Red cell disorders
Gene: ATP11C
10 individuals (4 M, 6F) from 7 unrelated families with haemolytic anemia (+/- iron overload) with a wide range of ages at diagnosis. The group identified 6 rare and novel variants in ATP11C gene (3 missense, 2 splice, 1 3'UTR). Skewed XCI explained the phenotypic expression in female patients. Functional studies were performed on 3 of the variants (p.R467C, p.D609V, and c.2226-1G>C), and revealed reduced ATP11C protein expression, as well as decreased flippase activity both in vitro and in ex vivo RBCs supporting a loss-of-function mechanism. Other papers have shown that ATP11C deficiency in murine models leads to a range of hematopoietic defects, including impaired B cell development, altered erythroid maturation, and increased apoptosis of hematopoietic progenitors.Created: 7 May 2026, 4:18 p.m.
Mode of inheritance
X-LINKED: hemizygous mutation in males, monoallelic mutations in females may cause disease (may be less severe, later onset than males)
Phenotypes
X-linked congenital hemolytic anemia, MONDO:0060455
Publications
PMID: 40869043 reports 3 unrelated families with haemolytic anaemia and ATP11C variants. Probands were all hemizygous boys who had maternally inherited variants, all variants were absent or only has 1 het in gnomad. One family had a frameshift, another ha 2 missense variants in cis, and the third had a -7 splice variant that RT-PCR showed resulted in an in frame insertion. 2 probands were shown to have normal G6PD activity and haemoglobin, the third was not tested. The proband with the ATP11C frameshift also had a de novo missense in ANK1
PMID: 37892263, 37671681, 26944472 report 3 hemizygous male haemolytic anaemia. However 2 of the patients had pathogenic variants in genes associated with spherocytosis SPTA1 and ANK1. The ATP11C variants were absent or rare in gnomad (note papers use different transcripts/p. numbering to gnomad).
PMID: 41523080 reports 2 of the same patients as PMID:40869043 and additionally looked at Val972Met in a very large cohort of blood donors, but this variant is called Val969Met in gnomad where it has thousands of hets and hemizygotes.
Sources: LiteratureCreated: 18 Feb 2026, 2:18 p.m.
Mode of inheritance
X-LINKED: hemizygous mutation in males, monoallelic mutations in females may cause disease (may be less severe, later onset than males)
Phenotypes
Hemolytic anemia, congenital, X-linked MIM#301015
Publications
Gene: atp11c has been classified as Green List (High Evidence).
Phenotypes for gene: ATP11C were changed from X-linked congenital hemolytic anemia, MONDO:0060455 to X-linked congenital hemolytic anemia, MONDO:0060455
Phenotypes for gene: ATP11C were changed from Hemolytic anemia, congenital, X-linked MIM#301015 to X-linked congenital hemolytic anemia, MONDO:0060455
Publications for gene: ATP11C were set to 41523080; 40869043; 37892263; 37671681; 26944472
Gene: atp11c has been classified as Green List (High Evidence).
gene: ATP11C was added gene: ATP11C was added to Red cell disorders. Sources: Expert Review Amber,Literature Mode of inheritance for gene: ATP11C was set to X-LINKED: hemizygous mutation in males, monoallelic mutations in females may cause disease (may be less severe, later onset than males) Publications for gene: ATP11C were set to 41523080; 40869043; 37892263; 37671681; 26944472 Phenotypes for gene: ATP11C were set to Hemolytic anemia, congenital, X-linked MIM#301015