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PubMed · 16417868

Answer to hypotonia: a simple hemogram.

Güler Kanra·Mualla Cetin·Sule Unal·Goknur Haliloglu·Tulay Akça·Nejat Akalan·Ates Kara
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Abstract

A 1-year-old boy with weight loss, decreased activity, and psychomotor regression is presented. He was subjected to an extremely detailed evaluation, including electroencephalography (EEG) and magnetic resonance imaging (MRI), until a simple hemogram in our center revealed that he had macrocytic anemia with megaloblastic changes in the bone marrow. His history revealed that he had been exclusively breast-fed by his vegetarian mother. Further investigations showed low serum vitamin B12 concentration, methylmalonic aciduria, and homocysteinemia, indicating that the macrocytic anemia was due to vitamin B12 deficiency. This boy represents a case of macrocytic anemia and hypotonia owing to vitamin B12 deficiency that developed because of exclusive breast-feeding by a vegetarian mother.

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Anemia, MacrocyticChild DevelopmentElectroencephalographyHematologic TestsHumansInfantMagnetic Resonance ImagingMaleMuscle HypotoniaVitamin B 12 DeficiencyWeight LossCase ReportsJournal Article

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Güler Kanra, Mualla Cetin, Sule Unal, Goknur Haliloglu, Tulay Akça, Nejat Akalan, Ates Kara. 2005. Answer to hypotonia: a simple hemogram.. https://doi.org/10.1177/08830738050200111501

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E2f4 regulates fetal erythropoiesis through the promotion of cellular proliferation.

The E2F proteins are major regulators of the transcriptional program required to coordinate cell cycle progression and exit. In particular, E2f4 has been proposed to be the principal family member responsible for the regulation of cell cycle exit chiefly through its transcriptional repressive properties. We have previously shown that E2f4(-/-) mice display a marked macrocytic anemia implicating E2f4 in the regulation of erythropoiesis. However, these studies could not distinguish whether E2f4 was required for differentiation, survival, or proliferation control. Here, we describe a novel function for E2f4 in the promotion of erythroid proliferation. We show that loss of E2f4 results in an impaired expansion of the fetal erythroid compartment in vivo that is associated with impaired cell cycle progression and decreased erythroid proliferation. Consistent with these observations, cDNA microarray analysis reveals cell cycle control genes as one of the major class of genes down-regulated in E2f4(-/-) FLs, and we provide evidence that E2f4 may directly regulate the transcriptional expression of a number of these genes. We conclude that the macrocytic anemia of E2f4(-/-) mice results primarily from impaired cellular proliferation and that the major role of E2f4 in fetal erythropoiesis is to promote cell cycle progression and cellular proliferation.

Anemia, Macrocytic↗