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Genetics Home Reference: your guide to understanding genetic conditions     A service of the U.S. National Library of Medicine®

Ghosal hematodiaphyseal dysplasia

Reviewed March 2014

What is Ghosal hematodiaphyseal dysplasia?

Ghosal hematodiaphyseal dysplasia is a rare inherited condition characterized by abnormally thick bones and a shortage of red blood cells (anemia). Signs and symptoms of the condition become apparent in early childhood.

In affected individuals, the long bones in the arms and legs are unusually dense and wide. The bone changes specifically affect the shafts of the long bones, called diaphyses, and areas near the ends of the bones called metaphyses. The bone abnormalities can lead to bowing of the legs and difficulty walking.

Ghosal hematodiaphyseal dysplasia also causes scarring (fibrosis) of the bone marrow, which is the spongy tissue inside long bones where blood cells are formed. The abnormal bone marrow cannot produce enough red blood cells, which leads to anemia. Signs and symptoms of anemia that have been reported in people with Ghosal hematodiaphyseal dysplasia include extremely pale skin (pallor) and excessive tiredness (fatigue).

How common is Ghosal hematodiaphyseal dysplasia?

Ghosal hematodiaphyseal dysplasia is a rare disorder; only a few cases have been reported in the medical literature. Most affected individuals have been from the Middle East and India.

What genes are related to Ghosal hematodiaphyseal dysplasia?

Ghosal hematodiaphyseal dysplasia results from mutations in the TBXAS1 gene. This gene provides instructions for making an enzyme called thromboxane A synthase 1, which acts as part of a chemical signaling pathway involved in normal blood clotting (hemostasis). Based on its role in Ghosal hematodiaphyseal dysplasia, researchers suspect that thromboxane A synthase 1 may also be important for bone remodeling, which is a normal process in which old bone is removed and new bone is created to replace it, and for the production of red blood cells in bone marrow.

Mutations in the TBXAS1 gene severely reduce the activity of thromboxane A synthase 1. Studies suggest that a lack of this enzyme's activity may lead to abnormal bone remodeling and fibrosis of the bone marrow. However, the mechanism by which a shortage of thromboxane A synthase 1 activity leads to the particular abnormalities characteristic of Ghosal hematodiaphyseal dysplasia is unclear.

Related Gene(s)

Changes in this gene are associated with Ghosal hematodiaphyseal dysplasia.

  • TBXAS1

How do people inherit Ghosal hematodiaphyseal dysplasia?

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 Ghosal hematodiaphyseal dysplasia?

These resources address the diagnosis or management of Ghosal hematodiaphyseal dysplasia and may include treatment providers.

  • Genetic Testing Registry: Ghosal syndrome (
  • National Heart, Lung, and Blood Institute: How is Anemia Diagnosed? (
  • National Heart, Lung, and Blood Institute: How is Anemia Treated? (

You might also find information on the diagnosis or management of Ghosal hematodiaphyseal dysplasia in Educational resources and Patient support.

General information about the diagnosis ( and management ( of genetic conditions is available in the Handbook. Read more about genetic testing (, particularly the difference between clinical tests and research tests (

To locate a healthcare provider, see How can I find a genetics professional in my area? ( in the Handbook.

Where can I find additional information about Ghosal hematodiaphyseal dysplasia?

You may find the following resources about Ghosal hematodiaphyseal dysplasia 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 Ghosal hematodiaphyseal dysplasia?

  • diaphyseal dysplasia associated with anemia
  • GHDD
  • Ghosal hemato-diaphyseal dysplasia
  • Ghosal syndrome
  • Ghosal-type hemato-diaphyseal dysplasia

For more information about naming genetic conditions, see the Genetics Home Reference Condition Naming Guidelines ( and How are genetic conditions and genes named? ( in the Handbook.

What if I still have specific questions about Ghosal hematodiaphyseal dysplasia?

Ask the Genetic and Rare Diseases Information Center (

What glossary definitions help with understanding Ghosal hematodiaphyseal dysplasia?

anemia ; autosomal ; autosomal recessive ; blood clotting ; bone marrow ; bone remodeling ; cell ; clotting ; dysplasia ; enzyme ; fibrosis ; gene ; hemostasis ; inherited ; pallor ; recessive ; syndrome ; tissue

You may find definitions for these and many other terms in the Genetics Home Reference Glossary.


  • Geneviève D, Proulle V, Isidor B, Bellais S, Serre V, Djouadi F, Picard C, Vignon-Savoye C, Bader-Meunier B, Blanche S, de Vernejoul MC, Legeai-Mallet L, Fischer AM, Le Merrer M, Dreyfus M, Gaussem P, Munnich A, Cormier-Daire V. Thromboxane synthase mutations in an increased bone density disorder (Ghosal syndrome). Nat Genet. 2008 Mar;40(3):284-6. doi: 10.1038/ng.2007.66. Epub 2008 Feb 10. (
  • Ghosal SP, Mukherjee AK, Mukherjee D, Ghosh AK. Diaphyseal dysplasia associated with anemia. J Pediatr. 1988 Jul;113(1 Pt 1):49-57. Erratum in: J Pediatr 1988 Aug;113(2):410. (
  • Gümrük F, Besim A, Altay C. Ghosal haemato-diaphyseal dysplasia: a new disorder. Eur J Pediatr. 1993 Mar;152(3):218-21. (
  • Isidor B, Dagoneau N, Huber C, Genevieve D, Bader-Meunier B, Blanche S, Picard C, De Vernejoul MC, Munnich A, Le Merrer M, Cormier-Daire V. A gene responsible for Ghosal hemato-diaphyseal dysplasia maps to chromosome 7q33-34. Hum Genet. 2007 Apr;121(2):269-73. Epub 2007 Jan 3. (


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? ( in the Handbook.

Reviewed: March 2014
Published: February 8, 2016