{"id":27168,"date":"2024-05-26T16:00:13","date_gmt":"2024-05-26T14:00:13","guid":{"rendered":"https:\/\/www.krebs-praedisposition.de\/?post_type=kompendium&#038;p=27168"},"modified":"2025-08-26T13:55:19","modified_gmt":"2025-08-26T11:55:19","slug":"sam9-deficiency","status":"publish","type":"kompendium","link":"https:\/\/www.krebs-praedisposition.de\/en\/kompendium\/sam9-deficiency\/","title":{"rendered":"SAMD9 Deficiency"},"content":{"rendered":"<p><div id=\"was-ist-das\" class=\"fusion-container-anchor\"><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling fusion-custom-z-index\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-z-index:180;--awb-padding-top:25px;--awb-padding-bottom:75px;--awb-padding-top-medium:25px;--awb-padding-bottom-medium:75px;--awb-padding-top-small:0px;--awb-padding-bottom-small:25px;--awb-background-color:var(--awb-color1);--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1456px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:40px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-margin-bottom-small:40px;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column fusion-content-nowrap\"><div class=\"fusion-title title fusion-title-1 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-two\" style=\"--awb-margin-right:10%;--awb-margin-bottom:10px;--awb-margin-left:10%;--awb-margin-bottom-small:5px;--awb-margin-top-medium:0px;--awb-margin-right-medium:0px;--awb-margin-bottom-medium:10px;--awb-margin-left-medium:0px;\"><h2 class=\"fusion-title-heading title-heading-center\" style=\"margin:0;\">SAMD9 Deficiency \u2013\u00a0Definition<\/h2><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:0px;margin-bottom:0px;width:100%;\"><div class=\"fusion-separator-border sep-single sep-solid\" style=\"--awb-height:20px;--awb-amount:20px;--awb-sep-color:var(--awb-custom10);border-color:var(--awb-custom10);border-top-width:5px;\"><\/div><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-1 fusion_builder_column_2_3 2_3 fusion-flex-column fusion-flex-align-self-stretch\" style=\"--awb-bg-size:cover;--awb-width-large:66.666666666667%;--awb-margin-top-large:0px;--awb-spacing-right-large:2.88%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:2.88%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-margin-bottom-medium:30px;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-margin-bottom-small:10px;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-center fusion-content-layout-column\"><div class=\"fusion-text fusion-text-1 fusion-text-no-margin\" style=\"--awb-content-alignment:left;--awb-font-size:var(--awb-typography4-font-size);--awb-line-height:var(--awb-typography4-line-height);--awb-letter-spacing:var(--awb-typography4-letter-spacing);--awb-text-transform:var(--awb-typography4-text-transform);--awb-margin-bottom:30px;--awb-text-font-family:var(--awb-typography4-font-family);--awb-text-font-weight:var(--awb-typography4-font-weight);--awb-text-font-style:var(--awb-typography4-font-style);\"><p>SAMD9 deficiency (OMIM #617053) is a genetic disorder caused by pathogenic variants in the <em>SAMD9<\/em> gene. It is also known as MIRAGE syndrome, an acronym made up of the most frequently observed symptoms: <strong>M<\/strong>yelodysplasia, <strong>i<\/strong>nfection, <strong>r<\/strong>estriction of growth, <strong>a<\/strong>drenal hypoplasia, <strong>g<\/strong>enital abnormalities, and <strong>e<\/strong>nteropathy. In addition, numerous other abnormalities can occur in various organs. The disease is often fatal within the first decade of life, usually due to severe infections.<\/p>\n<\/div><div class=\"fusion-builder-row fusion-builder-row-inner fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"width:104% !important;max-width:104% !important;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-0 fusion_builder_column_inner_1_4 1_4 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:25%;--awb-margin-top-large:0px;--awb-spacing-right-large:7.68%;--awb-margin-bottom-large:10px;--awb-spacing-left-large:7.68%;--awb-width-medium:33.333333333333%;--awb-order-medium:0;--awb-spacing-right-medium:5.76%;--awb-spacing-left-medium:5.76%;--awb-width-small:33.333333333333%;--awb-order-small:0;--awb-spacing-right-small:5.76%;--awb-spacing-left-small:5.76%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-2 fusion-text-no-margin text-16px\" style=\"--awb-font-size:16px;\"><p>Synonym:<\/p>\n<\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-1 fusion_builder_column_inner_3_4 3_4 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:75%;--awb-margin-top-large:0px;--awb-spacing-right-large:2.56%;--awb-margin-bottom-large:10px;--awb-spacing-left-large:2.56%;--awb-width-medium:66.666666666667%;--awb-order-medium:0;--awb-spacing-right-medium:2.88%;--awb-spacing-left-medium:2.88%;--awb-width-small:66.666666666667%;--awb-order-small:0;--awb-spacing-right-small:2.88%;--awb-spacing-left-small:2.88%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-3 fusion-text-no-margin text-16px\" style=\"--awb-font-size:16px;\"><p>MIRAGE Syndrome<\/p>\n<\/div><\/div><\/div><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;width:100%;\"><div class=\"fusion-separator-border sep-single sep-solid\" style=\"--awb-height:20px;--awb-amount:20px;--awb-sep-color:var(--awb-color2);border-color:var(--awb-color2);border-top-width:3px;\"><\/div><\/div><div class=\"fusion-builder-row fusion-builder-row-inner fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"width:104% !important;max-width:104% !important;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-2 fusion_builder_column_inner_1_4 1_4 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:25%;--awb-margin-top-large:10px;--awb-spacing-right-large:7.68%;--awb-margin-bottom-large:10px;--awb-spacing-left-large:7.68%;--awb-width-medium:33.333333333333%;--awb-order-medium:0;--awb-spacing-right-medium:5.76%;--awb-spacing-left-medium:5.76%;--awb-width-small:33.333333333333%;--awb-order-small:0;--awb-spacing-right-small:5.76%;--awb-spacing-left-small:5.76%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-4 fusion-text-no-margin text-16px\" style=\"--awb-font-size:16px;\"><p>Gene:<\/p>\n<\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-3 fusion_builder_column_inner_3_4 3_4 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:75%;--awb-margin-top-large:10px;--awb-spacing-right-large:2.56%;--awb-margin-bottom-large:10px;--awb-spacing-left-large:2.56%;--awb-width-medium:66.666666666667%;--awb-order-medium:0;--awb-spacing-right-medium:2.88%;--awb-spacing-left-medium:2.88%;--awb-width-small:66.666666666667%;--awb-order-small:0;--awb-spacing-right-small:2.88%;--awb-spacing-left-small:2.88%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-5 fusion-text-no-margin text-16px\" style=\"--awb-font-size:16px;\"><p><em>SAMD9<\/em> (sterile alpha motif domain-containing protein-9 gene)<\/p>\n<\/div><\/div><\/div><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;width:100%;\"><div class=\"fusion-separator-border sep-single sep-solid\" style=\"--awb-height:20px;--awb-amount:20px;--awb-sep-color:var(--awb-color2);border-color:var(--awb-color2);border-top-width:3px;\"><\/div><\/div><div class=\"fusion-builder-row fusion-builder-row-inner fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"width:104% !important;max-width:104% !important;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-4 fusion_builder_column_inner_1_4 1_4 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:25%;--awb-margin-top-large:10px;--awb-spacing-right-large:7.68%;--awb-margin-bottom-large:10px;--awb-spacing-left-large:7.68%;--awb-width-medium:33.333333333333%;--awb-order-medium:0;--awb-spacing-right-medium:5.76%;--awb-spacing-left-medium:5.76%;--awb-width-small:33.333333333333%;--awb-order-small:0;--awb-spacing-right-small:5.76%;--awb-spacing-left-small:5.76%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-6 fusion-text-no-margin text-16px\" style=\"--awb-font-size:16px;\"><p>Gen\u00ade product:<\/p>\n<\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-5 fusion_builder_column_inner_3_4 3_4 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:75%;--awb-margin-top-large:10px;--awb-spacing-right-large:2.56%;--awb-margin-bottom-large:10px;--awb-spacing-left-large:2.56%;--awb-width-medium:66.666666666667%;--awb-order-medium:0;--awb-spacing-right-medium:2.88%;--awb-spacing-left-medium:2.88%;--awb-width-small:66.666666666667%;--awb-order-small:0;--awb-spacing-right-small:2.88%;--awb-spacing-left-small:2.88%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-7 fusion-text-no-margin text-16px\" style=\"--awb-font-size:16px;\"><p>SAMD9<\/p>\n<\/div><\/div><\/div><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;width:100%;\"><div class=\"fusion-separator-border sep-single sep-solid\" style=\"--awb-height:20px;--awb-amount:20px;--awb-sep-color:var(--awb-color2);border-color:var(--awb-color2);border-top-width:3px;\"><\/div><\/div><div class=\"fusion-builder-row fusion-builder-row-inner fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"width:104% !important;max-width:104% !important;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-6 fusion_builder_column_inner_1_4 1_4 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:25%;--awb-margin-top-large:10px;--awb-spacing-right-large:7.68%;--awb-margin-bottom-large:10px;--awb-spacing-left-large:7.68%;--awb-width-medium:33.333333333333%;--awb-order-medium:0;--awb-spacing-right-medium:5.76%;--awb-spacing-left-medium:5.76%;--awb-width-small:33.333333333333%;--awb-order-small:0;--awb-spacing-right-small:5.76%;--awb-spacing-left-small:5.76%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-8 fusion-text-no-margin text-16px\" style=\"--awb-font-size:16px;\"><p>Function:<\/p>\n<\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-7 fusion_builder_column_inner_3_4 3_4 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:75%;--awb-margin-top-large:10px;--awb-spacing-right-large:2.56%;--awb-margin-bottom-large:10px;--awb-spacing-left-large:2.56%;--awb-width-medium:66.666666666667%;--awb-order-medium:0;--awb-spacing-right-medium:2.88%;--awb-spacing-left-medium:2.88%;--awb-width-small:66.666666666667%;--awb-order-small:0;--awb-spacing-right-small:2.88%;--awb-spacing-left-small:2.88%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-9 fusion-text-no-margin text-16px\" style=\"--awb-font-size:16px;\"><p>Growth repressor<\/p>\n<p>pathogenic variants of the <i>SAMD9<\/i> gene lead to gain-of-function<\/p>\n<\/div><\/div><\/div><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;width:100%;\"><div class=\"fusion-separator-border sep-single sep-solid\" style=\"--awb-height:20px;--awb-amount:20px;--awb-sep-color:var(--awb-color2);border-color:var(--awb-color2);border-top-width:3px;\"><\/div><\/div><div class=\"fusion-builder-row