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Cannata M, Cassarà F, Vinciguerra M, Licari P, Passarello C, Leto F, Lo Pinto C, Pitrolo L, Ganci R, Maggio A, Giambona A. Double Heterozygosity for Hb Durham-N.C. ( HBB: c.344T>C) [β114(G16)Leu→Pro] and the IVS-I-110 ( HBB: c.93-21G>A) Causing a Severe β-Thalassemia Phenotype. Hemoglobin 2019; 43:210-213. [PMID: 31456457 DOI: 10.1080/03630269.2019.1655030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The evaluation of a 10-month-old girl of Sicilian origin with a clinical phenotype of severe thalassemia led to the identification of two β-globin gene defects, a β-thalassemia (β-thal), mutation at IVS-I-110 (HBB: c.93-21G>A) and a variant hemoglobin (Hb) mutation at codon 114 (HBB: c.344T>C) on the other allele, reported as Hb Durham-N.C. (also known as Hb Brescia) [β114(G16)Leu→Pro] in the HbVar database. A very low Hb level (Hb 3.5 g/dL), microcytosis [mean corpuscular volume (MCV) 63.2 fL] and hypocromia [mean corpuscular Hb (MCH) 19.6 pg], increased red blood cell (RBC) distribution width (RDW) (36.0%), higher reticulocytes (6.2%), anisocytosis, poikilocytosis, hypocromia, basophilic stippling and inclusion body formation, were present in the affected subject. Analysis of other family components showed the presence of HBB: c.93-21G>A defect in the mother and in her brother, while Hb Durham-N.C. was absent in all other relatives, thus, this mutation has arisen as a de novo defect. This is the first case described as a severe thalassemic phenotype in a compound heterozygote carrier of this unstable Hb and a common β-thalassemic allele. The important information gained from this case is that a rare dominant or recessive mutation may arise in every individual, even if this is a very rare event.
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Affiliation(s)
- Monica Cannata
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of rare Diseases, Villa Sofia-Cervello Hospital , Palermo , Italy
| | - Filippo Cassarà
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of rare Diseases, Villa Sofia-Cervello Hospital , Palermo , Italy
| | - Margherita Vinciguerra
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of rare Diseases, Villa Sofia-Cervello Hospital , Palermo , Italy
| | - Paola Licari
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of rare Diseases, Villa Sofia-Cervello Hospital , Palermo , Italy
| | - Cristina Passarello
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of rare Diseases, Villa Sofia-Cervello Hospital , Palermo , Italy
| | - Filippo Leto
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of rare Diseases, Villa Sofia-Cervello Hospital , Palermo , Italy
| | - Carmen Lo Pinto
- Department of Pediatrics, Villa Sofia-Cervello Hospital , Palermo , Italy
| | - Lorella Pitrolo
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of rare Diseases, Villa Sofia-Cervello Hospital , Palermo , Italy
| | - Riccardo Ganci
- Department of Pediatrics, Villa Sofia-Cervello Hospital , Palermo , Italy
| | - Aurelio Maggio
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of rare Diseases, Villa Sofia-Cervello Hospital , Palermo , Italy
| | - Antonino Giambona
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of rare Diseases, Villa Sofia-Cervello Hospital , Palermo , Italy
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Kent MW, Oliveira JL, Hoyer JD, Swanson KC, Kluge ML, Dawson DB, Liang X, Winkler TJ, Breaux CW, LaCount R, Silliman CC. Hb Grand Junction (HBB: c.348_349delinsG; p.His117IlefsX42): a new hyperunstable hemoglobin variant. Hemoglobin 2014; 38:8-12. [PMID: 24432801 DOI: 10.3109/03630269.2013.853672] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Hyperunstable hemoglobinopathy (HUH) [dominantly inherited β-thalassemia (β-thal)] is a relatively rare form of congenital hemolytic anemia in which mutations occur in the genes encoding for α and β chains, or both chains of the hemoglobin (Hb) molecule. We describe two Hispanic adolescents with a new unstable Hb variant (HBB: c.348_349delinsG; p.His117IlefsX42), resulting from a frameshift mutation at codons 115/116 of the β-globin gene. Both patients also have a 3.7 kb deletion on one α gene, leading to a decreased imbalance between α and β chain formation, and subsequently a milder phenotype than that seen in other hyperunstable Hb variants.
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Affiliation(s)
- Michael W Kent
- Department of Research, Bonfils Blood Center , Denver, Colorado , USA
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Amato A, Cappabianca MP, Perri M, Zaghis I, Mastropietro F, Ponzini D, Di Biagio P, Piscitelli R. Hb Filottrano [codon 120 (-A)]: a novel frameshift mutation in exon 3 of the β-globin gene causing dominantly inherited β-thalassemia intermedia. Hemoglobin 2012; 36:480-4. [PMID: 22992010 DOI: 10.3109/03630269.2012.718309] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
We report a novel frameshift mutation in exon 3 of the β-globin gene, that, in the heterozygous state, leads to a β-thalassemia intermedia (β-TI) phenotype (marked anemia, splenomegaly, hyperbilirubinemia, jaundice, unbalanced synthesis of α/non-α chains in a 34-year-old Italian woman. This frameshift mutation, due to the deletion of the first nucleotide (-A) at codon 120, results in a β-globin chain that is elongated to 156 amino acid residues. These highly unstable abnormal chains precipitate in the erythroblasts as inclusion bodies, thus causing inefficient erythropoiesis and ultimately resulting in the observed dominant clinical phenotype.
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Affiliation(s)
- Antonio Amato
- Associazione Nazionale lotta contro Microcitemie in Italia (ANMI Onlus), Centro Studi Microcitemie, Roma, Italia.
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