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Aljabry M, Sulimani S, Alotaibi G, Aljabri H, Alomary S, Aljabri O, Sallam M, Alsultan A. Prevalence and Regional Distribution of Beta-Hemoglobin Variants in Saudi Arabia: Insights from the National Premarital Screening Program". J Epidemiol Glob Health 2024:10.1007/s44197-024-00281-x. [PMID: 39073533 DOI: 10.1007/s44197-024-00281-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2024] [Accepted: 07/23/2024] [Indexed: 07/30/2024] Open
Abstract
BACKGROUND Hemoglobinopathies are among the most prevalent inherited disorders globally, with carrier prevalence varying significantly across regions. In Saudi Arabia, high rates of consanguineous marriages amplify the risk of these disorders. AIM This study aims to assess the burden of hemoglobinopathies by evaluating the prevalence and regional distribution of beta-hemoglobin variants, including rare variants, among couples participating in the national premarital screening program. METHODS Data were collected from the premarital genetic screening program and entered into the SEHA platform, covering the 13 administrative regions of Saudi Arabia. Blood samples underwent various screening tests for infectious and genetic diseases. Hemoglobin electrophoresis samples were analyzed using capillary electrophoresis, High-Performance Liquid Chromatography (HPLC), or a combination of both methods. RESULTS From 2011 to 2018, 1,871,184 individuals were included in the study, with 49.8% male and 50.2% female. The average age was 30.2 years. Hemoglobin S (HbS) was identified in 88,431 individuals (4.7% of the tested population and 78.5% of abnormal screening results), primarily as a sickle cell trait. β-thalassemia was the second most common disorder, identified in 22,420 individuals (1.2% of the population and 19.9% of hemoglobin disorders). HbC and HbD were each detected in 0.04% of cases, while HbO-Arab was identified in 0.007% and HbG in 0.006%. Hemoglobin E and hemoglobin Lepore were found to be extremely rare. CONCLUSION The study demonstrates regional variation in the prevalence of hemoglobin genetic variants in Saudi Arabia. To effectively mitigate this risk, it is imperative to strengthen public education and awareness, particularly focusing on genetic screening and counseling.
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Affiliation(s)
- Mansour Aljabry
- Department of Pathology, College of Medicine, King Saud University Medical City King Saud University, Riyadh, Saudi Arabia.
| | - Suha Sulimani
- Premarital Program, Ministry of Health, Riyadh, Saudi Arabia
| | - Ghazi Alotaibi
- Division of Hematology/Oncology, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Hassan Aljabri
- Premarital Program Center, Madina region, Ministry of Health, Riyadh, Saudi Arabia
| | - Shaker Alomary
- Premarital Program, Ministry of Health, Riyadh, Saudi Arabia
| | - Omar Aljabri
- Laboratory Department, Cluster 3 Bin Riyadh Region, Ministry of Health, Riyadh, Saudi Arabia
| | - Maha Sallam
- Laboratory Department, Alahsa Cluster, Ministry of Health, Riyadh, Saudi Arabia
| | - Abdulrahman Alsultan
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Dholariya S, Parchwani DN, Sonagra A, Singh R, Motiani A, Kaliya M, Anandani G. Detection of HbD Punjab Trait in Saurashtra Region of Gujarat by HPLC Method. Indian J Clin Biochem 2024; 39:438-441. [PMID: 39005868 PMCID: PMC11239634 DOI: 10.1007/s12291-023-01160-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 10/14/2023] [Indexed: 07/16/2024]
Abstract
The HbD Punjab trait is a less common hemoglobin variant in the Saurashtra region of Gujarat. This patient presented to the General Medicine and Biochemistry Department at All India Institute of Medical Sciences, Rajkot, Hospital, for the HbA1c analysis by high-performance liquid chromatography (HPLC). The patient was 52 years old, a known case of type 2 diabetes mellitus and hypertension, and presented with complaints of generalized malaise and fatigability for the previous ten to twelve months. On physical examination, there was no evidence of pallor, lymphadenopathy, splenomegaly, or hepatomegaly. Peripheral blood smear revealed normocytic normochromic RBC, and platelets were adequate and normal in morphology. The HPLC analysis revealed heterozygous for hemoglobin D (HbD Punjab trait), and false high HbA1c corresponds to fasting plasma glucose (FPG) levels due to abnormal separation. However, genetic counseling is highly recommended to detect any potential reproductive risk factors.
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Affiliation(s)
- Sagar Dholariya
- All India Institute of Medical Sciences, Rajkot, Gujarat India
| | | | - Amit Sonagra
- All India Institute of Medical Sciences, Rajkot, Gujarat India
| | - Ragini Singh
- All India Institute of Medical Sciences, Rajkot, Gujarat India
| | - Anita Motiani
- All India Institute of Medical Sciences, Rajkot, Gujarat India
| | - Mehul Kaliya
- All India Institute of Medical Sciences, Rajkot, Gujarat India
| | - Garima Anandani
- All India Institute of Medical Sciences, Rajkot, Gujarat India
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Bowling GC, Ryden NA, Holmes AR, Lee LE, Stoll K. A Unique Case of a Compound Heterozygosity of Hemoglobin Korle-Bu and Sickle Cell Trait in a Military Trainee. J Hematol 2024; 13:116-120. [PMID: 38993734 PMCID: PMC11236362 DOI: 10.14740/jh1257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 04/08/2024] [Indexed: 07/13/2024] Open
Abstract
Hemoglobin Korle-Bu (Hb KB) is a rare and likely under-reported hemoglobin (Hb) variant resulting from an unusual point mutation on the beta-globin chain. Hb KB is typically clinically silent, and there are limited reports of Hb KB heterozygosity compounded with other hemoglobinopathies that can present with varying clinical phenotypes. Here, we report a case of compound Hb KB heterozygosity with Hb S in an asymptomatic military trainee with a positive sickle cell screening test. Hb capillary and gel electrophoresis predicted a compound Hb S/D-Punjab overlap, which foretells a severe clinical phenotype. Sequencing of the Hb beta gene HBB demonstrated Hb KB, allowing for a diagnosis that fit his asymptomatic clinical phenotype and allowed for retention in the military.