fusion-builder-row-inner fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"width:104% !important;max-width:104% !important;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-8 fusion_builder_column_inner_1_4 1_4 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:25%;--awb-margin-top-large:10px;--awb-spacing-right-large:7.68%;--awb-margin-bottom-large:10px;--awb-spacing-left-large:7.68%;--awb-width-medium:33.333333333333%;--awb-order-medium:0;--awb-spacing-right-medium:5.76%;--awb-spacing-left-medium:5.76%;--awb-width-small:33.333333333333%;--awb-order-small:0;--awb-spacing-right-small:5.76%;--awb-spacing-left-small:5.76%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-10 fusion-text-no-margin text-16px\" style=\"--awb-font-size:16px;\"><p>Pattern of inheritance:<\/p>\n<\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-9 fusion_builder_column_inner_3_4 3_4 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:75%;--awb-margin-top-large:10px;--awb-spacing-right-large:2.56%;--awb-margin-bottom-large:10px;--awb-spacing-left-large:2.56%;--awb-width-medium:66.666666666667%;--awb-order-medium:0;--awb-spacing-right-medium:2.88%;--awb-spacing-left-medium:2.88%;--awb-width-small:66.666666666667%;--awb-order-small:0;--awb-spacing-right-small:2.88%;--awb-spacing-left-small:2.88%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-11 fusion-text-no-margin text-16px\" style=\"--awb-font-size:16px;\"><p>Autosomal dominant, mostly <i>de novo<\/i> mutations<\/p>\n<\/div><\/div><\/div><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;width:100%;\"><div class=\"fusion-separator-border sep-single sep-solid\" style=\"--awb-height:20px;--awb-amount:20px;--awb-sep-color:var(--awb-color2);border-color:var(--awb-color2);border-top-width:3px;\"><\/div><\/div><div class=\"fusion-builder-row fusion-builder-row-inner fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"width:104% !important;max-width:104% !important;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-10 fusion_builder_column_inner_1_4 1_4 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:25%;--awb-margin-top-large:10px;--awb-spacing-right-large:7.68%;--awb-margin-bottom-large:10px;--awb-spacing-left-large:7.68%;--awb-width-medium:33.333333333333%;--awb-order-medium:0;--awb-spacing-right-medium:5.76%;--awb-spacing-left-medium:5.76%;--awb-width-small:33.333333333333%;--awb-order-small:0;--awb-spacing-right-small:5.76%;--awb-spacing-left-small:5.76%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-12 fusion-text-no-margin text-16px\" style=\"--awb-font-size:16px;\"><p>Prevalence:<\/p>\n<\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-11 fusion_builder_column_inner_3_4 3_4 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:75%;--awb-margin-top-large:10px;--awb-spacing-right-large:2.56%;--awb-margin-bottom-large:10px;--awb-spacing-left-large:2.56%;--awb-width-medium:66.666666666667%;--awb-order-medium:0;--awb-spacing-right-medium:2.88%;--awb-spacing-left-medium:2.88%;--awb-width-small:66.666666666667%;--awb-order-small:0;--awb-spacing-right-small:2.88%;--awb-spacing-left-small:2.88%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-13 fusion-text-no-margin text-16px\" style=\"--awb-font-size:16px;\"><p>Unknown<\/p>\n<\/div><\/div><\/div><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;width:100%;\"><div class=\"fusion-separator-border sep-single sep-solid\" style=\"--awb-height:20px;--awb-amount:20px;--awb-sep-color:var(--awb-color2);border-color:var(--awb-color2);border-top-width:3px;\"><\/div><\/div><div class=\"fusion-builder-row fusion-builder-row-inner fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"width:104% !important;max-width:104% !important;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-12 fusion_builder_column_inner_1_4 1_4 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:25%;--awb-margin-top-large:10px;--awb-spacing-right-large:7.68%;--awb-margin-bottom-large:10px;--awb-spacing-left-large:7.68%;--awb-width-medium:33.333333333333%;--awb-order-medium:0;--awb-spacing-right-medium:5.76%;--awb-spacing-left-medium:5.76%;--awb-width-small:33.333333333333%;--awb-order-small:0;--awb-spacing-right-small:5.76%;--awb-spacing-left-small:5.76%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-14 fusion-text-no-margin text-16px\" style=\"--awb-font-size:16px;\"><p>Genotype-phenotype correlation:<\/p>\n<\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-13 fusion_builder_column_inner_3_4 3_4 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:75%;--awb-margin-top-large:10px;--awb-spacing-right-large:2.56%;--awb-margin-bottom-large:10px;--awb-spacing-left-large:2.56%;--awb-width-medium:66.666666666667%;--awb-order-medium:0;--awb-spacing-right-medium:2.88%;--awb-spacing-left-medium:2.88%;--awb-width-small:66.666666666667%;--awb-order-small:0;--awb-spacing-right-small:2.88%;--awb-spacing-left-small:2.88%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-15 fusion-text-no-margin text-16px\" style=\"--awb-font-size:16px;\"><p>Very homogeneous phenotype in the patients diagnosed to date<\/p>\n<\/div><\/div><\/div><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;width:100%;\"><div class=\"fusion-separator-border sep-single sep-solid\" style=\"--awb-height:20px;--awb-amount:20px;--awb-sep-color:var(--awb-color2);border-color:var(--awb-color2);border-top-width:3px;\"><\/div><\/div><div class=\"fusion-builder-row fusion-builder-row-inner fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"width:104% !important;max-width:104% !important;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-14 fusion_builder_column_inner_1_4 1_4 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:25%;--awb-margin-top-large:10px;--awb-spacing-right-large:7.68%;--awb-margin-bottom-large:10px;--awb-spacing-left-large:7.68%;--awb-width-medium:33.333333333333%;--awb-order-medium:0;--awb-spacing-right-medium:5.76%;--awb-spacing-left-medium:5.76%;--awb-width-small:33.333333333333%;--awb-order-small:0;--awb-spacing-right-small:5.76%;--awb-spacing-left-small:5.76%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-16 fusion-text-no-margin text-16px\" style=\"--awb-font-size:16px;\"><p>Penetrance:<\/p>\n<\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-15 fusion_builder_column_inner_3_4 3_4 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:75%;--awb-margin-top-large:10px;--awb-spacing-right-large:2.56%;--awb-margin-bottom-large:10px;--awb-spacing-left-large:2.56%;--awb-width-medium:66.666666666667%;--awb-order-medium:0;--awb-spacing-right-medium:2.88%;--awb-spacing-left-medium:2.88%;--awb-width-small:66.666666666667%;--awb-order-small:0;--awb-spacing-right-small:2.88%;--awb-spacing-left-small:2.88%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-17 fusion-text-no-margin text-16px\" style=\"--awb-font-size:16px;\"><p>Unknown<\/p>\n<\/div><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-2 fusion_builder_column_1_3 1_3 fusion-flex-column fusion-flex-align-self-stretch\" style=\"--awb-overflow:hidden;--awb-bg-image:url(&#039;https:\/\/www.krebs-praedisposition.de\/wp-content\/uploads\/2023\/01\/FIT_BILD_Forschung-DNA-Spindel-X.jpg&#039;);--awb-bg-position:center top;--awb-bg-size:cover;--awb-box-shadow:0px 0px 10px 10px rgba(0,0,0,0.15) inset;;--awb-border-color:var(--awb-custom16);--awb-border-top:5px;--awb-border-right:5px;--awb-border-bottom:5px;--awb-border-left:5px;--awb-border-style:solid;--awb-border-radius:50px 50px 50px 50px;--awb-width-large:33.333333333333%;--awb-margin-top-large:0px;--awb-spacing-right-large:5.76%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:5.76%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:9.6%;--awb-spacing-left-medium:9.6%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-margin-bottom-small:20px;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-center fusion-content-layout-column fusion-column-has-bg-image\" data-bg-url=\"https:\/\/www.krebs-praedisposition.de\/wp-content\/uploads\/2023\/01\/FIT_BILD_Forschung-DNA-Spindel-X.jpg\"><div class=\"fusion-separator fusion-no-medium-visibility fusion-no-large-visibility fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-bottom:300px;width:100%;\"><\/div><div class=\"fusion-separator fusion-no-small-visibility fusion-no-large-visibility fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-bottom:350px;width:100%;\"><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-2 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling fusion-custom-z-index\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-z-index:170;--awb-background-color:var(--awb-color1);--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-stretch fusion-flex-content-wrap\" style=\"max-width:1456px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-3 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-padding-top:50px;--awb-padding-right:10%;--awb-padding-bottom:30px;--awb-padding-left:10%;--awb-padding-bottom-medium:20px;--awb-padding-top-small:40px;--awb-padding-right-small:20px;--awb-padding-bottom-small:10px;--awb-padding-left-small:20px;--awb-overflow:hidden;--awb-bg-color:#f4fbff;--awb-bg-color-hover:#f4fbff;--awb-bg-size:cover;--awb-border-radius:3px 3px 0px 0px;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-2 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-four\" style=\"--awb-margin-bottom-small:5px;--awb-margin-top-medium:0px;--awb-margin-right-medium:0px;--awb-margin-bottom-medium:0px;--awb-margin-left-medium:0px;\"><h4 class=\"fusion-title-heading title-heading-center\" style=\"margin:0;\">Overview of the Chapters on This Page:<\/h4><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-4 fusion_builder_column_1_1 1_1 fusion-flex-column fusion-no-medium-visibility fusion-no-large-visibility\" style=\"--awb-padding-top-small:0px;--awb-padding-right-small:20px;--awb-padding-bottom-small:20px;--awb-padding-left-small:20px;--awb-overflow:hidden;--awb-bg-image:linear-gradient(180deg, #f4fbff 0%,#e7f6ff 100%);--awb-bg-size:cover;--awb-border-radius:0px 0px 0px 3px;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:0px;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:50%;--awb-order-medium:0;--awb-spacing-right-medium:0px;--awb-spacing-left-medium:3.84%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-builder-row fusion-builder-row-inner fusion-row fusion-flex-align-items-stretch fusion-flex-content-wrap\" style=\"width:104% !important;max-width:104% !important;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-16 fusion_builder_column_inner_1_1 1_1 fusion-flex-column fusion-one-page-text-link\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-row fusion-content-nowrap\"><ul