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Cyanosis, transient neonatal(TNCY)

MedGen UID:
462771
Concept ID:
C3151421
Disease or Syndrome
Synonyms: CYANOSIS, TRANSIENT NEONATEL; TNCY
 
Gene (location): HBG2 (11p15.4)
 
Monarch Initiative: MONDO:0013511
OMIM®: 613977

Definition

Neonatal cyanosis is characterized by symptoms in the fetus and neonate that gradually abate by 5 to 6 months of age. The disorder is caused by a defect in the fetal hemoglobin chain, which causes reduced affinity for oxygen due to steric inhibition of oxygen binding and/or due to increased oxidation of the fetal hemoglobin molecule to methemoglobin (Hb FM), which has decreased oxygen-binding capacity. Some patients develop anemia resulting from increased destruction of red cells containing abnormal or unstable hemoglobin. The cyanosis resolves spontaneously by 5 to 6 months of age or earlier, as the adult beta-globin chain (HBB; 141900) is produced and replaces the fetal gamma-globin chain (summary by Crowley et al., 2011). [from OMIM]

Clinical features

From HPO
Hepatomegaly
MedGen UID:
42428
Concept ID:
C0019209
Finding
Abnormally increased size of the liver.
Jaundice
MedGen UID:
43987
Concept ID:
C0022346
Sign or Symptom
Yellow pigmentation of the skin due to bilirubin, which in turn is the result of increased bilirubin concentration in the bloodstream.
Anemia
MedGen UID:
1526
Concept ID:
C0002871
Disease or Syndrome
A reduction in erythrocytes volume or hemoglobin concentration.
Methemoglobinemia
MedGen UID:
6339
Concept ID:
C0025637
Disease or Syndrome
Abnormally increased levels of methemoglobin in the blood. In this form of hemoglobin, there is an oxidized ferric iron (Fe +3) rather than the reduced ferrous form (Fe 2+) that is normally found in hemoglobin. Methemoglobin has a reduced affinity for oxygen, resulting in a reduced ability to release oxygen to tissues.
Reticulocytosis
MedGen UID:
60089
Concept ID:
C0206160
Finding
An elevation in the number of reticulocytes (immature erythrocytes) in the peripheral blood circulation.
Cyanosis
MedGen UID:
1189
Concept ID:
C0010520
Sign or Symptom
Bluish discoloration of the skin and mucosa due to poor circulation or inadequate oxygenation of arterial or capillary blood.

Professional guidelines

PubMed

Stevens LH, Cope TI
Med J Aust 1969 Jun 7;1(23):1165-72. doi: 10.5694/j.1326-5377.1969.tb62251.x. PMID: 5792714

Recent clinical studies

Etiology

Gewillig M, Brown SC, Roggen M, Eyskens B, Heying R, Givron P, Cools B, de Catte L
Acta Cardiol 2017 Dec;72(6):625-635. Epub 2017 Jul 26 doi: 10.1080/00015385.2017.1314876. PMID: 28745124
Tochie JN, Choukem SP, Langmia RN, Barla E, Koki-Ndombo P
Pan Afr Med J 2016;24:152. Epub 2016 Jun 21 doi: 10.11604/pamj.2016.24.152.7066. PMID: 27642489Free PMC Article
Perna R, Cooper D
Appl Neuropsychol Child 2012;1(1):48-52. doi: 10.1080/09084282.2011.643946. PMID: 23428277
Kozma C
Am J Med Genet A 2005 Feb 1;132A(4):441-4. doi: 10.1002/ajmg.a.30501. PMID: 15633173
Haymond MW
Endocrinol Metab Clin North Am 1989 Mar;18(1):211-52. PMID: 2645128