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Affiliation(s)
- Gartrell C. Bowling
- San Antonio United Services Health Education Consortium, Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA
- School of Medicine, Uniformed Services University, Bethesda, MD 20814, USA
| | - Niels A. Ryden
- San Antonio United Services Health Education Consortium, Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA
- Department of Medicine, Brooke Army Medical Center, Fort Sam Houston, TX 78243, USA
| | - Allen R. Holmes
- Department of Medicine, Brooke Army Medical Center, Fort Sam Houston, TX 78243, USA
| | - Lauren E. Lee
- Department of Medicine, Brooke Army Medical Center, Fort Sam Houston, TX 78243, USA
| | - Kristin Stoll
- San Antonio United Services Health Education Consortium, Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA
- Department of Medicine, Brooke Army Medical Center, Fort Sam Houston, TX 78243, USA
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Colombatti R, Hegemann I, Medici M, Birkegård C. Systematic Literature Review Shows Gaps in Data on Global Prevalence and Birth Prevalence of Sickle Cell Disease and Sickle Cell Trait: Call for Action to Scale Up and Harmonize Data Collection. J Clin Med 2023; 12:5538. [PMID: 37685604 PMCID: PMC10488271 DOI: 10.3390/jcm12175538] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/18/2023] [Accepted: 08/22/2023] [Indexed: 09/10/2023] Open
Abstract
Sickle cell disease (SCD) is an inherited monogenic disorder with high prevalence throughout sub-Saharan Africa, the Mediterranean basin, the Middle East, and India. Sources of SCD epidemiology remain scarce and fragmented. A systematic literature review (SLR) to identify peer-reviewed studies on SCD epidemiology was performed, with a search of bibliographic databases and key conference proceedings from 1 January 2010 to 25 March 2022 (congress abstracts after 2018). The SLR followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Meta-analyses, using a binomial normal random-effects model, were performed to estimate global and regional prevalence and birth prevalence. Of 1770 journal articles and 468 abstracts screened, 115 publications met the inclusion criteria. Prevalence was highest in Africa (~800/100,000), followed by the Middle East (~200/100,000) and India (~100/100,000), in contrast to ~30/100,000 in Europe. Birth prevalence was highest in Africa (~1000/100,000) and lowest in North America (~50/100,000) and Europe (~30/100,000). This SLR confirmed that sub-Saharan and North-East Africa, India, the Middle East, and the Caribbean islands are global SCD hotspots. Publications including mortality data were sparse, and no conclusions could be drawn about mortality. The identified data were limited due to gaps in the published literature for large parts of the world population; the inconsistent reporting of SCD genotypes, diagnostic criteria, and settings; and a sparsity of peer-reviewed publications from countries with assumed high prevalence. This SLR demonstrated a lack of systematic knowledge and a need to provide uniform data collection on SCD prevalence and mortality.
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Affiliation(s)
- Raffaella Colombatti
- Clinic of Pediatric Hematology Oncology, Department of Child and Maternal Health, Azienda Ospedaliera, University of Padova, 35122 Padua, Italy
| | | | - Morten Medici
- Novo Nordisk A/S, 2860 Søborg, Denmark; (M.M.); (C.B.)
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Hafeez S, Zaidi NUSS. Red Blood Cell Substitutes: Liposome Encapsulated Hemoglobin and Magnetite Nanoparticle Conjugates as Oxygen Carriers. Int J Mol Sci 2023; 24:ijms24021618. [PMID: 36675142 PMCID: PMC9862797 DOI: 10.3390/ijms24021618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 12/06/2022] [Accepted: 12/09/2022] [Indexed: 01/17/2023] Open
Abstract
The established blood donation and transfusion system has contributed a lot to human health and welfare, but for this system to function properly, it requires a sufficient number of healthy donors, which is not always possible. Pakistan was a country hit hardest by COVID-19 which additionally reduced the blood donation rates. In order to address such challenges, the present study focused on the development of RBC substitutes that can be transfused to all blood types. This paper reports the development and characterization of RBC substitutes by combining the strategies of conjugated and encapsulated hemoglobin where magnetite nanoparticles would act as the carrier of hemoglobin, and liposomes would separate internal and external environments. The interactions of hemoglobin variants with bare magnetite nanoparticles were studied through molecular docking studies. Moreover, nanoparticles were synthesized, and hemoglobin was purified from blood. These components were then used to make conjugates, and it was observed that only the hemoglobin HbA1 variant was making protein corona. These conjugates were then encapsulated in liposomes to make negatively charged RBC substitutes with a size range of 1-2 μm. Results suggest that these RBC substitutes work potentially in a similar way as natural RBCs work and can be used in the time of emergency.
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Singh N, Seth T, Tyagi S. Review of clinical and hematological profile of hemoglobin D cases in a single centre. JOURNAL OF MARINE MEDICAL SOCIETY 2023. [DOI: 10.4103/jmms.jmms_165_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
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7
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Muacevic A, Adler JR, Fontenot A, Khan MW. Rare Combinational Hemoglobinopathies. Cureus 2022; 14:e32327. [PMID: 36628031 PMCID: PMC9825142 DOI: 10.7759/cureus.32327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2022] [Indexed: 12/13/2022] Open
Abstract
Hemoglobinopathies are genetic defects that result in the abnormal formation and composition of globin chains in the hemoglobin molecule. Sickle cell disease is one of the more common forms of genetic malformation, while Hemoglobin (Hb) Arab, Lepore, Korle-Bu, Kansas, D-Punjab, and Hasharon are uncommon presentations. Herein, we describe the case of a young patient who presented with a low hemoglobin level and was subsequently diagnosed with a rare combination of Hemoglobin Korle-Bu, D-Punjab, and sickle cell trait.
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Mansoor N, Meraj F, Shaikh A, Jabbar N. Spectrum of hemoglobinopathies with hematological and biochemical profile: A five year experience from a tertiary care hospital. Pak J Med Sci 2022; 38:2143-2149. [PMID: 36415225 PMCID: PMC9676578 DOI: 10.12669/pjms.38.8.5935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 02/18/2022] [Accepted: 08/28/2022] [Indexed: 10/17/2023] Open
Abstract
BACKGROUND & OBJECTIVE Determination of hemoglobinopathies is significant for epidemiological studies. There is a need to identify burden of hemoglobinopathies at national level to lay down the foundation of appropriate screening and prevention programs. The present study aimed to evaluate the spectrum of hemoglobinopathies along with hematological and biochemical parameters in a tertiary care hospital. METHODS This retrospective study included results of high performance liquid chromatography (HPLC) test from July 2015 - May 2020 in the department of Hematology, Indus Hospital and Health Network, Karachi, Pakistan. Data of all patients collected for red blood cell (RBC) indices, serum iron profile, and vitamin B12 and red cell folate levels. Diagnosis of hemoglobinopathies was done by an automatic analyzer ADAMS A1C Model No. HA-8180T Arkray/Japan. RESULTS Among 2422 participants, hemoglobinopathy observed in 14.5% (n=352). Beta thalassemia trait is observed as the most common hemoglobinopathy (6.4%). Severe anemia (Hb=5.1-5.5 g/dl) found in beta thalassemia major (BTM) and HbE disease. Red cell parameters showed significant association with different types of hemoglobinopathies. Mean ferritin level was high in E-beta thalassemia (687.8±591.9) followed by sickle cell disease (615.7±543.5). CONCLUSION Apparently, overall frequency is static however, results of this study are not applicable to general population due to sample bias. Moreover, true figures are difficult to identify due to high incidence of iron deficiency anemia that masks the diagnosis by conventional techniques. Molecular characterization by DNA analysis is the most reliable tool of diagnosis. However, this method is not widely available in our country due to lack of expertise and cost issues.