style=\"--awb-size:16px;--awb-iconcolor:var(--awb-color1);--awb-textcolor:var(--awb-custom15);--awb-line-height:27.2px;--awb-icon-width:27.2px;--awb-icon-height:27.2px;--awb-icon-margin:11.2px;--awb-content-margin:38.4px;--awb-circlecolor:var(--awb-custom15);--awb-circle-yes-font-size:14.08px;\" class=\"fusion-checklist fusion-checklist-1 fusion-checklist-default type-icons\"><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-yes\"><i class=\"fusion-li-icon fa-arrow-alt-down fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\">SAMD9 Deficiency \u2013 Definition (This Section)<\/div><\/li><\/ul><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-17 fusion_builder_column_inner_1_1 1_1 fusion-flex-column fusion-one-page-text-link fusion-column-inner-bg-wrapper\" style=\"--awb-inner-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\" data-scroll-devices=\"small-visibility,medium-visibility,large-visibility\"><span class=\"fusion-column-inner-bg hover-type-none\"><a class=\"fusion-column-anchor\" href=\"#diagnosis\"><span class=\"fusion-column-inner-bg-image\"><\/span><\/a><\/span><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-row fusion-content-nowrap\"><ul style=\"--awb-size:16px;--awb-iconcolor:var(--awb-color1);--awb-textcolor:var(--awb-custom10);--awb-line-height:27.2px;--awb-icon-width:27.2px;--awb-icon-height:27.2px;--awb-icon-margin:11.2px;--awb-content-margin:38.4px;--awb-circlecolor:var(--awb-custom10);--awb-circle-yes-font-size:14.08px;\" class=\"fusion-checklist fusion-checklist-2 fusion-checklist-default type-icons\"><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-yes\"><i class=\"fusion-li-icon fa-arrow-alt-down fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\">SAMD9 Deficiency \u2013 Diagnosis<\/div><\/li><\/ul><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-18 fusion_builder_column_inner_1_1 1_1 fusion-flex-column fusion-column-inner-bg-wrapper\" style=\"--awb-inner-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\" data-scroll-devices=\"small-visibility,medium-visibility,large-visibility\"><span class=\"fusion-column-inner-bg hover-type-none\"><a class=\"fusion-column-anchor\" href=\"#clinical-presentation\"><span class=\"fusion-column-inner-bg-image\"><\/span><\/a><\/span><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-row fusion-content-nowrap\"><ul style=\"--awb-size:16px;--awb-iconcolor:var(--awb-color1);--awb-textcolor:var(--awb-custom10);--awb-line-height:27.2px;--awb-icon-width:27.2px;--awb-icon-height:27.2px;--awb-icon-margin:11.2px;--awb-content-margin:38.4px;--awb-circlecolor:var(--awb-custom10);--awb-circle-yes-font-size:14.08px;\" class=\"fusion-checklist fusion-checklist-3 fusion-checklist-default type-icons\"><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-yes\"><i class=\"fusion-li-icon fa-arrow-alt-down fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\">\n<p>Clinical Presentation<\/p>\n<\/div><\/li><\/ul><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-19 fusion_builder_column_inner_1_1 1_1 fusion-flex-column fusion-column-inner-bg-wrapper\" style=\"--awb-inner-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\" data-scroll-devices=\"small-visibility,medium-visibility,large-visibility\"><span class=\"fusion-column-inner-bg hover-type-none\"><a class=\"fusion-column-anchor\" href=\"#special-features-of-treatment\"><span class=\"fusion-column-inner-bg-image\"><\/span><\/a><\/span><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-row fusion-content-nowrap\"><ul style=\"--awb-size:16px;--awb-iconcolor:var(--awb-color1);--awb-textcolor:var(--awb-custom10);--awb-line-height:27.2px;--awb-icon-width:27.2px;--awb-icon-height:27.2px;--awb-icon-margin:11.2px;--awb-content-margin:38.4px;--awb-circlecolor:var(--awb-custom10);--awb-circle-yes-font-size:14.08px;\" class=\"fusion-checklist fusion-checklist-4 fusion-checklist-default type-icons\"><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-yes\"><i class=\"fusion-li-icon fa-arrow-alt-down fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\">\n<p>Special Features of Treatment<\/p>\n<\/div><\/li><\/ul><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-20 fusion_builder_column_inner_1_1 1_1 fusion-flex-column fusion-column-inner-bg-wrapper\" style=\"--awb-inner-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\" data-scroll-devices=\"small-visibility,medium-visibility,large-visibility\"><span class=\"fusion-column-inner-bg hover-type-none\"><a class=\"fusion-column-anchor\" href=\"#recommendations-for-early-detection\"><span class=\"fusion-column-inner-bg-image\"><\/span><\/a><\/span><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-row fusion-content-nowrap\"><ul style=\"--awb-size:16px;--awb-iconcolor:var(--awb-color1);--awb-textcolor:var(--awb-custom10);--awb-line-height:27.2px;--awb-icon-width:27.2px;--awb-icon-height:27.2px;--awb-icon-margin:11.2px;--awb-content-margin:38.4px;--awb-circlecolor:var(--awb-custom10);--awb-circle-yes-font-size:14.08px;\" class=\"fusion-checklist fusion-checklist-5 fusion-checklist-default type-icons\"><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-yes\"><i class=\"fusion-li-icon fa-arrow-alt-down fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\">\n<p><span data-teams=\"true\">Surveillance Recommendations<\/span><\/p>\n<\/div><\/li><\/ul><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-21 fusion_builder_column_inner_1_1 1_1 fusion-flex-column fusion-column-inner-bg-wrapper\" style=\"--awb-inner-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\" data-scroll-devices=\"small-visibility,medium-visibility,large-visibility\"><span class=\"fusion-column-inner-bg hover-type-none\"><a class=\"fusion-column-anchor\" href=\"#further-information\"><span class=\"fusion-column-inner-bg-image\"><\/span><\/a><\/span><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-row fusion-content-nowrap\"><ul style=\"--awb-size:16px;--awb-iconcolor:var(--awb-color1);--awb-textcolor:var(--awb-custom10);--awb-line-height:27.2px;--awb-icon-width:27.2px;--awb-icon-height:27.2px;--awb-icon-margin:11.2px;--awb-content-margin:38.4px;--awb-circlecolor:var(--awb-custom10);--awb-circle-yes-font-size:14.08px;\" class=\"fusion-checklist fusion-checklist-6 fusion-checklist-default type-icons\"><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-yes\"><i class=\"fusion-li-icon fa-arrow-alt-down fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\">\n<p>Further Information (e.g., Links to Support Groups)<\/p>\n<\/div><\/li><\/ul><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-5 fusion_builder_column_1_2 1_2 fusion-flex-column fusion-no-small-visibility\" style=\"--awb-padding-right:5%;--awb-padding-bottom:50px;--awb-padding-left:10%;--awb-padding-right-medium:20px;--awb-padding-bottom-medium:30px;--awb-padding-left-medium:40px;--awb-overflow:hidden;--awb-bg-image:linear-gradient(180deg, #f4fbff 0%,#e7f6ff 100%);--awb-bg-size:cover;--awb-border-radius:0px 0px 0px 3px;--awb-width-large:50%;--awb-margin-top-large:0px;--awb-spacing-right-large:0px;--awb-margin-bottom-large:0px;--awb-spacing-left-large:3.84%;--awb-width-medium:50%;--awb-order-medium:0;--awb-spacing-right-medium:0px;--awb-spacing-left-medium:3.84%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-builder-row fusion-builder-row-inner fusion-row fusion-flex-align-items-stretch fusion-flex-content-wrap\" style=\"width:104% !important;max-width:104% !important;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-22 fusion_builder_column_inner_1_1 1_1 fusion-flex-column fusion-one-page-text-link\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\" data-scroll-devices=\"small-visibility,medium-visibility,large-visibility\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-row fusion-content-nowrap\"><ul style=\"--awb-iconcolor:var(--awb-color1);--awb-textcolor:var(--awb-custom15);--awb-line-height:30.6px;--awb-icon-width:30.6px;--awb-icon-height:30.6px;--awb-icon-margin:12.6px;--awb-content-margin:43.2px;--awb-circlecolor:var(--awb-custom15);--awb-circle-yes-font-size:15.84px;\" class=\"fusion-checklist fusion-checklist-7 fusion-checklist-default type-icons\"><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-yes\"><i class=\"fusion-li-icon fa-arrow-alt-down fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\">SAMD9 Deficiency \u2013 Definition (This Section)<\/div><\/li><\/ul><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-23 fusion_builder_column_inner_1_1 1_1 fusion-flex-column fusion-one-page-text-link fusion-column-inner-bg-wrapper\" style=\"--awb-inner-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\" data-scroll-devices=\"small-visibility,medium-visibility,large-visibility\"><span class=\"fusion-column-inner-bg hover-type-none\"><a class=\"fusion-column-anchor\" href=\"#diagnosis\"><span class=\"fusion-column-inner-bg-image\"><\/span><\/a><\/span><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-row fusion-content-nowrap\"><ul style=\"--awb-iconcolor:var(--awb-color1);--awb-textcolor:var(--awb-custom10);--awb-line-height:30.6px;--awb-icon-width:30.6px;--awb-icon-height:30.6px;--awb-icon-margin:12.6px;--awb-content-margin:43.2px;--awb-circlecolor:var(--awb-custom10);--awb-circle-yes-font-size:15.84px;\" class=\"fusion-checklist fusion-checklist-8 fusion-checklist-default type-icons\"><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-yes\"><i class=\"fusion-li-icon fa-arrow-alt-down fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\">SAMD9 Deficiency \u2013 Diagnosis<\/div><\/li><\/ul><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-24 fusion_builder_column_inner_1_1 1_1 fusion-flex-column fusion-column-inner-bg-wrapper\" style=\"--awb-inner-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\" data-scroll-devices=\"small-visibility,medium-visibility,large-visibility\"><span class=\"fusion-column-inner-bg hover-type-none\"><a class=\"fusion-column-anchor\" href=\"#clinical-presentation\"><span class=\"fusion-column-inner-bg-image\"><\/span><\/a><\/span><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-row fusion-content-nowrap\"><ul style=\"--awb-iconcolor:var(--awb-color1);--awb-textcolor:var(--awb-custom10);--awb-line-height:30.6px;--awb-icon-width:30.6px;--awb-icon-height:30.6px;--awb-icon-margin:12.6px;--awb-content-margin:43.2px;--awb-circlecolor:var(--awb-custom10);--awb-circle-yes-font-size:15.84px;\" class=\"fusion-checklist fusion-checklist-9 fusion-checklist-default type-icons\"><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-yes\"><i class=\"fusion-li-icon fa-arrow-alt-down fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\">\n<p>Clinical Presentation<\/p>\n<\/div><\/li><\/ul><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-6 fusion_builder_column_1_2 1_2 fusion-flex-column fusion-no-small-visibility\" style=\"--awb-padding-right:10%;--awb-padding-bottom:50px;--awb-padding-left:5%;--awb-padding-right-medium:40px;--awb-padding-bottom-medium:30px;--awb-padding-left-medium:20px;--awb-overflow:hidden;--awb-bg-image:linear-gradient(180deg, #f4fbff 