{"id":27173,"date":"2024-05-26T16:02:54","date_gmt":"2024-05-26T14:02:54","guid":{"rendered":"https:\/\/www.krebs-praedisposition.de\/?post_type=kompendium&#038;p=27173"},"modified":"2025-08-26T13:51:59","modified_gmt":"2025-08-26T11:51:59","slug":"samd9l-deficiency","status":"publish","type":"kompendium","link":"https:\/\/www.krebs-praedisposition.de\/en\/kompendium\/samd9l-deficiency\/","title":{"rendered":"SAMD9L 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;\">SAMD9L 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>SAMD9L deficiency, also called ataxia pancytopenia syndrome (ATXPC, OMIM #159550) is a genetic disease caused by pathogenic variants in the <em>SAMD9L<\/em> gene. It is characterized by cerebellar ataxia, varying degrees of hematological cytopenia, and a predisposition to bone marrow failure, myelodysplastic syndrome, and acute myeloid leukemia.<\/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>Ataxia pancytopenia 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>SAMD9L<\/em> (sterile alpha motif domain containing 9-like 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>Gene \u00adproduct:<\/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>SAMD9L<\/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>Plays a role in cell proliferation, mostly as a tumor suppressor<\/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<\/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>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-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>Incomplete<br \/>\nThe overall phenotypic pattern of hematological and neurological manifestations is very variable.<\/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\">SAMD9L 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\">SAMD9L 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\">SAMD9L 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\">SAMD9L 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;\">SAMD9L 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;\">Suspected Diagnosis<\/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>ATXPC is suspected in persons who exhibit more than one of the following findings:<\/p>\n<ul>\n<li>Cerebellar ataxia<\/li>\n<li>Variable hematological cytopenia in at least one cell line (e.g. anemia, neutropenia, thrombocytopenia)<\/li>\n<li>Myeloid leukemia or myelodysplastic syndrome with partial or complete, in part transient monosomy 7<\/li>\n<li>Cerebellar atrophy and changes in the white substance in the MRI<\/li>\n<li>A positive family history for one of the above findings<\/li>\n<\/ul>\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;\">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-19 fusion-text-no-margin\" style=\"--awb-text-transform:none;--awb-margin-bottom:40px;\"><p>The diagnosis of \u201cSAMD9L deficiency\u201d is confirmed by <span style=\"box-sizing: border-box; margin: 0px; padding: 0px;\">detecting a heterozygous pathogenic germline variant in the <em>SAMD9L<\/em> gene through single-gene (sequence) analysis or using<\/span>\u00a0panel studies consisting of multiple genes.<\/p>\n<p>The pathogenic <em>SAMD9L<\/em> variant is \u201ctoxic\u201d to hematopoietic cells of pathogenic variant carriers. The frequently observed loss of genetic material of chromosome 7 (e.g., monosomy 7) in hematopoietic cells in those affected results in a loss of the mutated allele (adaptation through the aneuploidy mechanism). For this reason, it may be helpful to analyze non-hematopoietic tissue for diagnostic purposes. Commonly observed monosomy 7 appears to be an essential leukemogenic step in these patients.<\/p>\n<\/div><div class=\"fusion-title title fusion-title-6 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;\">Clinical 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-20 fusion-text-no-margin\" style=\"--awb-text-transform:none;--awb-margin-bottom:40px;\"><p>To determine the extent of the disease, the following clinical diagnostics should be carried out after the genetic diagnosis has been established:<\/p>\n<ul>\n<li>Evaluation of the medical history<\/li>\n<li>Clinical examination, including a neurological examination<\/li>\n<li>Cranial MRI<\/li>\n<li>Complete blood count<\/li>\n<li>Bone marrow puncture<\/li>\n<\/ul>\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;\">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-21 fusion-text-no-margin\" style=\"--awb-text-transform:none;--awb-margin-bottom:40px;\"><ul>\n<li>Severe aplastic anemia<\/li>\n<li>Idiopathic thrombocytopenic purpura<\/li>\n<li>X-chromosomal sideroblastic anemia and ataxia<\/li>\n<li><a href=\"https:\/\/www.krebs-praedisposition.de\/en\/kompendium\/ataxia-telangiectasia\/\">Ataxia telangiectasia<\/a><\/li>\n<li><a href=\"https:\/\/www.krebs-praedisposition.de\/en\/kompendium\/fanconi-anemia\/\">Fanconi anemia<\/a><\/li>\n<li><a href=\"https:\/\/www.krebs-praedisposition.de\/en\/kompendium\/dyskeratosis-congenita\/\">Dyskeratosis congenita<\/a><\/li>\n<li>MIRAGE syndrome (SAMD9 deficiency)<\/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-8 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-22 fusion-text-no-margin\" style=\"--awb-text-transform:none;--awb-margin-bottom:20px;\"><p>Clinical manifestations usually occur for the first time during childhood, although the age of manifestation and the severity of the neurological or hematological diseases varies greatly within a particular family and between families. Hematological and neurological diseases are not concordant in their severity.