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Genetics Home Reference: your guide to understanding genetic conditions
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Shwachman-Diamond syndrome

Reviewed December 2007

What is Shwachman-Diamond syndrome?

Shwachman-Diamond syndrome is an inherited condition that affects many parts of the body, particularly the bone marrow, pancreas, and skeletal system.

The major function of bone marrow is to produce new blood cells. These include red blood cells, which carry oxygen to the body's tissues; white blood cells, which fight infection; and platelets, which are necessary for normal blood clotting. In Shwachman-Diamond syndrome, the bone marrow malfunctions and does not make some or all types of white blood cells. A shortage of neutrophils, the most common type of white blood cell, causes a condition called neutropenia. Most people with Shwachman-Diamond syndrome have at least occasional episodes of neutropenia, which makes them more vulnerable to infections such as pneumonia, recurrent ear infections (otitis media), and skin infections. Less commonly, bone marrow abnormalities lead to a shortage of red blood cells (anemia), which causes fatigue and weakness, or a reduction in the amount of platelets (thrombocytopenia), which can result in easy bruising and abnormal bleeding.

People with Shwachman-Diamond syndrome have an increased risk of several serious complications related to their malfunctioning bone marrow. Specifically, they have a higher-than-average chance of developing myelodysplastic syndrome (MDS) and aplastic anemia, which are disorders that affect blood cell production, and a cancer of blood-forming tissue known as acute myeloid leukemia (AML).

Shwachman-Diamond syndrome also affects the pancreas, which is an organ that plays an essential role in digestion. One of this organ's main functions is to produce enzymes that help break down and use the nutrients from food. In most infants with Shwachman-Diamond syndrome, the pancreas does not produce enough of these enzymes. This condition is known as pancreatic insufficiency. Infants with pancreatic insufficiency have trouble digesting food and absorbing nutrients that are needed for growth. As a result, they often have fatty, foul-smelling stools (steatorrhea); are slow to grow and gain weight (failure to thrive); and experience malnutrition. Pancreatic insufficiency often improves with age in people with Shwachman-Diamond syndrome.

Skeletal abnormalities are another common feature of Shwachman-Diamond syndrome. Many affected individuals have problems with bone formation and growth, most often affecting the hips and knees. Low bone density is also frequently associated with this condition. Some infants are born with a narrow rib cage and short ribs, which can cause life-threatening problems with breathing. The combination of skeletal abnormalities and slow growth results in short stature in most people with this disorder.

The complications of this condition can affect several other parts of the body, including the liver, heart, endocrine system (which produces hormones), eyes, teeth, and skin. Additionally, studies suggest that Shwachman-Diamond syndrome may be associated with delayed speech and the delayed development of motor skills such as sitting, standing, and walking.

How common is Shwachman-Diamond syndrome?

Researchers are not sure how common Shwachman-Diamond syndrome is. Several hundred cases have been reported in scientific studies.

What genes are related to Shwachman-Diamond syndrome?

Mutations in the SBDS gene have been identified in about 90 percent of people with the characteristic features of Shwachman-Diamond syndrome. This gene provides instructions for making a protein whose function is unknown, although it is active in cells throughout the body. Researchers suspect that the SBDS protein may play a role in processing RNA (a molecule that is a chemical cousin of DNA). This protein may also be involved in building ribosomes, which are cellular structures that process the cell's genetic instructions to create proteins. It is unclear how SBDS mutations lead to the major signs and symptoms of Shwachman-Diamond syndrome.

In cases where no SBDS mutation is found, the cause of this disorder is unknown.

Related Gene(s)

Changes in this gene are associated with Shwachman-Diamond syndrome.

  • SBDS

How do people inherit Shwachman-Diamond syndrome?

This condition is inherited in an autosomal recessive pattern, which means both copies of the gene in each cell have mutations. The parents of an individual with an autosomal recessive condition each carry one copy of the mutated gene, but they typically do not show signs and symptoms of the condition.

Where can I find information about diagnosis or management of Shwachman-Diamond syndrome?

These resources address the diagnosis or management of Shwachman-Diamond syndrome and may include treatment providers.

  • Gene Review: Shwachman-Diamond Syndrome (http://www.ncbi.nlm.nih.gov/books/NBK1756/)
  • Genetic Testing Registry: Shwachman syndrome (http://www.ncbi.nlm.nih.gov/gtr/conditions/C0272170)
  • MedlinePlus Encyclopedia: Malabsorption (http://www.nlm.nih.gov/medlineplus/ency/article/000299.htm)

You might also find information on the diagnosis or management of Shwachman-Diamond syndrome in Educational resources (http://www.ghr.nlm.nih.gov/condition/shwachman-diamond-syndrome/show/Educational+resources) and Patient support (http://www.ghr.nlm.nih.gov/condition/shwachman-diamond-syndrome/show/Patient+support).

