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Wu L, Peng Z, Lu S, Tan M, Rong Y, Tian R, Yang Y, Chen Y, Chen J. β‑thalassemia caused by compound heterozygous mutations and cured by bone marrow transplantation: A case report. Mol Med Rep 2017; 16:6552-6557. [PMID: 28901454 PMCID: PMC5865824 DOI: 10.3892/mmr.2017.7476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 05/25/2017] [Indexed: 11/25/2022] Open
Abstract
In the present study, a rare familial case of severe thalassemia with compound spontaneous mutations is reported. A 2.5-year-old boy, who suffered from severe anemia with yellowish skin, enlarged liver and spleen, was provided with a blood transfusion every 20 days to maintain hemoglobin levels between 90 and 100 g/l. Sanger sequencing combined with reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and Gap-PCR revealed that the proband was a carrier of 4 compound heterozygous mutations: Hemoglobin subunit β (HBB):IVS-II-654(C>T)β+; Southeast Asian-type-hereditary persistence of fetal hemoglobin (SEA-HPFH); HBB:c316-148G>T; hemoglobin subunit α2 (HBA2):c.46G>A. The father of the proband was identified as a carrier of the heterozygous SEA-HPFH mutation, the mother was a carrier of compound heterozygous mutations of HBB:IVS-II-654(C>T) and HBA2:c.46G>A, and the elder sister was heterozygous for HBB:IVS-II-654(C>T)β+. Based on these genetic results, it was determined that the proband had both of heavy β-thalassemia and α-thalassemia. Upon human leukocyte antigen matching, bone marrow transplantation (BMT) was successfully performed on the proband by selecting his HLA-compatible sister as a donor. Following treatment, the proband was revealed to only carry the IVS-II-654(C>T)β+ heterozygous mutation, and further regular blood transfusions have been avoided; BMT results remained normal at six months follow-up.
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Affiliation(s)
- Liusong Wu
- Department of Pediatrics, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China
| | - Zhiyu Peng
- Beijing Genomics Institute‑Shenzhen, Shenzhen, Guangdong 518000, P.R. China
| | - Sen Lu
- Beijing Genomics Institute‑Shenzhen, Shenzhen, Guangdong 518000, P.R. China
| | - Mei Tan
- Department of Pediatrics, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China
| | - Ying Rong
- Department of Pediatrics, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China
| | - Runmei Tian
- Department of Pediatrics, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China
| | - Yuhang Yang
- Department of Pediatrics, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China
| | - Yan Chen
- Department of Pediatrics, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China
| | - Jindong Chen
- Department of Urology, University of Rochester Medical Center, Rochester, NY 14642, USA
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He S, Qin Q, Lin L, Chen Q, Yi S, Wei H, Du J, Zheng C, Qiu X, Chen B. Complex Interaction of Hb Q-Thailand with α 0- and β 0-Thalassemia in a Chinese Family. Hemoglobin 2017; 41:68-72. [PMID: 28475397 DOI: 10.1080/03630269.2017.1295985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Hb Q-Thailand [α74(EF3)Asp→His (α1); HBA1: c.223 G>C] is an abnormal hemoglobin (Hb), variant found mainly in China and Southeast Asian countries. The association of the αQ-Thailand allele with other globin gene disorders has important implications in diagnosis. Here, we report a hitherto undescribed condition of patients with a double heterozygosity for Hb Q-Thailand with α0-thalassemia (α0-thal) and in combination with β0-thalassemia (β0-thal) in a Chinese family. Our study will provide some clinical manifestations, laboratory diagnosis and genetic counseling for complex hemoglobinopathies.
