{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:52:15Z","timestamp":1777596735513,"version":"3.51.4"},"reference-count":7,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2024,8,10]],"date-time":"2024-08-10T00:00:00Z","timestamp":1723248000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,8,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Ghosal hematodiaphyseal dysplasia (GHDD) is an autosomal recessive disorder characterized by diaphyseal dysplasia of long bones, bone marrow fibrosis, and steroid-responsive anemia. Patients with this disease have a mutation in the thromboxane-AS1 (TBXAS1) gene located on chromosome 7q33.34. They present with short stature, varying grades of myelofibrosis, and, hence cytopenias. Patients with the above presentation were evaluated through clinical presentation, X-ray of long bones, bone marrow examinations, and confirmed by genetic testing. In this article, we present two cases: The first case is a 3-year-old boy who presented with progressive pallor and ecchymotic patches for a year. On investigation, he had bicytopenia and bone marrow fibrosis. His anemia was steroid responsive and was finally diagnosed as GHDD. The second case is a 20-month-old girl who presented with blood in stools, developmental delay, anemia, and increased intensity of long bones on X-ray. Since other investigations were normal, suspicion of GHDD was raised, and a genetic workup was conducted which suggested mutation in TBXAS1 gene, confirming the diagnosis of GHDD. Children with refractory anemia and cortical thickening on skeletogram should always be evaluated for dysplasias. Timely treatment with steroids reduces transfusion requirements and halts bone damage, thus leading to better growth and improved quality of life.<\/jats:p>","DOI":"10.1093\/tropej\/fmae028","type":"journal-article","created":{"date-parts":[[2024,9,15]],"date-time":"2024-09-15T02:21:25Z","timestamp":1726366885000},"source":"Crossref","is-referenced-by-count":3,"title":["Steroid-responsive anemia with bony dysplasias: What lurks behind!"],"prefix":"10.1093","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-5312-7800","authenticated-orcid":false,"given":"Shipra","family":"Khandelwal","sequence":"first","affiliation":[{"name":"General Pediatrics, B.J. Wadia Hospital, Mumbai 400012, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ritika","family":"Khurana","sequence":"additional","affiliation":[{"name":"Pediatric Hematology-Oncology, B.J. Wadia Hospital , Mumbai, 400012, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Purva","family":"Kanvinde","sequence":"additional","affiliation":[{"name":"Pediatric Hematology-Oncology, B.J. Wadia Hospital , Mumbai, 400012, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanaa","family":"Khan","sequence":"additional","affiliation":[{"name":"Pediatric Hematology-Oncology, B.J. Wadia Hospital , Mumbai, 400012, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dhara","family":"Shah","sequence":"additional","affiliation":[{"name":"Pediatric Hematology-Oncology, B.J. Wadia Hospital , Mumbai, 400012, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Trupti","family":"Dhabale","sequence":"additional","affiliation":[{"name":"Pediatric Hematology-Oncology, B.J. Wadia Hospital , Mumbai, 400012, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vaibhav","family":"Chadha","sequence":"additional","affiliation":[{"name":"Pediatric Hematology-Oncology, B.J. Wadia Hospital , Mumbai, 400012, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nitin","family":"Shah","sequence":"additional","affiliation":[{"name":"Pediatric Hematology-Oncology, B.J. Wadia Hospital , Mumbai, 400012, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mukesh","family":"Desai","sequence":"additional","affiliation":[{"name":"Pediatric Hematology-Oncology, B.J. Wadia Hospital , Mumbai, 400012, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minnie","family":"Bodhanwala","sequence":"additional","affiliation":[{"name":"CEO of Wadia Hospitals , Mumbai, 400012, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Archana","family":"Swami","sequence":"additional","affiliation":[{"name":"Pediatric Hematology-Oncology, B.J. Wadia Hospital , Mumbai, 400012, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3955-2852","authenticated-orcid":false,"given":"Sangeeta","family":"Mudaliar","sequence":"additional","affiliation":[{"name":"Pediatric Hematology-Oncology, B.J. Wadia Hospital , Mumbai, 400012, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,9,14]]},"reference":[{"key":"2024091502212157400_fmae028-B1","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/S0022-3476(88)80527-4","article-title":"Diaphyseal dysplasia associated with anemia","volume":"113","author":"Ghosal","year":"1988","journal-title":"J Pediatr"},{"key":"2024091502212157400_fmae028-B2","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1038\/ng.2007.66","article-title":"Thromoboxane synthase mutations in an increased bone density disorder (Ghosal syndrome)","volume":"40","author":"Genevi\u00e8ve","year":"2008","journal-title":"Nat Genet"},{"key":"2024091502212157400_fmae028-B3","doi-asserted-by":"crossref","DOI":"10.18502\/ijhoscr.v14i2.2677","article-title":"Ghosal hematodiaphyseal dysplasia: a case report","author":"Shakiba","year":"2020","journal-title":"Int J Hematol Oncol Stem Cell Res"},{"key":"2024091502212157400_fmae028-B4","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.1002\/pbc.22662","article-title":"Ghosal hematodiaphyseal dysplasia: a rare cause of a myelophthisic anemia","volume":"55","author":"Mazaheri","year":"2010","journal-title":"Pediatr Blood Cancer"},{"key":"2024091502212157400_fmae028-B5","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1097\/MPH.0000000000000279","article-title":"Steroid-responsive anemia in patients of Ghosal hematodiaphyseal dysplasia: Simple to diagnose and easy to treat","volume":"37","author":"John","journal-title":"J Pediatr Hematol Oncol"},{"key":"2024091502212157400_fmae028-B6","doi-asserted-by":"crossref","DOI":"10.1002\/pbc.26777","article-title":"Chronic steroid-response pancytopenia and increased bone density due to thromboxane synthase deficiency","volume":"65","author":"Sharma","year":"2018","journal-title":"Pediatr Blood Cancer"},{"key":"2024091502212157400_fmae028-B7","doi-asserted-by":"crossref","first-page":"S22","DOI":"10.1016\/j.htct.2022.09.1226","article-title":"Ghosal hematodiaphyseal dysplasia (GHDD) diagnosis and treatment: case report","volume":"44","author":"Mammadova","year":"2022","journal-title":"Hematol Transfus Cell Ther"}],"container-title":["Journal of Tropical Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/tropej\/article-pdf\/70\/5\/fmae028\/59124460\/fmae028.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/tropej\/article-pdf\/70\/5\/fmae028\/59124460\/fmae028.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,15]],"date-time":"2024-09-15T02:21:32Z","timestamp":1726366892000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/tropej\/article\/doi\/10.1093\/tropej\/fmae028\/7758225"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,10]]},"references-count":7,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,8,10]]}},"URL":"https:\/\/doi.org\/10.1093\/tropej\/fmae028","relation":{},"ISSN":["0142-6338","1465-3664"],"issn-type":[{"value":"0142-6338","type":"print"},{"value":"1465-3664","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,10]]},"published":{"date-parts":[[2024,8,10]]},"article-number":"fmae028"}}