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Affiliation(s)
- Neelum Mansoor
- Neelum Mansoor, FCPS. Consultant, Department of Hematology and Blood Center, Indus Hospital and Health Network, Karachi, Pakistan
| | - Fatima Meraj
- Fatima Meraj, FCPS. Section Head, Department of Hematology and Blood Center, Indus Hospital and Health Network, Karachi, Pakistan
| | - Ameerah Shaikh
- Ameerah Shaikh, Medical Student, Ziauddin University Hospital, Karachi, Pakistan
| | - Naeem Jabbar
- Naeem Jabbar, FCPS. Consultant, Blood Centre, Indus Hospital and Health Network, Karachi, Pakistan
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9
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Abu-Shaheen A, Dahan D, Henaa H, Nofal A, Abdelmoety DA, Riaz M, AlSheef M, Almatary A, AlFayyad I. Sickle cell disease in Gulf Cooperation Council countries: a systematic review. Expert Rev Hematol 2022; 15:893-909. [PMID: 36217841 DOI: 10.1080/17474086.2022.2132225] [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: 11/04/2022]
Abstract
INTRODUCTION Evidence related to the national burden of Sickle Cell Disease (SCD) in Gulf Cooperation Council (GCC) largely fragmented. Thus, the aim of this study is to systemically review studies from GCC countries to assess the epidemiological profile of SCD. AREAS COVERED We searched combinations of key terms in MEDLINE/PubMed, CINAHL, and EMBASE. We selected relevant observational studies reporting the frequency, incidence, prevalence, risk factors, mortality rate, and complications of SCD among the GCC population. Studies restricted to laboratory diagnostic tests, experimental and animal studies, review articles, case reports and series, and conference proceedings and editorials were excluded. A total of 1,347 articles were retrieved, out of which 98 articles were found to be eligible and included in the study. The total number of participants from all the included studies was 3496447. The prevalence of SCD ranged from 0.24%-5.8% across the GCC and from 1.02%-45.8% for the sickle cell trait. Consanguineous marriage was a risk factor for likely giving children affected with hemoglobinopathies. EXPERT OPINION The prevalence of SCD and its complications vary among GCC. Because of the high prevalence of SCD and its complications, health authorities should focus on more rigorous prevention and treatment strategies.
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Affiliation(s)
| | - Doaa Dahan
- Research Center, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Humariya Henaa
- Research Center, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Abdullah Nofal
- Emergency Medicine Department, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Doaa A Abdelmoety
- Clinical Research Holy Management Department, Executive Administration of Research, King Abdullah Medical City in Capital, Makkah, Saudi Arabia
| | - Muhammad Riaz
- Department of Statistics, University of Malakand, Pakistan
| | - Mohammed AlSheef
- Internal Medicine Consultant, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Abdulrahman Almatary
- Neonatal Intensive Care Unit, King Fahad Medical City, Children specialized hospital. Riyadh, Saudi Arabia
| | - Isamme AlFayyad
- Research Center, King Fahad Medical City, Riyadh, Saudi Arabia
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Muacevic A, Adler JR. Profile of Hemoglobin D (HbD) Disease in Eastern Uttar Pradesh: A Single-Center Experience. Cureus 2022; 14:e30782. [PMID: 36337804 PMCID: PMC9621097 DOI: 10.7759/cureus.30782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2022] [Indexed: 11/21/2022] Open
Abstract
Hemoglobin D (HbD) disease was identified in 31 samples from 15 families out of the 2560 samples (1.20%) analyzed for variant Hbs. There were five patients with HbSD disease, three with HbDβ disease, and the remaining 23 were HbD trait. Patients with HbSD disease had a variable clinical presentation with a pair of siblings being transfusion dependent although the age of first blood transfusion was different in the two patients. The one with high HbF started transfusions much later. None of them had symptoms related to sickling. Patients with HbDβ also had a variable presentation with only one of them being transfusion-dependent. All patients with HbSD and HbDβ disease were started on hydroxyurea. Persons with HbD trait were asymptomatic with half of them having normal Hb. The remaining half had mild microcytic hypochromic anemia. All the families with HbD disease were natives of this region and not migrants from other states. Although HbD disease has not been reported from this region in previous studies, clinicians need to be aware of this entity as it can give rise to symptomatic disease in some cases if associated with beta-thalassemia or sickle cell trait.
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Spandana R, Panneerselvam K, Mani S, Krishnamoorthy N. An Interesting and Rare Case of Hemoglobin D-Punjab Variant in Tamil Nadu. Cureus 2022; 14:e22668. [PMID: 35371765 PMCID: PMC8965195 DOI: 10.7759/cureus.22668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2022] [Indexed: 11/05/2022] Open
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Arab-Indian −530 β-distal promoter haplotype and sickle/Hb D heterozygosis in Badagas of Nilgiris: is it suggestive of Harappan origin? J Genet 2022. [DOI: 10.1007/s12041-021-01348-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Huits R, Feyens AM, Lonneville N, Peyrassol X, Adam AS, Gulbis B, Van Esbroeck M. Diagnosis and clinical relevance of co-inheritance of haemoglobin D-Punjab/β+-thalassemia traits in an immigrant Afghan family. J Clin Pathol 2022; 75:861-864. [PMID: 35039448 DOI: 10.1136/jclinpath-2021-208009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 01/04/2022] [Indexed: 11/03/2022]
Abstract
We report on a Pashtun family affected by haemoglobin D-Punjab/β+-thalassemia to increase the awareness of the increasing prevalence of haemoglobinopathies among primary care physicians. We highlight the diagnostic approach of these conditions and the benefits of genetic counselling.