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Affiliation(s)
- Sheng He
- a Prenatal Diagnostic Center , Guangxi Zhuang Autonomous Region Women and Children Care Hospital , Nanning , Guangxi , People's Republic of China
| | - Qian Qin
- b Prenatal Diagnostic Center , Baise Women and Children Care Hospital , Baise , Guangxi , People's Republic of China
| | - Li Lin
- a Prenatal Diagnostic Center , Guangxi Zhuang Autonomous Region Women and Children Care Hospital , Nanning , Guangxi , People's Republic of China
| | - Qiuli Chen
- a Prenatal Diagnostic Center , Guangxi Zhuang Autonomous Region Women and Children Care Hospital , Nanning , Guangxi , People's Republic of China
| | - Shang Yi
- a Prenatal Diagnostic Center , Guangxi Zhuang Autonomous Region Women and Children Care Hospital , Nanning , Guangxi , People's Republic of China
| | - Honhwei Wei
- a Prenatal Diagnostic Center , Guangxi Zhuang Autonomous Region Women and Children Care Hospital , Nanning , Guangxi , People's Republic of China
| | - Juan Du
- a Prenatal Diagnostic Center , Guangxi Zhuang Autonomous Region Women and Children Care Hospital , Nanning , Guangxi , People's Republic of China
| | - Chenguang Zheng
- a Prenatal Diagnostic Center , Guangxi Zhuang Autonomous Region Women and Children Care Hospital , Nanning , Guangxi , People's Republic of China
| | - Xiaoxia Qiu
- a Prenatal Diagnostic Center , Guangxi Zhuang Autonomous Region Women and Children Care Hospital , Nanning , Guangxi , People's Republic of China
| | - Biyan Chen
- a Prenatal Diagnostic Center , Guangxi Zhuang Autonomous Region Women and Children Care Hospital , Nanning , Guangxi , People's Republic of China
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Chaibunruang A, Karnpean R, Fucharoen G, Fucharoen S. Genetic heterogeneity of hemoglobin AEBart's disease: A large cohort data from a single referral center in northeast Thailand. Blood Cells Mol Dis 2014; 52:176-80. [DOI: 10.1016/j.bcmd.2013.11.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Revised: 11/16/2013] [Accepted: 11/18/2013] [Indexed: 01/28/2023]
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Singha K, Fucharoen G, Fucharoen S. Five hemoglobin variants in a double heterozygote for α- and β-globin chain defects. Acta Haematol 2013; 131:71-5. [PMID: 24081021 DOI: 10.1159/000353123] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Accepted: 04/28/2013] [Indexed: 11/19/2022]
Abstract
Genetic interactions of different defective globin chains could render laboratory diagnostics in a routine setting difficult. We report a hitherto undescribed condition of double heterozygosity for hemoglobin (Hb) Q-Thailand with α(+)-thalassemia and Hb Tak found in 2 adult Thai individuals. Both patients were healthy and had no pertinent past medical history. A complete blood count revealed slight elevations of Hb and HCT values with low MCV and MCH. Interestingly, Hb analysis demonstrated, in addition to Hb A, A2, and F, as many as 5 Hb variants including Hb Tak (α(A)2β(Tak)2), Q-Thailand (α(QT)2β(A)2), QA2 (α(QT)2δ2), QF (α(QT)2γ2), and a novel variant, Hb QTak (α(QT)2β(Tak)2). Hematological findings of these unusual cases were compared with those of pure heterozygotes for Hb Q-Thailand and Hb Tak found in our series. Hb analysis using combined HPLC and capillary electrophoresis did help in the initial recognition and in making presumptive diagnoses, but definite diagnoses of these cases with complex α- and β-hemoglobinopathies could only be obtained after DNA analysis.
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Affiliation(s)
- Kritsada Singha
- Medical Sciences Program, Graduate School, Khon Kaen University, Khon Kaen, Thailand
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Dastidar R, Gajra B. Incidence of haemoglobin E and α-thalassaemia mutations and their interaction among the tribal populations of Assam and Arunachal Pradesh in North Eastern India. THE NUCLEUS 2013. [DOI: 10.1007/s13237-013-0088-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Khorshidi M, Roshan P, Bayat N, Mahdavi MR, Najmabadi H. Hemoglobin Q-Iran detected in family members from Northern Iran: a case report. J Med Case Rep 2012; 6:47. [PMID: 22309992 PMCID: PMC3293005 DOI: 10.1186/1752-1947-6-47] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2011] [Accepted: 02/06/2012] [Indexed: 11/12/2022] Open
Abstract
Introduction Hemoglobin Q-Iran (α75Asp→His) is an important member of the hemoglobin Q family, molecularly characterized by the replacement of aspartic acid by histidine. The first report of hemoglobin Q-Iran and the nomenclature of this hemoglobinopathy dates back to 1970. Iran is known as a country with a high prevalence of α- and β-thalassemia and different types of hemoglobinopathy. Many of these variants are yet to be identified as the practice of molecular laboratory techniques is limited in this part of the world. Applying such molecular methods, we report the first hemoglobin Q-Iran cases in Northern Iran. Case presentation An unusual band was detected in an isoelectric focusing test and cellulose acetate electrophoresis of a sample from a 22-year-old Iranian man from Mazandaran Province. Capillary zone electrophoresis analysis identified this band as hemoglobin Q. A similar band was also detected in his mother's electrophoresis (38 years, Iranian ethnicity). The cases underwent molecular investigation and the presence of a hemoglobin Q-Iran mutation was confirmed by the amplification refractory mutation system polymerase chain reaction method. Direct conventional sequencing revealed a single guanine to cytosine missense mutation (c.226G > C; GAC >CAC) at codon 75 in the α-globin gene in both cases. Conclusion The wide spectrum and high frequency of nondeletional α-globin mutations in Mazandaran Province is remarkable and seem to differ considerably from what has been found in Mediterranean populations. This short communication reports the first cases of patients with hemoglobin Q found in that region.
