Causes & Symptoms

What causes Fanconi Anaemia?

Fanconi Anaemia (FA) is caused by a mutation (change) in one of the 23 genes that make up the FA DNA repair pathway. These genes help cells fix damage to DNA, and when they don’t work properly, damage builds up, often leading to bone marrow failure, a higher risk of certain cancers, and other health complications.


Most individuals with FA inherit the faulty gene from both parents. This is called autosomal recessive inheritance. Parents who each carry one FA gene change usually do not have symptoms themselves but can pass the mutation on to their children.


Some FA gene mutations, such as BRCA1 and BRCA2, are also known for increasing breast, ovarian, and other cancer risks outside of FA.

Talk to a genetic counsellor

Talk to a genetic counsellor

A genetic counsellor can help your family understand the information, choices, and support available around Fanconi Anaemia.

Understand how FA is inherited

Learn about carrier testing for relatives

Explore options for family planning

Access emotional support while processing genetic information

South African genetic counselling resources

Find a genetic counsellor: Rare Diseases South Africa

Find a genetic counsellor: Rare Diseases South Africa

FA Diagnostics (post-natal and prenatal)

Jennifer Geel / Gita Naidu · Division of Human Genetics, National Health Laboratory Service / University of the Witwatersrand, Johannesburg, Gauteng

FA symptoms vary widely from person to person. Some individuals show signs at birth, others before age 12, and some only in adulthood.

FA symptoms vary widely from person to person. Some individuals show signs at birth, others before age 12, and some only in adulthood.

Physical manifestations at birth may include:

Thumb, hand, or arm anomalies (e.g. misshapen, missing, or extra thumbs; absent or underdeveloped radius bone).

Thumb, hand, or arm anomalies (e.g. misshapen, missing, or extra thumbs; absent or underdeveloped radius bone).

Skeletal anomalies of the hips, spine, or ribs.

Skeletal anomalies of the hips, spine, or ribs.

Kidney problems, including missing kidney or horseshoe kidney.

Kidney problems, including missing kidney or horseshoe kidney.

Skin discolouration (café-au-lait spots) or areas that appear suntanned.

Skin discolouration (café-au-lait spots) or areas that appear suntanned.

Small head or eyes.

Small head or eyes.

Developmental or learning disabilities.

Developmental or learning disabilities.

Low birth weight, poor appetite, or delayed growth.

Low birth weight, poor appetite, or delayed growth.

Gastrointestinal difficulties.

Gastrointestinal difficulties.

Small reproductive organs in males.

Small reproductive organs in males.

Heart defects (e.g. issues in tissues separating heart chambers).

Heart defects (e.g. issues in tissues separating heart chambers).

Symptoms that may appear later in life include:

Low blood counts (cytopenia): anaemia (low red cells), leukopenia (low white cells), or thrombocytopenia (low platelets).

Low blood counts (cytopenia): anaemia (low red cells), leukopenia (low white cells), or thrombocytopenia (low platelets).

Low blood counts (cytopenia): anaemia (low red cells), leukopenia (low white cells), or thrombocytopenia (low platelets).

Myelodysplasia (MDS), Acute Myeloid Leukemia (AML), or squamous cell carcinoma — sometimes the first sign of FA in young adults.

Myelodysplasia (MDS), Acute Myeloid Leukemia (AML), or squamous cell carcinoma — sometimes the first sign of FA in young adults.

Myelodysplasia (MDS), Acute Myeloid Leukemia (AML), or squamous cell carcinoma — sometimes the first sign of FA in young adults.

Short stature (affects approximately 60% of individuals with FA).

Short stature (affects approximately 60% of individuals with FA).

Short stature (affects approximately 60% of individuals with FA).

Nosebleeds, easy bruising, significant fatigue, and recurrent infections due to bone marrow failure (often first detected via a complete blood count).

Nosebleeds, easy bruising, significant fatigue, and recurrent infections due to bone marrow failure (often first detected via a complete blood count).

Nosebleeds, easy bruising, significant fatigue, and recurrent infections due to bone marrow failure (often first detected via a complete blood count).

Systemic impacts of FA may include:

Because FA is a DNA repair disorder, it can affect many areas of the body, including:

Hands and arms (absent radii)

Hands and arms (absent radii)

Hands and arms (absent radii)

Hormonal imbalances

Hormonal imbalances

Hormonal imbalances

Blood-related disorders

Blood-related disorders

Blood-related disorders

Gastrointestinal and nutritional issues

Gastrointestinal and nutritional issues

Gastrointestinal and nutritional issues

Gynaecological concerns

Gynaecological concerns

Gynaecological concerns

Dermatological conditions

Dermatological conditions

Dermatological conditions

Hearing loss

Hearing loss

Hearing loss

Individuals with FA also face a much higher risk of developing various cancers, particularly solid tumors of the head and neck at a younger age. Learning about cancer prevention in FA is critical for parents, patients and their treating physicians.


The Fanconi Anaemia Clinical Care Guidelines (5th Edition), published by the Fanconi Anaemia Research Fund and authored by FA clinical specialists, is the most comprehensive resource on FA complications and care.