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Affiliation(s)
- Ralph Huits
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Anne-Marie Feyens
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Niels Lonneville
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Xavier Peyrassol
- Service de Génétique-Centre de Génétique humaine de l'ULB, Universite Libre de Bruxelles, Bruxelles, Belgium
| | - Anne-Sophie Adam
- Department of Clinical Chemistry, Universite Libre de Bruxelles, Bruxelles, Belgium
| | - Beatrice Gulbis
- Department of Clinical Chemistry, Universite Libre de Bruxelles, Bruxelles, Belgium
| | - Marjan Van Esbroeck
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerpen, Belgium
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Heaton C, Witt M, Cole L, Eyre J, Tazzyman S, McColm R, Francese S. Detection and mapping of haemoglobin variants in blood fingermarks by MALDI MS for suspect "profiling". Analyst 2021; 146:4290-4302. [PMID: 34105523 DOI: 10.1039/d1an00578b] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Over the past seven years Matrix Assisted Laser Desorption Ionisation Mass Spectrometry Profiling (MALDI MSP) and Imaging (MALDI MSI) have proven to be feasible tools for the detection of blood and its provenance in stains and fingermarks. However, whilst this capability as a confirmatory test addresses the primary questions at the scene of a violent crime, additional intelligence recoverable from blood can also prove important for investigations. A DNA profile is the most obvious and important example of such intelligence; however, it is not always suitable for identification purposes, depending on quantity, age and environmental conditions. Proteins are much more stable and determining the presence of haemoglobin variants in blood recovered at a crime scene may provide associative and possibly corroborating evidence on the presence of an individual at a particular location. This evidence gains more incriminatory value, the lower the incidence of the variant in a certain geographical area or population and may contribute to narrowing down the pool of suspects. In this study, a MALDI based mass spectrometric method has been developed and tested on six haemoglobin variants for their fast and reliable identification and mapping in blood fingermarks.
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Affiliation(s)
- Cameron Heaton
- Biomolecular Science Research Centre, Centre for Mass Spectrometry Imaging, Sheffield Hallam University, Sheffield, UK.
| | | | - Laura Cole
- Biomolecular Science Research Centre, Centre for Mass Spectrometry Imaging, Sheffield Hallam University, Sheffield, UK.
| | - Jason Eyre
- Sheffield Teaching Hospitals, Sheffield, UK
| | | | - Richard McColm
- Defence Science and Technology Laboratory, Porton Down, UK
| | - Simona Francese
- Biomolecular Science Research Centre, Centre for Mass Spectrometry Imaging, Sheffield Hallam University, Sheffield, UK.
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15
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Pandit N, Kalaria T, Lakhani JD, Jasani J. Assessment of protective relationship of G6PD and other lifestyle factors with Malaria: A case-control study of medical professionals from a teaching medical institute, Gujarat. J Family Med Prim Care 2020; 9:5638-5645. [PMID: 33532407 PMCID: PMC7842447 DOI: 10.4103/jfmpc.jfmpc_947_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 08/31/2020] [Accepted: 09/18/2020] [Indexed: 11/04/2022] Open
Abstract
Background There remains equivocal evidence in terms of glucose-6-phosphate dehydrogenase (G6PD) and malaria occurrence. A case-control study was performed to assess protective relationship of G6PD and other lifestyle factors with malaria. Methods One-hundred twenty six medical professionals were randomly selected from a tertiary care clinical institute. Along with demographic and lifestyle details, subjects were interviewed about their history of occurrence of malaria at all in previous 10 years. Their hematological, biochemical, and metabolic profile was assessed clinically as well as by investigations. The analysis was carried out with two groups: (1) those who were subjected with malaria at least once in past 10 years (Malaria Ever Group); (2) those who never encountered malaria (Malaria Never Group). Results Out of 126, 65 subjects were in Malaria Ever Group and 61were in Malaria Never Group. There was no difference in lifestyle measures, hematological, and biochemical parameters. Mean G6PD levels were found similar in both the groups. Of 61 subjects in "malaria-never" group, 1 had deficient (1.1 unit/gm of Hb), 9 had low normal (between 2.5 and 10 units/gm of Hb), 48 had normal (10.1-20.5 units/gm of Hb), and 3 had higher than normal (>20.5 units/gm of Hb) G6PD levels. In comparison, 65 participants from "malaria ever" group, none was deficient, 6 had low normal, 58 had normal, and none had higher than normal G6PD levels. HPLC-based hemoglobin analysis showed significant higher number of participants in "malaria-never" group having altered hemoglobin. 12 participants had increased hemoglobin A2 levels, of which 10 were in "Malaria Occurrence Never" group; of them 6 could be diagnosed having hemoglobinopathy of specified variety. 3 of these 10 participants of "malaria-never" group had low G6PD levels also. Conclusion Malaria Protection Hypothesis was not found to be true as per our findings, but there were subtle hints that G6PD protection with or without change in hemoglobin alteration maybe operable.
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Affiliation(s)
- Niraj Pandit
- Prof and Head, Department of Community Medicine, SBKS Medical Institute and Research Centre and Dhiraj Hospital, Sumandeep Deemed University, Piparia, (Dist :Vadodara) Gujarat, India
| | - Tejaskumar Kalaria
- Ex. Assistant Professor in Biochemistry, SBKS Medical Institute and Research Centre and Dhiraj Hospital, Sumandeep Deemed University, Piparia, (Dist :Vadodara) Gujarat, India
| | - Jitendra D Lakhani
- Professor of Medicine and Academic Director, SBKS Medical Institute and Research Centre and Dhiraj Hospital, Sumandeep Deemed University, Piparia, (Dist :Vadodara) Gujarat, India
| | - Jasmin Jasani
- Professor of Pathology and Incharge Central Laboratory, SBKS Medical Institute and Research Centre and Dhiraj Hospital, Sumandeep Deemed University, Piparia, (Dist :Vadodara) Gujarat, India
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Patel S, Krishnan VP, Kanvinde P, Mudaliar S, Shah N, Swami A, Desai M, Agarwal B. Clinical Course of Patients With Sickle Cell Anemia and Co-inherited Hematological Disorders: Experience at a Tertiary Hematological Centre. Indian J Hematol Blood Transfus 2020; 36:754-757. [PMID: 33100722 DOI: 10.1007/s12288-020-01303-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 06/04/2020] [Indexed: 11/30/2022] Open
Abstract
To study the clinical course of patients with sickle cell anemia and coinherited hematological disorders. Retrospective analysis of clinical data of patients enrolled at our hospital over last 7 years was performed. Eighty four patients of symptomatic sickling disorders were registered during this period, comprising of HbSS (n = 49), HbS-β thalassemia (n = 28), HbS-HbD disease (n = 5), HbS-β thalassemia with G6PD deficiency (n = 1) and HbS-hemophilia A (n = 1). Among HbS-β thalassemia, 18% suffered from occasional pain crises and 27% required occasional blood transfusion. 40% patients with HbS-HbD disease required occasional blood transfusions, one patient was transfusion dependent, while none suffered from crisis episodes. Patient with HbS-β thalassemia with G6PD deficiency had increased transfusion requirement during first 3 years of life, which decreased after that. Patient with HbS and severe hemophilia A had only one episode of severe bleeding, suffered from 1 crisis episode. In conclusion, HbA reduces severity of HbS in HbS-β + thalassemia. HbS-HbD disease can manifest as a transfusion dependent illness. HbSS reduces severity of G6PD deficiency after first few years of life. HbSS and hemophilia coinheritance ameliorates symptoms of hemophilia.