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Affiliation(s)
- Mohammad Khorshidi
- Kariminejad-Najmabadi Pathology & Genetics Center, 2 Medical Building, 4th Street, Hassan Seyf Street, Shahrak Gharb, Tehran, PO Box: 14665/154, Iran.
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Hemoglobin Lepore EF Bart’s disease: a molecular, hematological, and diagnostic aspects. Ann Hematol 2011; 90:1337-40. [DOI: 10.1007/s00277-011-1173-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2010] [Accepted: 01/25/2011] [Indexed: 10/18/2022]
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Singsanan S, Karnpean R, Fucharoen G, Sanchaisuriya K, Sae-Ung N, Fucharoen S. Hemoglobin Q-Thailand related disorders: origin, molecular, hematological and diagnostic aspects. Blood Cells Mol Dis 2010; 45:210-4. [PMID: 20615730 DOI: 10.1016/j.bcmd.2010.06.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2010] [Accepted: 05/31/2010] [Indexed: 11/15/2022]
Abstract
We describe the molecular and hematological profiles of thalassemia syndromes caused by interactions of hemoglobin (Hb) Q-Thailand [α74(EF3) Asp-His] and various hemoglobinopathies found in 52 unrelated adult Thai subjects. Ten genotypes including several previously undescribed conditions were observed, which were classified into 4 groups. Group I included 26 Hb Q-Thailand heterozygotes and a homozygotous subject. Group II included subjects with Hb Q-Thailand and other α-thalassemia alleles in trans including 1 compound Hb Q-Thailand/α(+)-thalassemia (-α(3.7)), 2 Hb Q-Thailand/Hb Constant Spring disease and 6 Hb H/Q-Thailand disease. The average levels of Hb Q-Thailand were found to be 29.8%, 82.3%, 34.7%, 49.2-49.3% and 79.4%, respectively. Both Hbs Bart's and H were observed in addition to Hb Q-Thailand in all 6 cases with Hb Q-H disease but not in a homozygous Hb Q-Thailand. Group III included 7 double heterozygotes for Hb Q-Thailand/Hb E, 3 Hb Q-Thailand/Hb E/α(+)-thalassemia (-α(3.7)), 3 heterozygous Hb Q-Thailand/homozygous Hb E and 1 triple heterozygote for Hb Q-Thailand/Hb Constant Spring/Hb E. In this group, Hbs E (α(A)(2)β(E)(2)), Q-Thailand (α(QT)(2)β(A)(2)) and QE (α(QT)(2)β(E)(2)) were observed on both HPLC and capillary electrophoresis. The Hb QE, rather than Hb Q-Thailand, was detected in all 3 cases with heterozygous Hb Q-Thailand and homozygous Hb E. The remaining two cases in group 4 were double heterozygotes for Hb Q-Thailand and β(0)-thalassemia in which Hb Q-Thailand, elevated Hb A(2) (α(A)(2)δ(2)), and Hb QA(2) (α(QT)(2)δ(2)) were detected. DNA analysis identified the Hb Q-Thailand mutation (α74: GAC-CAC) and the linked (-α(4.2)) in all cases. Analysis of α-globin gene haplotype provided the first evidence of a single origin of this Hb variant in Thai population.
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Affiliation(s)
- Sanita Singsanan
- The Graduate School, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
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