0%,#e7f6ff 100%);--awb-bg-size:cover;--awb-border-radius:0px 0px 3px 0px;--awb-width-large:50%;--awb-margin-top-large:0px;--awb-spacing-right-large:3.84%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:0px;--awb-width-medium:50%;--awb-order-medium:0;--awb-spacing-right-medium:3.84%;--awb-spacing-left-medium:0px;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-builder-row fusion-builder-row-inner fusion-row fusion-flex-align-items-stretch fusion-flex-content-wrap\" style=\"width:104% !important;max-width:104% !important;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-25 fusion_builder_column_inner_1_1 1_1 fusion-flex-column fusion-column-inner-bg-wrapper\" style=\"--awb-inner-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\" data-scroll-devices=\"small-visibility,medium-visibility,large-visibility\"><span class=\"fusion-column-inner-bg hover-type-none\"><a class=\"fusion-column-anchor\" href=\"#special-features-of-treatment\"><span class=\"fusion-column-inner-bg-image\"><\/span><\/a><\/span><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-row fusion-content-nowrap\"><ul style=\"--awb-iconcolor:var(--awb-color1);--awb-textcolor:var(--awb-custom10);--awb-line-height:30.6px;--awb-icon-width:30.6px;--awb-icon-height:30.6px;--awb-icon-margin:12.6px;--awb-content-margin:43.2px;--awb-circlecolor:var(--awb-custom10);--awb-circle-yes-font-size:15.84px;\" class=\"fusion-checklist fusion-checklist-10 fusion-checklist-default type-icons\"><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-yes\"><i class=\"fusion-li-icon fa-arrow-alt-down fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\">\n<p>Special Features of Treatment<\/p>\n<\/div><\/li><\/ul><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-26 fusion_builder_column_inner_1_1 1_1 fusion-flex-column fusion-column-inner-bg-wrapper\" style=\"--awb-inner-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\" data-scroll-devices=\"small-visibility,medium-visibility,large-visibility\"><span class=\"fusion-column-inner-bg hover-type-none\"><a class=\"fusion-column-anchor\" href=\"#recommendations-for-early-detection\"><span class=\"fusion-column-inner-bg-image\"><\/span><\/a><\/span><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-row fusion-content-nowrap\"><ul style=\"--awb-iconcolor:var(--awb-color1);--awb-textcolor:var(--awb-custom10);--awb-line-height:30.6px;--awb-icon-width:30.6px;--awb-icon-height:30.6px;--awb-icon-margin:12.6px;--awb-content-margin:43.2px;--awb-circlecolor:var(--awb-custom10);--awb-circle-yes-font-size:15.84px;\" class=\"fusion-checklist fusion-checklist-11 fusion-checklist-default type-icons\"><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-yes\"><i class=\"fusion-li-icon fa-arrow-alt-down fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\">\n<p><span data-teams=\"true\">Surveillance Recommendations<\/span><\/p>\n<\/div><\/li><\/ul><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-27 fusion_builder_column_inner_1_1 1_1 fusion-flex-column fusion-column-inner-bg-wrapper\" style=\"--awb-inner-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\" data-scroll-devices=\"small-visibility,medium-visibility,large-visibility\"><span class=\"fusion-column-inner-bg hover-type-none\"><a class=\"fusion-column-anchor\" href=\"#further-information\"><span class=\"fusion-column-inner-bg-image\"><\/span><\/a><\/span><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-row fusion-content-nowrap\"><ul style=\"--awb-iconcolor:var(--awb-color1);--awb-textcolor:var(--awb-custom10);--awb-line-height:30.6px;--awb-icon-width:30.6px;--awb-icon-height:30.6px;--awb-icon-margin:12.6px;--awb-content-margin:43.2px;--awb-circlecolor:var(--awb-custom10);--awb-circle-yes-font-size:15.84px;\" class=\"fusion-checklist fusion-checklist-12 fusion-checklist-default type-icons\"><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-yes\"><i class=\"fusion-li-icon fa-arrow-alt-down fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\">\n<p>Further Information (e.g., Links to Support Groups)<\/p>\n<\/div><\/li><\/ul><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div id=\"diagnose\" class=\"fusion-container-anchor\"><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-3 fusion-flex-container has-pattern-background has-mask-background hundred-percent-fullwidth non-hundred-percent-height-scrolling fusion-custom-z-index\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-z-index:160;--awb-padding-top:0px;--awb-padding-right:0px;--awb-padding-bottom:0px;--awb-padding-left:0px;--awb-margin-top:-55px;--awb-margin-top-medium:-25px;--awb-margin-top-small:-25px;--awb-background-color:var(--awb-color1);--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"width:104% !important;max-width:104% !important;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-7 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-overflow:hidden;--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-builder-row fusion-builder-row-inner fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"width:104% !important;max-width:104% !important;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-28 fusion_builder_column_inner_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-section-separator section-separator bigtriangle fusion-section-separator-1\" style=\"--awb-spacer-height:100px;--awb-svg-margin-left:1.92%;--awb-svg-margin-right:1.92%;--awb-svg-margin-left-medium:1.92%;--awb-svg-margin-right-medium:1.92%;--awb-svg-margin-left-small:1.92%;--awb-svg-margin-right-small:1.92%;--awb-divider-height:100px;--awb-spacer-padding-top:inherit;--awb-divider-height-medium:75px;--awb-spacer-height-medium:75px;--awb-divider-height-small:50px;--awb-spacer-height-small:50px;--awb-sep-padding:0;--awb-svg-padding:0;\"><div class=\"fusion-section-separator-svg\"><svg class=\"fusion-big-triangle-candy\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" version=\"1.1\" width=\"100%\" height=\"100\" viewBox=\"0 0 100 100\" preserveAspectRatio=\"none\" fill=\"rgba(231,246,255,1)\"><path d=\"M-1 -1 L50 99 L101 -1 Z\"><\/path><\/svg><\/div><div class=\"fusion-section-separator-spacer\"><div class=\"fusion-section-separator-spacer-height\"><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div id=\"diagnose\" class=\"fusion-container-anchor\"><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-4 fusion-flex-container has-pattern-background has-mask-background hundred-percent-fullwidth non-hundred-percent-height-scrolling fusion-custom-z-index\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-z-index:150;--awb-padding-top:0px;--awb-padding-right:0px;--awb-padding-bottom:0px;--awb-padding-left:0px;--awb-background-color:var(--awb-color1);--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"width:104% !important;max-width:104% !important;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-8 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-overflow:hidden;--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:-30px;width:100%;\"><div class=\"fusion-separator-border sep-single sep-solid\" style=\"--awb-height:20px;--awb-amount:20px;--awb-sep-color:var(--awb-color1);border-color:var(--awb-color1);border-top-width:50px;\"><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div id=\"diagnosis\" class=\"fusion-container-anchor\"><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-5 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling fusion-custom-z-index\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-z-index:140;--awb-margin-top:-50px;--awb-margin-bottom:-50px;--awb-margin-top-medium:-25px;--awb-margin-bottom-medium:-50px;--awb-margin-top-small:-25px;--awb-margin-bottom-small:-50px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1456px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-9 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-section-separator section-separator bigtriangle fusion-section-separator-2\" style=\"--awb-spacer-height:100px;--awb-svg-margin-left:1.92%;--awb-svg-margin-right:1.92%;--awb-svg-margin-left-medium:1.92%;--awb-svg-margin-right-medium:1.92%;--awb-svg-margin-left-small:1.92%;--awb-svg-margin-right-small:1.92%;--awb-divider-height:100px;--awb-spacer-padding-top:inherit;--awb-divider-height-medium:75px;--awb-spacer-height-medium:75px;--awb-divider-height-small:50px;--awb-spacer-height-small:50px;--awb-sep-padding:0;--awb-svg-padding:0;\"><div class=\"fusion-section-separator-svg\"><svg class=\"fusion-big-triangle-candy\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" version=\"1.1\" width=\"100%\" height=\"100\" viewBox=\"0 0 100 100\" preserveAspectRatio=\"none\" fill=\"rgba(255,255,255,1)\"><path d=\"M-1 -1 L50 99 L101 -1 Z\"><\/path><\/svg><\/div><div class=\"fusion-section-separator-spacer\"><div class=\"fusion-section-separator-spacer-height\"><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-6 fusion-flex-container has-pattern-background has-mask-background fusion-parallax-none nonhundred-percent-fullwidth non-hundred-percent-height-scrolling fusion-custom-z-index\" style=\"--awb-background-position:center bottom;--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-z-index:130;--awb-padding-top:150px;--awb-padding-bottom:100px;--awb-padding-top-medium:125px;--awb-padding-bottom-medium:80px;--awb-padding-top-small:100px;--awb-padding-bottom-small:75px;--awb-background-image:url(&quot;https:\/\/www.krebs-praedisposition.de\/wp-content\/uploads\/2022\/04\/FIT_HG_Gentapete-hellgrau-EF-Verlauf-04.jpg&quot;);--awb-background-size:cover;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1456px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-10 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:60px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-margin-bottom-medium:50px;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-margin-bottom-small:20px;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-3 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-two\" style=\"--awb-margin-right:10%;--awb-margin-bottom:10px;--awb-margin-left:10%;--awb-margin-bottom-small:5px;--awb-margin-top-medium:0px;--awb-margin-right-medium:0px;--awb-margin-bottom-medium:10px;--awb-margin-left-medium:0px;\"><h2 class=\"fusion-title-heading title-heading-center\" style=\"margin:0;\">SAMD9 Deficiency \u2013 Diagnosis<\/h2><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:0px;margin-bottom:0px;width:100%;\"><div class=\"fusion-separator-border sep-single sep-solid\" style=\"--awb-height:20px;--awb-amount:20px;--awb-sep-color:var(--awb-custom10);border-color:var(--awb-custom10);border-top-width:5px;\"><\/div><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-11 fusion_builder_column_1_3 