Diagnosis

Akın MŞ, Ağaçkıran D, Ünal E, Yavuz ÖÖ, Yiğit Ş
Turk J Pediatr 2020;62(1):160-164. doi: 10.24953/turkjped.2020.01.025. PMID: 32253885
Tochie JN, Choukem SP, Langmia RN, Barla E, Koki-Ndombo P
Pan Afr Med J 2016;24:152. Epub 2016 Jun 21 doi: 10.11604/pamj.2016.24.152.7066. PMID: 27642489Free PMC Article
Hermansen CL, Mahajan A
Am Fam Physician 2015 Dec 1;92(11):994-1002. PMID: 26760414
Ranjit MS
Indian J Pediatr 2000 Mar;67(3 Suppl):S26-9. PMID: 11129917
Haymond MW
Endocrinol Metab Clin North Am 1989 Mar;18(1):211-52. PMID: 2645128

Therapy

Dos Santos CS, Silva PV, Castelo R, Tiago J
BMJ Case Rep 2021 Jun 24;14(6) doi: 10.1136/bcr-2021-243485. PMID: 34167992Free PMC Article
Malekzadeh-Milani S, Jalal Z, Tamisier D, Boudjemline Y
Catheter Cardiovasc Interv 2016 Sep;88(3):446-51. Epub 2016 Mar 29 doi: 10.1002/ccd.26502. PMID: 27027640
Hermansen CL, Mahajan A
Am Fam Physician 2015 Dec 1;92(11):994-1002. PMID: 26760414
Kozma C
Am J Med Genet A 2005 Feb 1;132A(4):441-4. doi: 10.1002/ajmg.a.30501. PMID: 15633173
Haymond MW
Endocrinol Metab Clin North Am 1989 Mar;18(1):211-52. PMID: 2645128

Prognosis

Gewillig M, Brown SC, Roggen M, Eyskens B, Heying R, Givron P, Cools B, de Catte L
Acta Cardiol 2017 Dec;72(6):625-635. Epub 2017 Jul 26 doi: 10.1080/00015385.2017.1314876. PMID: 28745124
Tochie JN, Choukem SP, Langmia RN, Barla E, Koki-Ndombo P
Pan Afr Med J 2016;24:152. Epub 2016 Jun 21 doi: 10.11604/pamj.2016.24.152.7066. PMID: 27642489Free PMC Article
Soyer T, Yalcin S, Bozkaya D, Yiğit S, Tanyel FC
J Perinatol 2014 Oct;34(10):800-1. doi: 10.1038/jp.2014.101. PMID: 25263728
Ranjit MS
Indian J Pediatr 2000 Mar;67(3 Suppl):S26-9. PMID: 11129917
Saigal S, Usher RH
Biol Neonate 1977;32(1-2):62-72. doi: 10.1159/000240996. PMID: 901882

Clinical prediction guides

Gewillig M, Brown SC, Roggen M, Eyskens B, Heying R, Givron P, Cools B, de Catte L
Acta Cardiol 2017 Dec;72(6):625-635. Epub 2017 Jul 26 doi: 10.1080/00015385.2017.1314876. PMID: 28745124
Tochie JN, Choukem SP, Langmia RN, Barla E, Koki-Ndombo P
Pan Afr Med J 2016;24:152. Epub 2016 Jun 21 doi: 10.11604/pamj.2016.24.152.7066. PMID: 27642489Free PMC Article
Crowley MA, Mollan TL, Abdulmalik OY, Butler AD, Goodwin EF, Sarkar A, Stolle CA, Gow AJ, Olson JS, Weiss MJ
N Engl J Med 2011 May 12;364(19):1837-43. doi: 10.1056/NEJMoa1013579. PMID: 21561349Free PMC Article
Aycan Z, Berberoğlu M, Ocal G, Altundas N, Adiyaman P, Evliyaoğlu O
Indian J Pediatr 2002 Dec;69(12):1087-9. doi: 10.1007/BF02724395. PMID: 12557965
Bobitt JR, Brown GL, Tull AH
Obstet Gynecol 1980 May;55(5 Suppl):171S-177S. PMID: 6990332

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