachkie MM
Neurol Clin 2014 Aug;32(3):647-70, viii. doi: 10.1016/j.ncl.2014.04.009. PMID: 25037083Free PMC Article
Suresh E, Wimalaratna S
Postgrad Med J 2013 Aug;89(1054):470-7. Epub 2013 Apr 17 doi: 10.1136/postgradmedj-2013-131752. PMID: 23596213

Therapy

Newman CB
Endocrinol Metab Clin North Am 2022 Sep;51(3):655-679. Epub 2022 Jul 8 doi: 10.1016/j.ecl.2022.01.004. PMID: 35963634
Wu SH, Chen KL, Hsu C, Chen HC, Chen JY, Yu SY, Shiu YJ
Nutrients 2022 Mar 16;14(6) doi: 10.3390/nu14061255. PMID: 35334912Free PMC Article
Vinci P, Panizon E, Tosoni LM, Cerrato C, Pellicori F, Mearelli F, Biasinutto C, Fiotti N, Di Girolamo FG, Biolo G
Int J Mol Sci 2021 Oct 28;22(21) doi: 10.3390/ijms222111687. PMID: 34769118Free PMC Article
Mohassel P, Mammen AL
J Neuromuscul Dis 2018;5(1):11-20. doi: 10.3233/JND-170282. PMID: 29480216Free PMC Article
Tomaszewski M, Stępień KM, Tomaszewska J, Czuczwar SJ
Pharmacol Rep 2011;63(4):859-66. doi: 10.1016/s1734-1140(11)70601-6. PMID: 22001973

Prognosis

Opinc AH, Makowska JS
Semin Arthritis Rheum 2021 Feb;51(1):72-83. Epub 2020 Dec 22 doi: 10.1016/j.semarthrit.2020.09.020. PMID: 33360231
Mammen AL
Continuum (Minneap Minn) 2016 Dec;22(6, Muscle and Neuromuscular Junction Disorders):1852-1870. doi: 10.1212/01.CON.0000511070.50715.ab. PMID: 27922497Free PMC Article
Friedrich O, Reid MB, Van den Berghe G, Vanhorebeek I, Hermans G, Rich MM, Larsson L
Physiol Rev 2015 Jul;95(3):1025-109. doi: 10.1152/physrev.00028.2014. PMID: 26133937Free PMC Article
Latronico N, Bolton CF
Lancet Neurol 2011 Oct;10(10):931-41. doi: 10.1016/S1474-4422(11)70178-8. PMID: 21939902
Hoehn MM, Yahr MD
Neurology 1967 May;17(5):427-42. doi: 10.1212/wnl.17.5.427. PMID: 6067254

Clinical prediction guides

Suh J, Amato AA
Muscle Nerve 2024 Aug;70(2):166-172. Epub 2024 May 27 doi: 10.1002/mus.28114. PMID: 38801022
Merlonghi G, Antonini G, Garibaldi M
Autoimmun Rev 2022 Feb;21(2):102993. Epub 2021 Nov 16 doi: 10.1016/j.autrev.2021.102993. PMID: 34798316
Vinci P, Panizon E, Tosoni LM, Cerrato C, Pellicori F, Mearelli F, Biasinutto C, Fiotti N, Di Girolamo FG, Biolo G
Int J Mol Sci 2021 Oct 28;22(21) doi: 10.3390/ijms222111687. PMID: 34769118Free PMC Article
Opinc AH, Makowska JS
Semin Arthritis Rheum 2021 Feb;51(1):72-83. Epub 2020 Dec 22 doi: 10.1016/j.semarthrit.2020.09.020. PMID: 33360231
Friedrich O, Reid MB, Van den Berghe G, Vanhorebeek I, Hermans G, Rich MM, Larsson L
Physiol Rev 2015 Jul;95(3):1025-109. doi: 10.1152/physrev.00028.2014. PMID: 26133937Free PMC Article

Recent systematic reviews

Lepri B, Romani D, Storari L, Barbari V
Int J Environ Res Public Health 2023 Feb 24;20(5) doi: 10.3390/ijerph20054098. PMID: 36901108Free PMC Article
Masiello F, Pati I, Veropalumbo E, Pupella S, Cruciani M, De Angelis V
Blood Transfus 2023 Mar;21(2):119-136. Epub 2022 Oct 17 doi: 10.2450/2022.0087-22. PMID: 36346880Free PMC Article
Sarzi-Puttini P, Giorgi V, Marotto D, Atzeni F
Nat Rev Rheumatol 2020 Nov;16(11):645-660. Epub 2020 Oct 6 doi: 10.1038/s41584-020-00506-w. PMID: 33024295
Lenoir H, Mares O, Carlier Y
Orthop Traumatol Surg Res 2019 Dec;105(8S):S241-S246. Epub 2019 Sep 19 doi: 10.1016/j.otsr.2019.09.004. PMID: 31543413
Page MJ, Green S, McBain B, Surace SJ, Deitch J, Lyttle N, Mrocki MA, Buchbinder R
Cochrane Database Syst Rev 2016 Jun 10;2016(6):CD012224. doi: 10.1002/14651858.CD012224. PMID: 27283590Free PMC Article

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