1_3 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:33.333333333333%;--awb-margin-top-large:0px;--awb-spacing-right-large:5.76%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:5.76%;--awb-width-medium:25%;--awb-order-medium:0;--awb-spacing-right-medium:7.68%;--awb-spacing-left-medium:7.68%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-margin-bottom-small:-15px;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-image-element \" style=\"text-align:center;--awb-margin-right-small:20%;--awb-margin-bottom-small:25px;--awb-margin-left-small:20%;--awb-max-width:300px;--awb-caption-title-font-family:var(--h2_typography-font-family);--awb-caption-title-font-weight:var(--h2_typography-font-weight);--awb-caption-title-font-style:var(--h2_typography-font-style);--awb-caption-title-size:var(--h2_typography-font-size);--awb-caption-title-transform:var(--h2_typography-text-transform);--awb-caption-title-line-height:var(--h2_typography-line-height);--awb-caption-title-letter-spacing:var(--h2_typography-letter-spacing);\"><span class=\" fusion-imageframe imageframe-none imageframe-1 hover-type-none\"><img decoding=\"async\" width=\"1000\" height=\"1000\" src=\"https:\/\/www.krebs-praedisposition.de\/wp-content\/uploads\/2023\/03\/FIT_ICON-LEXIKON_Diagnose.png\" alt class=\"img-responsive wp-image-26581\" srcset=\"https:\/\/www.krebs-praedisposition.de\/wp-content\/uploads\/2023\/03\/FIT_ICON-LEXIKON_Diagnose-200x200.png 200w, https:\/\/www.krebs-praedisposition.de\/wp-content\/uploads\/2023\/03\/FIT_ICON-LEXIKON_Diagnose-400x400.png 400w, https:\/\/www.krebs-praedisposition.de\/wp-content\/uploads\/2023\/03\/FIT_ICON-LEXIKON_Diagnose-600x600.png 600w, https:\/\/www.krebs-praedisposition.de\/wp-content\/uploads\/2023\/03\/FIT_ICON-LEXIKON_Diagnose-800x800.png 800w, https:\/\/www.krebs-praedisposition.de\/wp-content\/uploads\/2023\/03\/FIT_ICON-LEXIKON_Diagnose.png 1000w\" sizes=\"(max-width: 1299px) 100vw, (max-width: 640px) 100vw, 600px\" \/><\/span><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-12 fusion_builder_column_2_3 2_3 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:66.666666666667%;--awb-margin-top-large:0px;--awb-spacing-right-large:2.88%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:2.88%;--awb-width-medium:75%;--awb-order-medium:0;--awb-spacing-right-medium:2.56%;--awb-spacing-left-medium:2.56%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-4 fusion-sep-none fusion-title-text fusion-title-size-four\" style=\"--awb-margin-bottom-small:0px;--awb-margin-top-medium:0px;--awb-margin-bottom-medium:0px;\"><h4 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\">Genetic Diagnostics<\/h4><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:0px;margin-bottom:28px;width:100%;\"><div class=\"fusion-separator-border sep-single sep-solid\" style=\"--awb-height:20px;--awb-amount:20px;--awb-sep-color:var(--awb-custom13);border-color:var(--awb-custom13);border-top-width:3px;\"><\/div><\/div><div class=\"fusion-text fusion-text-18 fusion-text-no-margin\" style=\"--awb-text-transform:none;--awb-margin-bottom:40px;\"><p>The &#8220;SAMD9 deficiency&#8221; diagnosis is confirmed by detecting a heterozygous pathogenic germline variant of the <em>SAMD9<\/em> gene by sequence analysis.<\/p>\n<p>In hematopoietic cells of carriers of a pathogenic <em>SAMD9<\/em> variant, the pathogenic variant is &#8220;toxic&#8221;. The frequently observed loss of genetic material from chromosome 7 (e.g., monosomy 7) in hematopoietic cells of affected individuals leads to a loss of the mutated allele (adaptation-by-aneuploidy mechanism). Therefore, it may be useful to analyze non-hematopoietic tissue for diagnostic purposes. The frequently observed monosomy 7 appears to be an important leukemogenesis step in these patients.<\/p>\n<\/div><div class=\"fusion-title title fusion-title-5 fusion-sep-none fusion-title-text fusion-title-size-four\" style=\"--awb-margin-bottom-small:0px;--awb-margin-top-medium:0px;--awb-margin-bottom-medium:0px;\"><h4 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\">Differential Diagnoses<\/h4><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:0px;margin-bottom:10px;width:100%;\"><div class=\"fusion-separator-border sep-single sep-solid\" style=\"--awb-height:20px;--awb-amount:20px;--awb-sep-color:var(--awb-custom13);border-color:var(--awb-custom13);border-top-width:3px;\"><\/div><\/div><div class=\"fusion-text fusion-text-19 fusion-text-no-margin\" style=\"--awb-text-transform:none;\"><ul>\n<li>SAMD9L deficiency<\/li>\n<li>IMAGe syndrome &#8211; <strong>I<\/strong>ntrauterine growth retardation,<strong> m<\/strong>etaphyseal dysplasia, <strong>a<\/strong>drenal hypoplasia, <strong>g<\/strong>enital anomalies (pathogenic variant in the <em>CDKN1C<\/em> gene)<\/li>\n<\/ul>\n<\/div><\/div><\/div><\/div><\/div><div id=\"clinical-presentation\" class=\"fusion-container-anchor\"><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-7 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling fusion-custom-z-index\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-z-index:120;--awb-margin-top:-50px;--awb-margin-bottom:0px;--awb-margin-top-medium:-25px;--awb-margin-bottom-medium:0px;--awb-margin-top-small:-25px;--awb-margin-bottom-small:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1456px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-13 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-section-separator section-separator bigtriangle fusion-section-separator-3\" style=\"--awb-spacer-height:100px;--awb-svg-margin-left:1.92%;--awb-svg-margin-right:1.92%;--awb-svg-margin-left-medium:1.92%;--awb-svg-margin-right-medium:1.92%;--awb-svg-margin-left-small:1.92%;--awb-svg-margin-right-small:1.92%;--awb-divider-height:100px;--awb-spacer-padding-top:inherit;--awb-divider-height-medium:75px;--awb-spacer-height-medium:75px;--awb-divider-height-small:50px;--awb-spacer-height-small:50px;--awb-sep-padding:0;--awb-svg-padding:0;\"><div class=\"fusion-section-separator-svg\"><svg class=\"fusion-big-triangle-candy\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" version=\"1.1\" width=\"100%\" height=\"100\" viewBox=\"0 0 100 100\" preserveAspectRatio=\"none\" fill=\"rgba(239,239,239,1)\"><path d=\"M-1 -1 L50 99 L101 -1 Z\"><\/path><\/svg><\/div><div class=\"fusion-section-separator-spacer\"><div class=\"fusion-section-separator-spacer-height\"><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-8 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling fusion-custom-z-index\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-z-index:110;--awb-padding-top:100px;--awb-padding-bottom:100px;--awb-padding-top-medium:75px;--awb-padding-bottom-medium:100px;--awb-padding-top-small:50px;--awb-padding-bottom-small:75px;--awb-background-color:var(--awb-color1);--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1456px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-14 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:60px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-margin-bottom-medium:50px;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-margin-bottom-small:20px;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-6 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-two\" style=\"--awb-margin-right:10%;--awb-margin-bottom:10px;--awb-margin-left:10%;--awb-margin-bottom-small:5px;--awb-margin-top-medium:0px;--awb-margin-right-medium:0px;--awb-margin-bottom-medium:10px;--awb-margin-left-medium:0px;\"><h2 class=\"fusion-title-heading title-heading-center\" style=\"margin:0;\">Clinical Presentation<\/h2><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;width:100%;\"><div class=\"fusion-separator-border sep-single sep-solid\" style=\"--awb-height:20px;--awb-amount:20px;--awb-sep-color:var(--awb-custom10);border-color:var(--awb-custom10);border-top-width:5px;\"><\/div><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-15 fusion_builder_column_1_3 1_3 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:33.333333333333%;--awb-margin-top-large:0px;--awb-spacing-right-large:5.76%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:5.76%;--awb-width-medium:25%;--awb-order-medium:0;--awb-spacing-right-medium:7.68%;--awb-spacing-left-medium:7.68%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-margin-bottom-small:-15px;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-image-element \" style=\"text-align:center;--awb-margin-right-small:20%;--awb-margin-bottom-small:25px;--awb-margin-left-small:20%;--awb-max-width:300px;--awb-caption-title-font-family:var(--h2_typography-font-family);--awb-caption-title-font-weight:var(--h2_typography-font-weight);--awb-caption-title-font-style:var(--h2_typography-font-style);--awb-caption-title-size:var(--h2_typography-font-size);--awb-caption-title-transform:var(--h2_typography-text-transform);--awb-caption-title-line-height:var(--h2_typography-line-height);--awb-caption-title-letter-spacing:var(--h2_typography-letter-spacing);\"><span class=\" fusion-imageframe imageframe-none imageframe-2 hover-type-none\"><img decoding=\"async\" width=\"1000\" height=\"1000\" title=\"FIT_ICON-LEXIKON_Krebsentstehung\" src=\"https:\/\/www.krebs-praedisposition.de\/wp-content\/uploads\/2023\/02\/FIT_ICON-LEXIKON_Krebsentstehung.png\" alt class=\"img-responsive wp-image-21075\" srcset=\"https:\/\/www.krebs-praedisposition.de\/wp-content\/uploads\/2023\/02\/FIT_ICON-LEXIKON_Krebsentstehung-200x200.png 200w, https:\/\/www.krebs-praedisposition.de\/wp-content\/uploads\/2023\/02\/FIT_ICON-LEXIKON_Krebsentstehung-400x400.png 400w, https:\/\/www.krebs-praedisposition.de\/wp-content\/uploads\/2023\/02\/FIT_ICON-LEXIKON_Krebsentstehung-600x600.png 600w, https:\/\/www.krebs-praedisposition.de\/wp-content\/uploads\/2023\/02\/FIT_ICON-LEXIKON_Krebsentstehung-800x800.png 800w, https:\/\/www.krebs-praedisposition.de\/wp-content\/uploads\/2023\/02\/FIT_ICON-LEXIKON_Krebsentstehung.png 1000w\" sizes=\"(max-width: 1299px) 100vw, (max-width: 640px) 100vw, 600px\" \/><\/span><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-16 fusion_builder_column_2_3 2_3 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:66.666666666667%;--awb-margin-top-large:0px;--awb-spacing-right-large:2.88%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:2.88%;--awb-width-medium:75%;--awb-order-medium:0;--awb-spacing-right-medium:2.56%;--awb-spacing-left-medium:2.56%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-20 fusion-text-no-margin\" style=\"--awb-text-transform:none;--awb-margin-bottom:40px;\"><p>SAMD9 deficiency can lead to diseases in various organ systems.