<\/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;\">Hematological Manifestations<\/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-23 fusion-text-no-margin\" style=\"--awb-text-transform:none;--awb-margin-bottom:40px;\"><p>The occurrence and age of manifestation varies greatly with hematological manifestations. The earliest occurrence described was at the age of 3 months. Cytopenias of all cell lines may range from mild to very severe. Anemia occurs in many cases, while immunodeficiency is only described in one family. In addition, cases of myelodysplastic syndrome or acute myeloid leukemia (AML) are described that are frequently associated with partial or complete monosomy 7.<\/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;\">Neurological Manifestations<\/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:20px;\"><p>A neurological manifestation has so far been diagnosed in all patients with a pathogenic <em>SAMD9L<\/em> variant. The age of manifestation varies greatly, with ages ranging from infancy to 62 years. Ataxia usually presents itself clinically as horizontal and vertical nystagmus, dysmetria, tendon reflexes, and easily triggered clonus of the foot. A positive Babinski reflex was able to be observed in a few patients. Impaired gait and other neurological abnormalities generally exhibit a slow progression. X-rays show cerebellar atrophy and changes in the white substance.<\/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-11 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-25 fusion-text-no-margin\" style=\"--awb-margin-bottom:40px;\"><p>Patients with SAMD9L deficiency should be treated by an interdisciplinary team, and it is helpful to discuss this with the EWOG MDS principal investigator.<\/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;\">Hematological Manifestations<\/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-26 fusion-text-no-margin\"><ul>\n<li>With thrombocytopenia, NSAID, anticoagulants, and thrombolytically active substances should be avoided.<\/li>\n<li>Administer erythrocyte or thrombocyte concentrates depending on the severity of the cytopenia.<\/li>\n<li>Treatment of other causes of anemia, such as with iron or vitamin substitution<\/li>\n<li>Treatment of myeloid neoplasia in patients with a pathogenic <em>SAMD9L<\/em> variant should be discussed thoroughly with the corresponding study center.<\/li>\n<li>A bone marrow transplant may be an option, especially for patients with myeloid neoplasia.<\/li>\n<\/ul>\n<\/div><div class=\"fusion-title title fusion-title-13 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;\">Neurological Manifestations<\/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-27 fusion-text-no-margin\"><p>The treatment of ataxia is purely supportive since no therapy is yet available that can slow down or stop the progression of the disease.<\/p>\n<ul>\n<li>Alcohol and sedating medications should be avoided since they impair gait and coordination even more.<\/li>\n<li>Patients should remain mobile as long as possible. Walking aids can help to prevent falls.<\/li>\n<li>Keep weight under control since obesity will limit mobility even more.<\/li>\n<\/ul>\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 of SAMD9L 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 SAMD9L 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 SAMD9L deficiency should be referred to a centre where they can receive appropriate haemato-oncological care and genetic counselling.<\/p>\n<p>Screening should include the following<\/p>\n<ul>\n<li>Regular clinical examinations<\/li>\n<li>Complete blood count including reticulocytes every 3-4 months<\/li>\n<li>Bone marrow aspiration and biopsy and somatic gene panel annually<\/li>\n<li>SAMD9L deficiency patients, their families and their attending 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:100px;--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;\">SAMD9L 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 Study<\/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;\"><ul>\n<li><a href=\"https:\/\/www.facebook.com\/groups\/samd9l\">SAMD9L Support group on Facebook<\/a><\/li>\n<\/ul>\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-27173","kompendium","type-kompendium","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.krebs-praedisposition.de\/en\/wp-json\/wp\/v2\/kompendium\/27173","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=27173"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}