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Affiliation(s)
- Swati Patel
- Department of Pediatric Hematology and Oncology, Bai Jerbai Wadia Hospital for Children, Acharya Donde Marg, Parel, Mumbai, Maharashtra 400054 India
| | - V P Krishnan
- Department of Pediatric Hematology and Oncology, Bai Jerbai Wadia Hospital for Children, Acharya Donde Marg, Parel, Mumbai, Maharashtra 400054 India
| | - Purva Kanvinde
- Department of Pediatric Hematology and Oncology, Bai Jerbai Wadia Hospital for Children, Acharya Donde Marg, Parel, Mumbai, Maharashtra 400054 India
| | - Sangeeta Mudaliar
- Department of Pediatric Hematology and Oncology, Bai Jerbai Wadia Hospital for Children, Acharya Donde Marg, Parel, Mumbai, Maharashtra 400054 India
| | - Nitin Shah
- Department of Pediatric Hematology and Oncology, Bai Jerbai Wadia Hospital for Children, Acharya Donde Marg, Parel, Mumbai, Maharashtra 400054 India
| | - Archana Swami
- Department of Pediatric Hematology and Oncology, Bai Jerbai Wadia Hospital for Children, Acharya Donde Marg, Parel, Mumbai, Maharashtra 400054 India
| | - Mukesh Desai
- Department of Pediatric Hematology and Oncology, Bai Jerbai Wadia Hospital for Children, Acharya Donde Marg, Parel, Mumbai, Maharashtra 400054 India
| | - Bharat Agarwal
- Department of Pediatric Hematology and Oncology, Bai Jerbai Wadia Hospital for Children, Acharya Donde Marg, Parel, Mumbai, Maharashtra 400054 India
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17
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Is Hemoglobin D Trait Hematologically Silent: Comparison With Healthy Controls and β-thalassemia Carriers. J Pediatr Hematol Oncol 2020; 42:e698-e701. [PMID: 31688629 DOI: 10.1097/mph.0000000000001628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Hemoglobin D-Los Angeles, a recessively inherited hemoglobin variant, has been introduced as hematologically silent in the heterozygous state. However, as its compound heterozygosity with other hemoglobinopathies may lead to a severe clinical phenotype, with hemoglobin S being the most serious, the detection of carriers is important. To clarify the hematologic picture, we assessed erythrocyte parameters in D carriers and compared values in healthy controls and β-thalassemia carriers. Although values in D carriers, in the absence of confounding factors, significantly differed from thalassemia carriers (P<0.05 for all), they were not similar to healthy controls. Microcytosis (absent in healthy controls) (mean corpuscular volume: 80.7 vs. 83.5 fL, P=0.038) and erythrocytosis (6 times more than in healthy controls) (red blood cell: 5.2 vs. 4.7×10/L, P=0.002) were detected, making questionable the true silence of the D trait.
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18
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Sasi S, Yassin MA, Nair AP, Al Maslamani MS. A Case of COVID-19 in a Patient with Asymptomatic Hemoglobin D Thalassemia and Glucose-6-Phosphate Dehydrogenase Deficiency. AMERICAN JOURNAL OF CASE REPORTS 2020; 21:e925788. [PMID: 32697769 PMCID: PMC7394553 DOI: 10.12659/ajcr.925788] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Patient: Gender, 26-year-old Final Diagnosis: COVID-19 Symptoms: Cough • fever Medication:— Clinical Procedure: — Specialty: Hematology
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Affiliation(s)
- Sreethish Sasi
- Department of Internal Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Mohamed A Yassin
- Department of Hematology, National Centre for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | - Arun Prabhakaran Nair
- Department of Infectious Diseases, Communicable Disease Center, Hamad Medical Corporation, Doha, Qatar
| | - Muna S Al Maslamani
- Department of Infectious Diseases, Communicable Disease Center, Hamad Medical Corporation, Doha, Qatar
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19
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Hirani S, Gupta S, Veillon D, Patan S, Master S, Mansour R. The curious case of hemoglobin DC disease masquerading as sickle cell anemia. Hematol Rep 2020; 12:8519. [PMID: 32499906 PMCID: PMC7256626 DOI: 10.4081/hr.2020.8519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 03/03/2020] [Indexed: 11/23/2022] Open
Abstract
Hemoglobin D is a relatively rare disease first reported in 1951. We present the first reported case of Hemoglobin DC disease. This is a case of a Hemoglobinopathy with DC disease in a woman with a previous diagnosis of Hemoglobin SC disease. A 19-year-old woman presented to the Adult Hematology clinic at a tertiary care hospital in Northwest Louisiana for transition of care from Pediatric Hematology for a diagnosis of Hemoglobin SC disease diagnosed at the age 4. Historical data suggested no avascular necrosis, acute chest syndrome, and very few episodes of pain crisis. She has never taken hydroxyurea. Laboratory work showed persistently normal hemoglobin and white blood cell counts. All sickle cell preparations in the past were negative. Computerized tomography scan of the abdomen was reviewed and showed a spleen grossly normal in size and appearance. Given the incongruent clinical picture for sickle cell disease, repeat hemoglobinopathy evaluation with Capillary electrophoresis and confirmatory acid electrophoresis (to differentiate hemoglobins that co-migrate with Hemoglobin S) showed a probable double heterozygote for Hemoglobin D and C with suspected coexistent alpha thalassemia minor based on red blood cell indices. This case confirms the importance of the required confirmatory method to ensure a correct diagnosis since a misdiagnosis can lead to numerous adverse clinical or psychological effects for patients.