General information about the diagnosis (http://ghr.nlm.nih.gov/handbook/consult/diagnosis) and management (http://ghr.nlm.nih.gov/handbook/consult/treatment) of genetic conditions is available in the Handbook. Read more about genetic testing (http://ghr.nlm.nih.gov/handbook/testing), particularly the difference between clinical tests and research tests (http://ghr.nlm.nih.gov/handbook/testing/researchtesting).

To locate a healthcare provider, see How can I find a genetics professional in my area? (http://ghr.nlm.nih.gov/handbook/consult/findingprofessional) in the Handbook.

Where can I find additional information about Shwachman-Diamond syndrome?

You may find the following resources about Shwachman-Diamond syndrome helpful. These materials are written for the general public.

You may also be interested in these resources, which are designed for healthcare professionals and researchers.

What other names do people use for Shwachman-Diamond syndrome?

  • Congenital Lipomatosis of Pancreas
  • Metaphyseal chondrodysplasia, Shwachman type
  • SDS
  • Shwachman-Bodian-Diamond syndrome
  • Shwachman-Bodian syndrome
  • Shwachman-Diamond-Oski Syndrome
  • Shwachman syndrome

For more information about naming genetic conditions, see the Genetics Home Reference Condition Naming Guidelines (http://ghr.nlm.nih.gov/ConditionNameGuide) and How are genetic conditions and genes named? (http://ghr.nlm.nih.gov/handbook/mutationsanddisorders/naming) in the Handbook.

What if I still have specific questions about Shwachman-Diamond syndrome?

Ask the Genetic and Rare Diseases Information Center (http://rarediseases.info.nih.gov/GARD/).

What glossary definitions help with understanding Shwachman-Diamond syndrome?

acute ; acute myeloid leukemia ; AML ; anemia ; aplastic anemia ; autosomal ; autosomal recessive ; blood clotting ; bone density ; bone formation ; bone marrow ; cancer ; cell ; clotting ; congenital ; deficiency ; digestion ; DNA ; endocrine system ; failure to thrive ; gene ; infection ; inherited ; leukemia ; molecule ; motor ; mutation ; myelodysplastic syndrome ; myeloid ; neutropenia ; neutrophils ; otitis media ; oxygen ; pancreas ; pancreatic ; platelets ; pneumonia ; protein ; recessive ; ribosomes ; RNA ; short stature ; stature ; steatorrhea ; syndrome ; thrombocytopenia ; tissue ; white blood cells

You may find definitions for these and many other terms in the Genetics Home Reference Glossary (http://www.ghr.nlm.nih.gov/glossary).

References

  • Dror Y, Donadieu J, Koglmeier J, Dodge J, Toiviainen-Salo S, Makitie O, Kerr E, Zeidler C, Shimamura A, Shah N, Cipolli M, Kuijpers T, Durie P, Rommens J, Siderius L, Liu JM. Draft consensus guidelines for diagnosis and treatment of Shwachman-Diamond syndrome. Ann N Y Acad Sci. 2011 Dec;1242:40-55. doi: 10.1111/j.1749-6632.2011.06349.x. (http://www.ncbi.nlm.nih.gov/pubmed/22191555?dopt=Abstract)
  • Dror Y. Shwachman-Diamond syndrome. Pediatr Blood Cancer. 2005 Dec;45(7):892-901. Review. (http://www.ncbi.nlm.nih.gov/pubmed/16047374?dopt=Abstract)
  • Grinspan ZM, Pikora CA. Infections in patients with Shwachman-Diamond syndrome. Pediatr Infect Dis J. 2005 Feb;24(2):179-81. Review. (http://www.ncbi.nlm.nih.gov/pubmed/15702050?dopt=Abstract)
  • Hall GW, Dale P, Dodge JA. Shwachman-Diamond syndrome: UK perspective. Arch Dis Child. 2006 Jun;91(6):521-4. Review. (http://www.ncbi.nlm.nih.gov/pubmed/16714727?dopt=Abstract)
  • Rothbaum R, Perrault J, Vlachos A, Cipolli M, Alter BP, Burroughs S, Durie P, Elghetany MT, Grand R, Hubbard V, Rommens J, Rossi T. Shwachman-Diamond syndrome: report from an international conference. J Pediatr. 2002 Aug;141(2):266-70. Review. (http://www.ncbi.nlm.nih.gov/pubmed/12183725?dopt=Abstract)
  • Shimamura A. Shwachman-Diamond syndrome. Semin Hematol. 2006 Jul;43(3):178-88. Review. (http://www.ncbi.nlm.nih.gov/pubmed/16822460?dopt=Abstract)

 

The resources on this site should not be used as a substitute for professional medical care or advice. Users seeking information about a personal genetic disease, syndrome, or condition should consult with a qualified healthcare professional. See How can I find a genetics professional in my area? (http://ghr.nlm.nih.gov/handbook/consult/findingprofessional) in the Handbook.

 
Reviewed: December 2007
Published: August 25, 2014