<\/p>\n<\/div><div class=\"fusion-title title fusion-title-7 fusion-sep-none fusion-title-text fusion-title-size-four\" style=\"--awb-margin-bottom-small:0px;--awb-margin-top-medium:0px;--awb-margin-bottom-medium:0px;\"><h4 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\">Myelodysplasia<\/h4><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:0px;margin-bottom:30px;width:100%;\"><div class=\"fusion-separator-border sep-single sep-solid\" style=\"--awb-height:20px;--awb-amount:20px;--awb-sep-color:var(--awb-custom13);border-color:var(--awb-custom13);border-top-width:3px;\"><\/div><\/div><div class=\"fusion-text fusion-text-21 fusion-text-no-margin\" style=\"--awb-text-transform:none;--awb-margin-bottom:40px;\"><p>Hematological abnormalities include transient or persistent thrombocytopenia and\/or anemia, which usually occur in infancy but resolve spontaneously. Mild lymphopenia may also occur, and some patients may develop leukopenia. Rarely, myelodysplastic syndrome (MDS) may develop.<\/p>\n<\/div><div class=\"fusion-title title fusion-title-8 fusion-sep-none fusion-title-text fusion-title-size-four\" style=\"--awb-margin-bottom-small:0px;--awb-margin-top-medium:0px;--awb-margin-bottom-medium:0px;\"><h4 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\">Infections<\/h4><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:0px;margin-bottom:28px;width:100%;\"><div class=\"fusion-separator-border sep-single sep-solid\" style=\"--awb-height:20px;--awb-amount:20px;--awb-sep-color:var(--awb-custom13);border-color:var(--awb-custom13);border-top-width:3px;\"><\/div><\/div><div class=\"fusion-text fusion-text-22 fusion-text-no-margin\" style=\"--awb-text-transform:none;--awb-margin-bottom:40px;\"><p>Almost all patients diagnosed to date have developed severe, sometimes recurrent infections, often in the form of sepsis, meningitis, or systemic mycosis. Recurrent viral or bacterial infections can also occur. Severe infections are often fatal before the child reaches the age of two.<\/p>\n<\/div><div class=\"fusion-title title fusion-title-9 fusion-sep-none fusion-title-text fusion-title-size-four\" style=\"--awb-margin-bottom-small:0px;--awb-margin-top-medium:0px;--awb-margin-bottom-medium:0px;\"><h4 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\">Retarded Growth<\/h4><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:0px;margin-bottom:28px;width:100%;\"><div class=\"fusion-separator-border sep-single sep-solid\" style=\"--awb-height:20px;--awb-amount:20px;--awb-sep-color:var(--awb-custom13);border-color:var(--awb-custom13);border-top-width:3px;\"><\/div><\/div><div class=\"fusion-text fusion-text-23 fusion-text-no-margin\" style=\"--awb-text-transform:none;--awb-margin-bottom:40px;\"><p>Patients with the pathogenic variant in <em>SAMD9<\/em> are characterized by retarded longitudinal growth and low body weight, both pre-and postnatally. Some patients also have intellectual and\/or motor developmental delays.<\/p>\n<\/div><div class=\"fusion-title title fusion-title-10 fusion-sep-none fusion-title-text fusion-title-size-four\" style=\"--awb-margin-bottom-small:0px;--awb-margin-top-medium:0px;--awb-margin-bottom-medium:0px;\"><h4 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\">Adrenal Hypoplasia<\/h4><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:0px;margin-bottom:28px;width:100%;\"><div class=\"fusion-separator-border sep-single sep-solid\" style=\"--awb-height:20px;--awb-amount:20px;--awb-sep-color:var(--awb-custom13);border-color:var(--awb-custom13);border-top-width:3px;\"><\/div><\/div><div class=\"fusion-text fusion-text-24 fusion-text-no-margin\" style=\"--awb-text-transform:none;--awb-margin-bottom:40px;\"><p>Adrenal hypoplasia, which is frequently described in the context of a pathogenic <em>SAMD9<\/em> variant, is usually noticeable due to skin hyperpigmentation even before salt loss symptoms occur. Adrenal hypoplasia has been diagnosed in all patients examined sonographically to date.<\/p>\n<\/div><div class=\"fusion-title title fusion-title-11 fusion-sep-none fusion-title-text fusion-title-size-four\" style=\"--awb-margin-bottom-small:0px;--awb-margin-top-medium:0px;--awb-margin-bottom-medium:0px;\"><h4 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\">Genital Anomalies<\/h4><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:0px;margin-bottom:28px;width:100%;\"><div class=\"fusion-separator-border sep-single sep-solid\" style=\"--awb-height:20px;--awb-amount:20px;--awb-sep-color:var(--awb-custom13);border-color:var(--awb-custom13);border-top-width:3px;\"><\/div><\/div><div class=\"fusion-text fusion-text-25 fusion-text-no-margin\" style=\"--awb-text-transform:none;--awb-margin-bottom:40px;\"><p>All patients with a male karyotype showed genital underdevelopment in the form of micropenis, cryptorchidism, hypospadias and even a completely female external genitalia. Patients with a female karyotype may have hypoplastic or dysgenetic ovaries with only a few primordial follicles. The ovaries may also be completely absent.<\/p>\n<\/div><div class=\"fusion-title title fusion-title-12 fusion-sep-none fusion-title-text fusion-title-size-four\" style=\"--awb-margin-bottom-small:0px;--awb-margin-top-medium:0px;--awb-margin-bottom-medium:0px;\"><h4 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\">Enteropathy<\/h4><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:0px;margin-bottom:28px;width:100%;\"><div class=\"fusion-separator-border sep-single sep-solid\" style=\"--awb-height:20px;--awb-amount:20px;--awb-sep-color:var(--awb-custom13);border-color:var(--awb-custom13);border-top-width:3px;\"><\/div><\/div><div class=\"fusion-text fusion-text-26 fusion-text-no-margin\" style=\"--awb-text-transform:none;--awb-margin-bottom:20px;\"><p>Enteropathy is manifested by chronic diarrhea and colonic dilatation in the context of a\u00a0 pathogenic variant in <em>SAMD9<\/em>. Gastroesophageal reflux may also be present.<\/p>\n<p>Furthermore, an open ductus arteriosus, a hypoplastic or absent thymus, recurrent urinary tract infections and skeletal anomalies (congenital scoliosis, radial club hand, overlapping fingers, club feet, congenital flat feet) have been described.<\/p>\n<\/div><\/div><\/div><\/div><\/div><div id=\"special-features-of-treatment\" class=\"fusion-container-anchor\"><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-9 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling fusion-custom-z-index\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-z-index:100;--awb-margin-top:-50px;--awb-margin-bottom:-50px;--awb-margin-top-medium:-25px;--awb-margin-bottom-medium:-50px;--awb-margin-top-small:-25px;--awb-margin-bottom-small:-50px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1456px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-17 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-section-separator section-separator bigtriangle fusion-section-separator-4\" style=\"--awb-spacer-height:100px;--awb-svg-margin-left:1.92%;--awb-svg-margin-right:1.92%;--awb-svg-margin-left-medium:1.92%;--awb-svg-margin-right-medium:1.92%;--awb-svg-margin-left-small:1.92%;--awb-svg-margin-right-small:1.92%;--awb-divider-height:100px;--awb-spacer-padding-top:inherit;--awb-divider-height-medium:75px;--awb-spacer-height-medium:75px;--awb-divider-height-small:50px;--awb-spacer-height-small:50px;--awb-sep-padding:0;--awb-svg-padding:0;\"><div class=\"fusion-section-separator-svg\"><svg class=\"fusion-big-triangle-candy\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" version=\"1.1\" width=\"100%\" height=\"100\" viewBox=\"0 0 100 100\" preserveAspectRatio=\"none\" fill=\"rgba(255,255,255,1)\"><path d=\"M-1 -1 L50 99 L101 -1 Z\"><\/path><\/svg><\/div><div class=\"fusion-section-separator-spacer\"><div class=\"fusion-section-separator-spacer-height\"><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-10 fusion-flex-container has-pattern-background has-mask-background fusion-parallax-none nonhundred-percent-fullwidth non-hundred-percent-height-scrolling fusion-custom-z-index\" style=\"--awb-background-position:center bottom;--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-z-index:90;--awb-padding-top:150px;--awb-padding-bottom:100px;--awb-padding-top-medium:125px;--awb-padding-bottom-medium:100px;--awb-padding-top-small:100px;--awb-padding-bottom-small:75px;--awb-background-image:url(&quot;https:\/\/www.krebs-praedisposition.de\/wp-content\/uploads\/2022\/04\/FIT_HG_Gentapete-hellgrau-EF-Verlauf-04.jpg&quot;);--awb-background-size:cover;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1456px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-18 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:60px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-margin-bottom-medium:50px;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-margin-bottom-small:20px;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-13 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-two\" style=\"--awb-margin-right:10%;--awb-margin-bottom:10px;--awb-margin-left:10%;--awb-margin-bottom-small:5px;--awb-margin-top-medium:0px;--awb-margin-right-medium:0px;--awb-margin-bottom-medium:10px;--awb-margin-left-medium:0px;\"><h2 class=\"fusion-title-heading title-heading-center\" style=\"margin:0;\">Special Features of Treatment<\/h2><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;width:100%;\"><div class=\"fusion-separator-border sep-single sep-solid\" style=\"--awb-height:20px;--awb-amount:20px;--awb-sep-color:var(--awb-custom10);border-color:var(--awb-custom10);border-top-width:5px;\"><\/div><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-19 fusion_builder_column_1_3 1_3 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:33.333333333333%;--awb-margin-top-large:0px;--awb-spacing-right-large:5.76%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:5.76%;--awb-width-medium:25%;--awb-order-medium:0;--awb-spacing-right-medium:7.68%;--awb-spacing-left-medium:7.68%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-margin-bottom-small:-15px;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-image-element \" style=\"text-align:center;--awb-margin-right-small:20%;--awb-margin-bottom-small:25px;--awb-margin-left-small:20%;--awb-max-width:300px;--awb-caption-title-font-family:var(--h2_typography-font-family);--awb-caption-title-font-weight:var(--h2_typography-font-weight);--awb-caption-title-font-style:var(--h2_typography-font-style);--awb-caption-title-size:var(--h2_typography-font-size);--awb-caption-title-transform:var(--h2_typography-text-transform);--awb-caption-title-line-height:var(--h2_typography-line-height);--awb-caption-title-letter-spacing:var(--h2_typography-letter-spacing);\"><span class=\" fusion-imageframe imageframe-none imageframe-3 hover-type-none\"><img decoding=\"async\" width=\"1000\" height=\"1000\" title=\"FIT_ICON-LEXIKON_Therapie\" src=\"https:\/\/www.krebs-praedisposition.de\/wp-content\/uploads\/2023\/02\/FIT_ICON-LEXIKON_Therapie.png\" alt class=\"img-responsive wp-image-21077\" srcset=\"https:\/\/www.krebs-praedisposition.de\/wp-content\/uploads\/2023\/02\/FIT_ICON-LEXIKON_Therapie-200x200.png 200w, https:\/\/www.krebs-praedisposition.de\/wp-content\/uploads\/2023\/02\/FIT_ICON-LEXIKON_Therapie-400x400.png 400w, https:\/\/www.krebs-praedisposition.de\/wp-content\/uploads\/2023\/02\/FIT_ICON-LEXIKON_Therapie-600x600.png 600w, https:\/\/www.krebs-praedisposition.de\/wp-content\/uploads\/2023\/02\/FIT_ICON-LEXIKON_Therapie-800x800.png 800w, https:\/\/www.krebs-praedisposition.de\/wp-content\/uploads\/2023\/02\/FIT_ICON-LEXIKON_Therapie.png 1000w\" sizes=\"(max-width: 1299px) 100vw, (max-width: 640px) 100vw, 600px\" \/><\/span><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-20 fusion_builder_column_2_3 2_3 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:66.666666666667%;--awb-margin-top-large:0px;--awb-spacing-right-large:2.88%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:2.88%;--awb-width-medium:75%;--awb-order-medium:0;--awb-spacing-right-medium:2.56%;--awb-spacing-left-medium:2.56%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-27 fusion-text-no-margin\"><p>The treatment of patients with SAMD9 deficiency should be interdisciplinary, and the therapy should be individually adapted to the respective manifestation.