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Affiliation(s)
| | | | - Diana Veillon
- Department of Pathology, Louisiana State University Health Sciences Center, Shreveport, LA
| | - Shajadi Patan
- Division of Hematology-Oncology, Feist-Weiller Cancer Center, Louisiana State University Health Sciences Center, Shreveport, LA, USA
| | - Samip Master
- Division of Hematology-Oncology, Feist-Weiller Cancer Center, Louisiana State University Health Sciences Center, Shreveport, LA, USA
| | - Richard Mansour
- Division of Hematology-Oncology, Feist-Weiller Cancer Center, Louisiana State University Health Sciences Center, Shreveport, LA, USA
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20
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van Gammeren AJ, Pelkmans L, Endschot CCWV, Roelofsen-de Beer RJAC, Harteveld CL. An Unusual Compound Heterozygosity for Hb O-Arab ( HBB: c.364G>A) and Hb D-Los Angeles ( HBB: c.364G>C). Hemoglobin 2020; 44:61-63. [PMID: 31973650 DOI: 10.1080/03630269.2019.1710530] [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: 10/25/2022]
Abstract
We report a newborn with a compound heterozygosity for Hb O-Arab (HBB: 364G>A) and Hb D-Los Angeles (HBB: 364G>C). To the best of our knowledge, the combination of these two hemoglobin (Hb) variants has not been identified and reported before. The variants of the proband and parents were identified by high-performance liquid chromatography (HPLC) and capillary electrophoresis (CE). DNA analysis was performed to confirm the variants. The levels of Hb variants of the proband were determined post-partum, at 3 months and 1 year after birth. Blood count analysis after 1 year revealed that the proband had a mild microcytic anemia. Furthermore, HPLC and CE analysis revealed an equal distribution of Hb D-Los Angeles compared to Hb O-Arab at the age of 1 year. The follow-up of the patient, suggested that the Hb combination is clinically silent or mild.
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Affiliation(s)
- Adriaan J van Gammeren
- Department of Clinical Chemistry and Hematology, Amphia Hospital, Breda, The Netherlands
| | - Leonie Pelkmans
- Department of Clinical Chemistry and Hematology, Amphia Hospital, Breda, The Netherlands
| | - Corné C W van Endschot
- Department of Clinical Chemistry and Hematology, Amphia Hospital, Breda, The Netherlands
| | | | - Cornelis L Harteveld
- The Reference Hemoglobinopathies Laboratory, Department of Human and Clinical Genetics, Leiden University Medical Centre, Leiden, The Netherlands
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21
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Zioga A, Thanopoulou E, Hatzi E, Chaliasos N, Georgiou I, Makis A. Rare Association of Hb D-Los Angeles (HBB: c.364G>C) with Hb H Disease: Diagnosis and Clinical Implications. Hemoglobin 2019; 42:336-338. [PMID: 30626242 DOI: 10.1080/03630269.2018.1558066] [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: 10/27/2022]
Abstract
Hb D-Los Angeles (or Hb D-Punjab) (HBB: c.364G > C) is found worldwide and is derived from a point mutation in the β-globin gene prevalent in the Punjab region of Northwestern India. Heterozygous or homozygous inheritance does not cause significant medical problems, whereas association with other hemoglobinopathies, especially β-thalassemia (β-thal) and sickle cell disease, changes the phenotype. Coinheritance of Hb D-Los Angeles with Hb H disease (α-/- -) has never been reported before. The presence of this rare combination in a family of Greek origin is herein described, and the challenges involving clinical management are discussed.
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Affiliation(s)
- Aikaterini Zioga
- a Child Health Department, Faculty of Medicine , University of Ioannina , Ioannina , Greece
| | - Eleni Thanopoulou
- b Genetics and IVF Unit, Department of Obstetrics and Gynecology, Faculty of Medicine , University of Ioannina , Ioannina , Greece
| | - Elissavet Hatzi
- b Genetics and IVF Unit, Department of Obstetrics and Gynecology, Faculty of Medicine , University of Ioannina , Ioannina , Greece
| | - Nikolaos Chaliasos
- a Child Health Department, Faculty of Medicine , University of Ioannina , Ioannina , Greece
| | - Ioannis Georgiou
- b Genetics and IVF Unit, Department of Obstetrics and Gynecology, Faculty of Medicine , University of Ioannina , Ioannina , Greece
| | - Alexandros Makis
- a Child Health Department, Faculty of Medicine , University of Ioannina , Ioannina , Greece
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22
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Kundrapu S, Janaki N, Meyerson HJ. Compound Heterozygosity for Hb D-Ibadan (HBB: c.263C>A) and Hb C (HBB: c.19G>A). Hemoglobin 2019; 42:269-271. [PMID: 30604644 DOI: 10.1080/03630269.2018.1523799] [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: 10/27/2022]
Abstract
We report an individual with a compound heterozygosity for Hb D-Ibadan (HBB: c.263C>A) and Hb C (HBB: c.19G>A), a hemoglobin (Hb) combination not previously identified. The compound hemoglobinopathy was detected in a young woman during routine prenatal screening. Variant Hbs were identified and confirmed by high performance liquid chromatography (HPLC) and capillary electrophoresis (CE) followed by Sanger DNA sequencing. Hb D-Ibadan was present in significant excess over Hb C (70.3 to 24.4%). A complete blood count (CBC) revealed moderate microcytosis with slight anemia. The history suggests the Hb combination is clinically silent. The findings indicate the compound hemoglobinopathy demonstrates thalassemia minor-like red cell indices with an unequal distribution of the variant Hbs. Comparison with other Hb D-like heterozygous conditions is reviewed.
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Affiliation(s)
- Sirisha Kundrapu
- a Department of Pathology , University Hospitals Cleveland Medical Center and Case Western Reserve University , Cleveland , OH , USA
| | - Nafiseh Janaki
- a Department of Pathology , University Hospitals Cleveland Medical Center and Case Western Reserve University , Cleveland , OH , USA
| | - Howard J Meyerson
- a Department of Pathology , University Hospitals Cleveland Medical Center and Case Western Reserve University , Cleveland , OH , USA
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23
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Hassan M, Ali Al-Barazanchi Z, Abdulateef S, Jaber R. Double heterozygosity for hemoglobin S and D Punjab in Basra, Iraq: A Clinical and hematological study of 42 patients. JOURNAL OF APPLIED HEMATOLOGY 2019. [DOI: 10.4103/joah.joah_65_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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24
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Petrenko AA, Pivnik AV, Kim PP, Demidova EY, Surin VL, Abdullaev AO, Sudarikov AB, Petrova NA, Maryina SA. Coinheritance of HbD-Punjab/β+-thalassemia (IVSI+5 G-C) in patient with Gilbert's syndrome. TERAPEVT ARKH 2018; 90:105-109. [PMID: 30701931 DOI: 10.26442/terarkh2018907105-109] [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: 11/22/2022]
Abstract
Thalassemia and qualitative hemoglobinopathy are hereditary disorders of Hb synthesis that lead to change in the Hb conformation or a decrease in the synthesis of structurally normal Hb, and consequently, to erythron pathology. Many variants of Hb are unstable or have altered affinity for oxygen, and, in heterozygous form can be associated with clinical and hematological manifestations (hemolytic anemia, hypochromic microcytic anemia, erythrocytosis). HbD-Punjab [β121 (GH4) Glu → Gln; HBB: C.364G> C] is variant of Hb carrying the amino acid substitution in the 121 position of β-globin chain. In all cases reported so far, patients with HbD-Punjab/β+-thalassemia (IVSI+5 G-C) combination experienced typical thalassemia with hypochromic microcytosis. HbD-Punjab was detected by electrophoresis from 37 to 94% of total Hb. The article describes rare clinical case of the cohabitation of HbD-Punjab/β+-thalassemia (IVSI+5 G-C) in a patient with homozygous variant of Gilbert's syndrome observed in AS Loginov Moscow Clinical Scientific Center.
