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A rare syndromic, inherited form of sideroblastic anemia in which the cause of the disease is a mutation in the ABCB7 gene and is characterized by mild to moderate anemia (with hypochromia and microcytosis) and early-onset, non- or slowly progressive spinocerebellar ataxia.
Features include always present findings: Language impairment, Short stature, Abnormal basal ganglia MRI signal intensity, and Interictal EEG abnormality and others; and very common findings: Ataxia, Increased erythrocyte protoporphyrin concentration, Low red blood cell count (anemia), and Gait ataxia and others. 60 total HPO annotations.
Organ System | Phenotype Count | Example Features |
|---|---|---|
Brain and nerves | 22 | Seizure, Ataxia, Depression |
Blood and immune system | 4 | Hypochromic microcytic anemia, Sideroblastic anemia, Low red blood cell count (anemia) |
Growth and development | 4 | Short stature, Weight loss, Intrauterine growth retardation |
Muscles | 4 | Low muscle tone (hypotonia), Shrinkage of the cerebellum (cerebellar atrophy), Reduced tendon reflexes |
Bones and joints | 3 | Postural instability, Bone marrow hypercellularity, Increased bone marrow iron |
Eyes | 2 | Strabismus, Nystagmus |
Lab test results | 1 | Increased erythrocyte protoporphyrin concentration |
ABCB7 encodes ATP binding cassette subfamily B member 7 (752 aa). Exports glutathione-coordinated iron-sulfur clusters such as [2Fe-2S]-(GS)4 cluster from the mitochondria to the cytosol in an ATP-dependent manner allowing the assembly of the cytosolic iron-sulfur (Fe/S) cluster-containing proteins and participates in iron homeostasis. Highest expression in Cells EBV-transformed lymphocytes (44.2 TPM) and Uterus (25.4 TPM).
X-linked sideroblastic anemia with ataxia is associated with mutations in the ABCB7 gene on chromosome X.
The ABCB7 protein participates in 4Fe-4S cluster assembles on NUBP2:NUBP1 scaffold, ABC7, mABC1 and mABC2 mediate heme transport, and Cytosolic iron-sulfur cluster assembly pathways.
ABCB7 is classified as a druggable target (Abc Transporter, Druggable Genome, and Transporter categories) with score 0.9.
7 pathogenic variants reported in ABCB7 in ClinVar.
Genetic testing for ABCB7 is available. Testing is considered confirmatory for diagnosis.
Phenotype severity distribution: 28 always present features, 6 very common features, 11 common features.
Estimated prevalence: <1 in 1,000,000 (VERY_RARE).
No clinical trials have been registered for X-linked sideroblastic anemia with ataxia.
2 publications have been identified in PubMed for X-linked sideroblastic anemia with ataxia. Research spans Review / Meta-Analysis (50%) and Basic Science / Preclinical (50%).
Ju S (2026). [PMID: 42103889](https://pubmed.ncbi.nlm.nih.gov/42103889/). *Commun Biol*. [Basic Science / Preclinical]
Ogunbileje JO (2024). [PMID: 38929857](https://pubmed.ncbi.nlm.nih.gov/38929857/). *J Pers Med*. [Review / Meta-Analysis]
Data assembled from 7 of 12 sources · Last updated Sep 19, 2026, 7:52 AM UTC
Online Mendelian Inheritance in Man
European rare disease database
Genetic and Rare Diseases Info Center
Common questions about X-linked sideroblastic anemia with ataxia