<\/p>\n<p>If MDS occurs, it is advisable to discuss it with the EWOG-MDS study management. A bone marrow transplant may be an option for patients with MDS.<\/p>\n<\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-11 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling fusion-custom-z-index\" style=\"--awb-border-sizes-top:10px;--awb-border-color:var(--awb-custom10);--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-z-index:60;--awb-padding-top:50px;--awb-padding-bottom:30px;--awb-padding-top-small:60px;--awb-padding-bottom-small:60px;--awb-background-image:linear-gradient(180deg, var(--awb-custom14) 0%,var(--awb-custom15) 100%);--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-stretch fusion-flex-content-wrap\" style=\"max-width:1456px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-21 fusion_builder_column_1_1 1_1 fusion-flex-column fusion-no-medium-visibility fusion-no-large-visibility\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-14 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-two\" style=\"--awb-text-color:var(--awb-color1);--awb-margin-bottom-small:5px;\"><h2 class=\"fusion-title-heading title-heading-center\" style=\"margin:0;\">Diagnosis ofSAMD9 Deficiency- What's Next?<\/h2><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-bottom:40px;width:100%;\"><div class=\"fusion-separator-border sep-single sep-solid\" style=\"--awb-height:20px;--awb-amount:20px;--awb-sep-color:var(--awb-color1);border-color:var(--awb-color1);border-top-width:5px;\"><\/div><\/div><div class=\"fusion-text fusion-text-28 fusion-text-no-margin\" style=\"--awb-content-alignment:center;--awb-text-transform:none;--awb-text-color:var(--awb-color1);--awb-margin-right:10%;\"><p>Once diagnosed, it is recommended that a cancer predisposition specialist manage the patient. The following section explains whether cancer screening tests or other measures are necessary and how they should be performed. Some additional information, including links to support groups, is also included at the end of this page.<\/p>\n<\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-22 fusion_builder_column_1_2 1_2 fusion-flex-column fusion-no-small-visibility\" style=\"--awb-padding-top:20px;--awb-padding-right:50px;--awb-padding-bottom:20px;--awb-bg-size:cover;--awb-border-color:var(--awb-color1);--awb-border-top:0;--awb-border-right:2px;--awb-border-bottom:0;--awb-border-left:0;--awb-border-style:solid;--awb-width-large:50%;--awb-margin-top-large:0px;--awb-spacing-right-large:0px;--awb-margin-bottom-large:0px;--awb-spacing-left-large:3.84%;--awb-width-medium:50%;--awb-order-medium:0;--awb-spacing-right-medium:0px;--awb-spacing-left-medium:3.84%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-center fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-15 fusion-sep-none fusion-title-text fusion-title-size-two\" style=\"--awb-text-color:var(--awb-color1);--awb-margin-left:10%;--awb-margin-top-medium:0px;--awb-margin-right-medium:0px;--awb-margin-bottom-medium:0px;--awb-margin-left-medium:0px;\"><h2 class=\"fusion-title-heading title-heading-right\" style=\"margin:0;\">Diagnosis of SAMD9 Deficiency - What's Next?<\/h2><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-23 fusion_builder_column_1_2 1_2 fusion-flex-column fusion-no-small-visibility\" style=\"--awb-padding-top:20px;--awb-padding-bottom:20px;--awb-padding-left:50px;--awb-bg-size:cover;--awb-border-color:var(--awb-color1);--awb-border-top:0;--awb-border-right:0;--awb-border-bottom:0;--awb-border-left:2px;--awb-border-style:solid;--awb-width-large:50%;--awb-margin-top-large:0px;--awb-spacing-right-large:3.84%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:0px;--awb-width-medium:50%;--awb-order-medium:0;--awb-spacing-right-medium:3.84%;--awb-spacing-left-medium:0px;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-center fusion-content-layout-column\"><div class=\"fusion-text fusion-text-29 fusion-text-no-margin\" style=\"--awb-content-alignment:left;--awb-text-transform:none;--awb-text-color:var(--awb-color1);--awb-margin-right:10%;\"><p>Once diagnosed, it is recommended that a cancer predisposition specialist manage the patient. The following section explains whether cancer screening tests or other measures are necessary and how they should be performed. Some additional information, including links to support groups, is also included at the end of this page.<\/p>\n<\/div><\/div><\/div><\/div><\/div><div id=\"recommendations-for-early-detection\" class=\"fusion-container-anchor\"><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-12 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling fusion-custom-z-index\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-z-index:50;--awb-margin-top:-50px;--awb-margin-bottom:0px;--awb-margin-top-medium:-25px;--awb-margin-bottom-medium:0px;--awb-margin-top-small:-25px;--awb-margin-bottom-small:0px;--awb-background-color:#f6fcff;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1456px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-24 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-section-separator section-separator bigtriangle fusion-section-separator-5\" style=\"--awb-spacer-height:100px;--awb-svg-margin-left:1.92%;--awb-svg-margin-right:1.92%;--awb-svg-margin-left-medium:1.92%;--awb-svg-margin-right-medium:1.92%;--awb-svg-margin-left-small:1.92%;--awb-svg-margin-right-small:1.92%;--awb-divider-height:100px;--awb-spacer-padding-top:inherit;--awb-divider-height-medium:75px;--awb-spacer-height-medium:75px;--awb-divider-height-small:50px;--awb-spacer-height-small:50px;--awb-sep-padding:0;--awb-svg-padding:0;\"><div class=\"fusion-section-separator-svg\"><svg class=\"fusion-big-triangle-candy\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" version=\"1.1\" width=\"100%\" height=\"100\" viewBox=\"0 0 100 100\" preserveAspectRatio=\"none\" fill=\"rgba(58,79,92,1)\"><path d=\"M-1 -1 L50 99 L101 -1 Z\"><\/path><\/svg><\/div><div class=\"fusion-section-separator-spacer\"><div class=\"fusion-section-separator-spacer-height\"><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-13 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling fusion-custom-z-index\" style=\"--awb-background-position:center bottom;--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-z-index:40;--awb-padding-top:100px;--awb-padding-bottom:50px;--awb-padding-top-medium:75px;--awb-padding-bottom-medium:75px;--awb-padding-top-small:50px;--awb-padding-bottom-small:75px;--awb-margin-bottom:0px;--awb-background-image:linear-gradient(180deg, #f6fcff 0%,#f4fbff 100%);--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1456px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-25 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:60px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-margin-bottom-medium:50px;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-margin-bottom-small:20px;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-16 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-two\" style=\"--awb-margin-right:10%;--awb-margin-bottom:10px;--awb-margin-left:10%;--awb-margin-bottom-small:5px;--awb-margin-top-medium:0px;--awb-margin-right-medium:0px;--awb-margin-bottom-medium:10px;--awb-margin-left-medium:0px;\"><h2 class=\"fusion-title-heading title-heading-center\" style=\"margin:0;\"><span data-teams=\"true\">Surveillance Recommendations<\/span><\/h2><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;width:100%;\"><div class=\"fusion-separator-border sep-single sep-solid\" style=\"--awb-height:20px;--awb-amount:20px;--awb-sep-color:var(--awb-custom10);border-color:var(--awb-custom10);border-top-width:5px;\"><\/div><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-26 fusion_builder_column_1_3 1_3 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:33.333333333333%;--awb-margin-top-large:0px;--awb-spacing-right-large:5.76%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:5.76%;--awb-width-medium:25%;--awb-order-medium:0;--awb-spacing-right-medium:7.68%;--awb-spacing-left-medium:7.68%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-margin-bottom-small:-15px;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-image-element \" style=\"text-align:center;--awb-margin-right-small:20%;--awb-margin-bottom-small:25px;--awb-margin-left-small:20%;--awb-max-width:300px;--awb-caption-title-font-family:var(--h2_typography-font-family);--awb-caption-title-font-weight:var(--h2_typography-font-weight);--awb-caption-title-font-style:var(--h2_typography-font-style);--awb-caption-title-size:var(--h2_typography-font-size);--awb-caption-title-transform:var(--h2_typography-text-transform);--awb-caption-title-line-height:var(--h2_typography-line-height);--awb-caption-title-letter-spacing:var(--h2_typography-letter-spacing);\"><span class=\" fusion-imageframe imageframe-none imageframe-4 hover-type-none\"><img decoding=\"async\" width=\"1000\" height=\"1000\" src=\"https:\/\/www.krebs-praedisposition.de\/wp-content\/uploads\/2023\/03\/FIT_ICON-LEXIKON_Frueherkennung.png\" alt class=\"img-responsive wp-image-26582\" srcset=\"https:\/\/www.krebs-praedisposition.de\/wp-content\/uploads\/2023\/03\/FIT_ICON-LEXIKON_Frueherkennung-200x200.png 200w, https:\/\/www.krebs-praedisposition.de\/wp-content\/uploads\/2023\/03\/FIT_ICON-LEXIKON_Frueherkennung-400x400.png 400w, https:\/\/www.krebs-praedisposition.de\/wp-content\/uploads\/2023\/03\/FIT_ICON-LEXIKON_Frueherkennung-600x600.png 600w, https:\/\/www.krebs-praedisposition.de\/wp-content\/uploads\/2023\/03\/FIT_ICON-LEXIKON_Frueherkennung-800x800.png 800w, https:\/\/www.krebs-praedisposition.de\/wp-content\/uploads\/2023\/03\/FIT_ICON-LEXIKON_Frueherkennung.png 1000w\" sizes=\"(max-width: 1299px) 100vw, (max-width: 640px) 100vw, 600px\" \/><\/span><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-27 fusion_builder_column_2_3 2_3 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:66.666666666667%;--awb-margin-top-large:0px;--awb-spacing-right-large:2.88%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:2.88%;--awb-width-medium:75%;--awb-order-medium:0;--awb-spacing-right-medium:2.56%;--awb-spacing-left-medium:2.56%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-30 fusion-text-no-margin\" style=\"--awb-text-transform:none;\"><p>Patients with SAMD9 deficiency should be referred to a centre where they can receive appropriate haemato-oncological care and genetic counselling.