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Affiliation(s)
- A A Petrenko
- Peoples' Friendship University of Russia (RUDN University), Moscow, Russia
| | - A V Pivnik
- Peoples' Friendship University of Russia (RUDN University), Moscow, Russia.,AS Loginov Moscow Clinical Scientific Center, Moscow, Russia
| | - P P Kim
- AS Loginov Moscow Clinical Scientific Center, Moscow, Russia
| | - E Yu Demidova
- National Research Center for Hematology, Moscow, Russia
| | - V L Surin
- National Research Center for Hematology, Moscow, Russia
| | - A O Abdullaev
- National Research Center for Hematology, Moscow, Russia
| | - A B Sudarikov
- National Research Center for Hematology, Moscow, Russia
| | - N A Petrova
- National Research Center for Hematology, Moscow, Russia
| | - S A Maryina
- National Research Center for Hematology, Moscow, Russia
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25
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Hegde SN, Srikousthubha MS, Anupama YJ. A case of undetectable glycated hemoglobin (HbA1C). QJM 2018; 111:567-568. [PMID: 29660089 DOI: 10.1093/qjmed/hcy080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- S N Hegde
- Department of Internal Medicine, Anushri Medical and Diabetes Care Centre, Shivamogga, Karnataka, India
| | - M S Srikousthubha
- Department of Pathology, Shimoga Diagnostics Centre, Shivamogga, Karnataka, India
| | - Y J Anupama
- Department of Nephrology, Nanjappa Hospital and Shivamogga, Karnataka, India
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26
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Panyasai S, Rahad S, Pornprasert S. Coinheritance of hemoglobin D-Punjab and β 0-thalassemia 3.4 kb deletion in a Thai girl. Asian J Transfus Sci 2017; 11:199-202. [PMID: 28970692 PMCID: PMC5613431 DOI: 10.4103/ajts.ajts_117_16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Hemoglobin (Hb) D. Punjab [β121(GH4) Glu→Gln; HBB: C.364G>C] and β0-thalassemia 3.4 kb deletion are very rare in the Thai population. For the first time, the coinheritance of HbD-Punjab with β0-thalassemia 3.4 kb deletion was reported in a 7-year-old Thai girl. She had mild anemia (Hb 115.0 g/L and mean corpuscular hemoglobin 18.1 pg) with red blood cell microcytosis (mean corpuscular volume 52.5 fL). By capillary electrophoresis (CE), HbD-Punjab was found at a migration position of 180 s with the value of 81.9% while the level of HbA2 was 7.3%. Based on the elevated HbA2, the molecular analysis for detection of β0-thalassemia mutations was performed. The 490 bp amplified fragments from β0-thalassemia 3.4 kb deletion was observed. Thus, the coinheritance of HbD-Punjab with β0-thalassemia can be found in the Thai population. The HbA2 measured on CE is a reliable parameter for differentiating the homozygote of HbD-Punjab and compound heterozygote of HbD-Punjab and β0-thalassemia.
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Affiliation(s)
- Sitthichai Panyasai
- Department of Medical Technology, School of Allied Health Sciences, University of Phayao, Phayao, Thailand
| | - Sarinna Rahad
- Depertment of Clinical Pathology, Hatyai Hospital, Songkhla, Thailand
| | - Sakorn Pornprasert
- Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
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27
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Abstract
BACKGROUND Due to the increasing numbers of migrants and asylum seekers, hemoglobinopathies and glucose-6-phosphate dehydrogenase deficiency are no longer rare diseases in Germany. As a result of the current migration movements these genetically determined diseases will gain in importance. METHODS Following a literature search the prevalence of the original endemic regions was compiled and compared to the population composition based on statistical data on migrants, foreign residents and asylum seekers in Germany. RESULTS In the endemic regions a prevalence of 40 % and sometimes higher have been found for glucose-6-phosphate dehydrogenase deficiency and hemoglobinopathies. The number of people arriving in Germany from these endemic regions is rapidly increasing. CONCLUSION Due to the high number of asylum seekers arriving from Asian and African regions, genetic erythrocyte defects will gain importance in the differential diagnosis of anemia; therefore, medical education and training must incorporate heightened awareness of risks, diagnostics and therapy of these disease patterns.
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28
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Shekhda KM, Leuva AC, Mannari JG, Ponda AV, Amin A. Co-Inheritance of Haemoglobin D-Punjab and Beta Thalassemia - A Rare Variant. J Clin Diagn Res 2017; 11:OD21-OD22. [PMID: 28764232 DOI: 10.7860/jcdr/2017/27816.10114] [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] [Received: 02/23/2017] [Accepted: 05/15/2017] [Indexed: 11/24/2022]
Abstract
Haemoglobinopathies are a frequent cause of anaemia in Northwestern India due to traditional practices of consanguineous marriages. Haemoglobin D-Punjab is one of the most common subvariants (55%) of haemoglobin D, which can be inherited as a homozygous or a heterozygous trait with other haemoglobinopathies. Though, haemoglobin D-Punjab is commonly seen, a heterozygous trait with beta thalassemia is a very rare presentation. Here, we present a rare case of co-inheritance of haemoglobin D-Punjab and beta thalassemia in a 19-year-old male of Indian origin. He came with gradually progressive generalised weakness with easy fatigability for the past two months. No history of similar complaints in the past. On examination, he was pale and icteric with splenomegaly and Grade I hemorrhoids on systemic examination. On investigation, there was severe anaemia, pancytopenia (mixed picture on smear), vitamin B12 deficiency and raised Lactate Dehydrogenase (LDH). Haemoglobin electrophoresis showed co-inheritance of haemoglobin D-Punjab and beta thalassemia. After Pack Cell Volume (PCV) and B12 supplements, haemoglobin improved. He was counseled about his disease and advised regular follow-up.