<\/p>\n<p>Early detection measures should include<\/p>\n<ul>\n<li>Regular clinical examinations<\/li>\n<li>CBC including reticulocytes every 3-4 months<\/li>\n<li>Bone marrow aspiration and biopsy and somatic gene panel annually<\/li>\n<li>Patients with SAMD9 deficiency, their families and their physicians should be aware of suspicious clinical symptoms that may indicate the development of leukaemia<\/li>\n<li>Family history should be regularly updated for neoplasia, cytopenias and haemorrhages<\/li>\n<\/ul>\n<\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-14 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling fusion-custom-z-index\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-z-index:30;--awb-margin-top:0px;--awb-margin-bottom:-95px;--awb-margin-bottom-medium:-50px;--awb-margin-bottom-small:-25px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1456px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-28 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-section-separator section-separator big-half-circle fusion-section-separator-6\" style=\"--awb-spacer-height:100px;--awb-svg-margin-left:1.92%;--awb-svg-margin-right:1.92%;--awb-svg-margin-left-medium:1.92%;--awb-svg-margin-right-medium:1.92%;--awb-svg-margin-left-small:1.92%;--awb-svg-margin-right-small:1.92%;--awb-divider-height:100px;--awb-spacer-padding-top:inherit;--awb-divider-height-medium:50px;--awb-spacer-height-medium:50px;--awb-divider-height-small:25px;--awb-spacer-height-small:25px;--awb-sep-padding:0;--awb-svg-padding:0;\"><div class=\"fusion-section-separator-svg\"><svg class=\"fusion-big-half-circle-candy\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" version=\"1.1\" width=\"100%\" height=\"100\" viewBox=\"0 0 100 100\" preserveAspectRatio=\"none\" fill=\"rgba(244,251,255,1)\"><path d=\"M0 0 C55 180 100 0 100 0 Z\"><\/path><\/svg><\/div><div class=\"fusion-section-separator-spacer\"><div class=\"fusion-section-separator-spacer-height\"><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div id=\"further-information\" class=\"fusion-container-anchor\"><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-15 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling fusion-custom-z-index\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-z-index:20;--awb-padding-top:0px;--awb-padding-right:0px;--awb-padding-bottom:0px;--awb-padding-left:0px;--awb-margin-bottom:-100px;--awb-margin-bottom-medium:-50px;--awb-margin-bottom-small:-25px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1456px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-29 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;width:100%;\"><div class=\"fusion-separator-border sep-single sep-solid\" style=\"--awb-height:20px;--awb-amount:20px;--awb-sep-color:var(--awb-color1);border-color:var(--awb-color1);border-top-width:5px;\"><\/div><\/div><div class=\"fusion-section-separator section-separator big-half-circle fusion-section-separator-7\" style=\"--awb-spacer-height:100px;--awb-svg-margin-left:1.92%;--awb-svg-margin-right:1.92%;--awb-svg-margin-left-medium:1.92%;--awb-svg-margin-right-medium:1.92%;--awb-svg-margin-left-small:1.92%;--awb-svg-margin-right-small:1.92%;--awb-divider-height:100px;--awb-spacer-padding-top:inherit;--awb-divider-height-medium:50px;--awb-spacer-height-medium:50px;--awb-divider-height-small:25px;--awb-spacer-height-small:25px;--awb-sep-padding:0;--awb-svg-padding:0;\"><div class=\"fusion-section-separator-svg\"><svg class=\"fusion-big-half-circle-candy\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" version=\"1.1\" width=\"100%\" height=\"100\" viewBox=\"0 0 100 100\" preserveAspectRatio=\"none\" fill=\"rgba(255,255,255,1)\"><path d=\"M0 0 C55 180 100 0 100 0 Z\"><\/path><\/svg><\/div><div class=\"fusion-section-separator-spacer\"><div class=\"fusion-section-separator-spacer-height\"><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-16 fusion-flex-container has-pattern-background has-mask-background fusion-parallax-none nonhundred-percent-fullwidth non-hundred-percent-height-scrolling fusion-custom-z-index\" style=\"--awb-background-position:center bottom;--awb-background-repeat:repeat-x;--awb-background-blend-mode:overlay;--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-overflow:hidden;--awb-z-index:10;--awb-padding-top:150px;--awb-padding-bottom:98px;--awb-background-image:url(&quot;https:\/\/www.krebs-praedisposition.de\/wp-content\/uploads\/2024\/05\/1f9b4316-8c45-4ff3-82ed-42ccb0969b29.png&quot;);--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-stretch fusion-flex-content-wrap\" style=\"max-width:1456px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-30 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:60px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\" data-scroll-devices=\"small-visibility,medium-visibility,large-visibility\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-17 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-two\" style=\"--awb-margin-right:10%;--awb-margin-bottom:10px;--awb-margin-left:10%;\"><h2 class=\"fusion-title-heading title-heading-center\" style=\"margin:0;\">SAMD9 Deficiency- Further Information<\/h2><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:0px;margin-bottom:0px;width:100%;\"><div class=\"fusion-separator-border sep-single sep-solid\" style=\"--awb-height:20px;--awb-amount:20px;--awb-sep-color:#871c40;border-color:#871c40;border-top-width:5px;\"><\/div><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-31 fusion_builder_column_1_2 1_2 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:50%;--awb-margin-top-large:0px;--awb-spacing-right-large:3.84%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:3.84%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\" data-scroll-devices=\"small-visibility,medium-visibility,large-visibility\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-18 fusion-sep-none fusion-title-text fusion-title-size-five\"><h5 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\"><p class=\"fusion-title-heading title-heading-left\">Open Clinical Trials\/ Registers<\/p><\/h5><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:0px;margin-bottom:10px;width:100%;\"><div class=\"fusion-separator-border sep-single sep-solid\" style=\"--awb-height:20px;--awb-amount:20px;--awb-sep-color:#939ea6;border-color:#939ea6;border-top-width:3px;\"><\/div><\/div><div class=\"fusion-text fusion-text-31 fusion-text-no-margin\" style=\"--awb-margin-bottom:-20px;\"><ul>\n<li><a href=\"https:\/\/ewog-mds-saa.org\/\">EWOG-MDS<\/a><\/li>\n<li><a href=\"https:\/\/www.krebs-praedisposition.de\/en\/cps-research\/cps-registry\/\">CPS Registry\u00a0<\/a><\/li>\n<\/ul>\n<\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-bottom:50px;width:100%;\"><\/div><div class=\"fusion-title title fusion-title-19 fusion-sep-none fusion-title-text fusion-title-size-five\"><h5 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\"><p class=\"fusion-title-heading title-heading-left\">Additional Resources and Links<\/p><\/h5><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:0px;margin-bottom:10px;width:100%;\"><div class=\"fusion-separator-border sep-single sep-solid\" style=\"--awb-height:20px;--awb-amount:20px;--awb-sep-color:#939ea6;border-color:#939ea6;border-top-width:3px;\"><\/div><\/div><div class=\"fusion-text fusion-text-32 fusion-text-no-margin\" style=\"--awb-margin-bottom:20px;\"><p>Unfortunately, we are not aware of any support groups for patients with SAMD9 Deficiency. We will add new information as soon as it becomes available.<\/p>\n<\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-32 fusion_builder_column_1_2 1_2 fusion-flex-column\" style=\"--awb-padding-top:30px;--awb-padding-right:30px;--awb-padding-bottom:20px;--awb-padding-left:30px;--awb-overflow:hidden;--awb-bg-size:cover;--awb-border-color:#c38d9f;--awb-border-top:3px;--awb-border-right:3px;--awb-border-bottom:3px;--awb-border-left:3px;--awb-border-style:solid;--awb-border-radius:25px 25px 25px 25px;--awb-width-large:50%;--awb-margin-top-large:0px;--awb-spacing-right-large:3.84%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:3.84%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\" data-scroll-devices=\"small-visibility,medium-visibility,large-visibility\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-20 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-five small-text-groesser medium-text-groesser\" style=\"--awb-margin-bottom:10px;\"><h5 class=\"fusion-title-heading title-heading-center\" style=\"margin:0;\">Sources<\/h5><\/div><div class=\"fusion-text fusion-text-33 fusion-text-no-margin\" style=\"--awb-font-size:12px;\"><ul>\n<li><em>Maese LD, Wlodarski MW, Kim SY, et al. Update on Recommendations for Surveillance for Children with Predisposition to Hematopoietic Malignancy. Clin Cancer Res. 2024;30(19):4286-4295. doi:10.1158\/1078-0432.CCR-24-0685<\/em><\/li>\n<li><em>Christopher C. Porter,\u00a0Todd E. Druley,\u00a0Ayelet Erez,\u00a0et al. Recommendations for Surveillance for Children with Leukemia-Predisposing Conditions.\u00a0<\/em>Clin Cancer Res<em>\u00a01 June 2017; 23 (11): e14\u2013e22.\u00a0https:\/\/doi.org\/10.1158\/1078-0432.CCR-17-0428<\/em><\/li>\n<\/ul>\n<\/div><\/div><\/div><\/div><\/div><\/p>\n","protected":false},"featured_media":0,"template":"","class_list":["post-27168","kompendium","type-kompendium","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.krebs-praedisposition.de\/en\/wp-json\/wp\/v2\/kompendium\/27168","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.krebs-praedisposition.de\/en\/wp-json\/wp\/v2\/kompendium"}],"about":[{"href":"https:\/\/www.krebs-praedisposition.de\/en\/wp-json\/wp\/v2\/types\/kompendium"}],"wp:attachment":[{"href":"https:\/\/www.krebs-praedisposition.de\/en\/wp-json\/wp\/v2\/media?parent=27168"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}