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Affiliation(s)
- Kalyan Mansukhbhai Shekhda
- Assistant Professor, Department of Medicine, Pramukhswami Medical College and Research Institute, Karamsad, Gujarat, India
| | - Alpa C Leuva
- Professor, Department of Medicine, Pramukhswami Medical College and Research Institute, Karamsad, Gujarat, India
| | - Jyoti G Mannari
- Professor and Head, Department of Medicine, Pramukhswami Medical College and Research Institute, Karamsad, Gujarat, India
| | - Aashka Vikas Ponda
- Postgraduate Trainee, Department of Medicine, Pramukhswami Medical College and Research Institute, Karamsad, Gujarat, India
| | - Amee Amin
- Intern, Department of Medicine, Pramukhswami Medical College and Research Institute, Karamsad, Gujarat, India
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29
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Santiago RP, Oliveira RM, Soares LF, Figueiredo CVB, Silva DO, Hurtado-Guerrero AF, Fiuza LM, Guarda CC, Adorno EV, Barbosa CG, Gonçalves MS. Hemoglobin Variant Profiles among Brazilian Quilombola Communities. Hemoglobin 2017; 41:83-88. [PMID: 28589738 DOI: 10.1080/03630269.2017.1321014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Brazilian Quilombolas are communities composed of African-derived populations that have their territories guaranteed by the Brazilian Constitution. The present study investigated the hemoglobin (Hb) variants among these population groups. This study was conducted in a total of 2843 individuals of Brazilian Quilombola communities of the Bahia, Pará, and Piauí states. All the participants had their Hb profiles evaluated. The Hb S (HBB: c.20A>T) variant was described in all the studied localities. However, the individuals in Bahia State had the highest frequency of the Hb C (HBB: c.19G>A) variant; individuals from Piauí State had a higher frequency of the Hb D-Punjab (HBB: c.364G>C) variant compared to the other states, and individuals from Pará State only carried the Hb S variant. The present study revealed a specific distribution of Hb variants that could represent different waves of African influence in these Brazilian populations.
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Affiliation(s)
- Rayra P Santiago
- a Laboratório de Hematologia, Genética e Biologia Computacional , Instituto Gonçalo Moniz, Fundação Oswaldo Cruz , Bahia , Brasil.,b Departamento de Análises Clínicas e Toxicológicas , Universidade Federal da Bahia , Bahia , Brasil
| | - Rodrigo M Oliveira
- a Laboratório de Hematologia, Genética e Biologia Computacional , Instituto Gonçalo Moniz, Fundação Oswaldo Cruz , Bahia , Brasil.,b Departamento de Análises Clínicas e Toxicológicas , Universidade Federal da Bahia , Bahia , Brasil
| | - Leonardo F Soares
- c Departamento de Bioquímica e Farmacologia , Universidade Estadual da Paraíba , Campina Grande , Brasil
| | - Camylla V B Figueiredo
- a Laboratório de Hematologia, Genética e Biologia Computacional , Instituto Gonçalo Moniz, Fundação Oswaldo Cruz , Bahia , Brasil.,b Departamento de Análises Clínicas e Toxicológicas , Universidade Federal da Bahia , Bahia , Brasil
| | - Denise Oliveira Silva
- d Laboratório de Situação de Saúde e Gestão do Cuidado às Populações em Situação de Vulnerabilidade, Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz , Manaus , Brasil
| | - Ana F Hurtado-Guerrero
- d Laboratório de Situação de Saúde e Gestão do Cuidado às Populações em Situação de Vulnerabilidade, Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz , Manaus , Brasil
| | - Luciana M Fiuza
- a Laboratório de Hematologia, Genética e Biologia Computacional , Instituto Gonçalo Moniz, Fundação Oswaldo Cruz , Bahia , Brasil.,b Departamento de Análises Clínicas e Toxicológicas , Universidade Federal da Bahia , Bahia , Brasil
| | - Caroline C Guarda
- a Laboratório de Hematologia, Genética e Biologia Computacional , Instituto Gonçalo Moniz, Fundação Oswaldo Cruz , Bahia , Brasil.,b Departamento de Análises Clínicas e Toxicológicas , Universidade Federal da Bahia , Bahia , Brasil
| | - Elisângela V Adorno
- b Departamento de Análises Clínicas e Toxicológicas , Universidade Federal da Bahia , Bahia , Brasil
| | - Cynara G Barbosa
- b Departamento de Análises Clínicas e Toxicológicas , Universidade Federal da Bahia , Bahia , Brasil
| | - Marilda S Gonçalves
- a Laboratório de Hematologia, Genética e Biologia Computacional , Instituto Gonçalo Moniz, Fundação Oswaldo Cruz , Bahia , Brasil.,b Departamento de Análises Clínicas e Toxicológicas , Universidade Federal da Bahia , Bahia , Brasil
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30
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Gorello P, Arcioni F, Palmieri A, Barbanera Y, Ceccuzzi L, Adami C, Marchesi M, Angius A, Minelli O, Onorato M, Piga A, Caniglia M, Mecucci C, Roetto A. The Molecular Spectrum of β- and α-Thalassemia Mutations in Non-Endemic Umbria, Central Italy. Hemoglobin 2017; 40:371-376. [PMID: 28361595 DOI: 10.1080/03630269.2017.1289101] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The aim of this study was to describe the mutational spectrum of hemoglobinopathies during the period 1988-2015 in Umbria, Central Italy, which has never been considered endemic for these conditions. Twenty-four different β-globin gene mutations were identified in 188 patients and eight different α-globin gene mutations in 74 patients. Sixty percent β-thalassemia (β-thal), 85.0% sickle cell disease, 44.0% Hb S (HBB: c.20A>T)/β-thal and 85.0% compound heterozygotes for hemoglobin (Hb) variant-carrying patients were diagnosed or molecularly characterized in the last 3 years. Moreover, most homozygous or compound heterozygous patients (84.5%) came from foreign countries, while only 15.5% were of Italian origin. These data are in accordance with the increasing foreign resident population in Umbria, which has nearly doubled in 10 years (2004-2014). Different from β-globin gene variations, no increasing trend in α defects was observed in our study cohort. Consistently, 58.0% of patients have an Italian origin, suggesting no broad influence of foreign migration in the α-globin genes genetic background. As few defects are prevalent in each country of origin or ethnic group, their knowledge may provide a proper strategy for the identification of mutations in immigrant individuals in a non-endemic region and be important for carrier identification and prenatal screening.
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Affiliation(s)
- Paolo Gorello
- a Dipartimento di Medicina, Ematologia , Università degli Studi di Perugia , Perugia , Italia
| | - Francesco Arcioni
- b Oncoematologia Pediatrica , Ospedale Santa Maria della Misericordia , Perugia , Italia
| | - Antonietta Palmieri
- c Dipartimento di Scienze Cliniche e Biologiche , Università degli Studi di Torino, Azienda Ospedaliera Universitaria San Luigi Gonzaga , Torino , Italia
| | - Ylenia Barbanera
- a Dipartimento di Medicina, Ematologia , Università degli Studi di Perugia , Perugia , Italia
| | - Laura Ceccuzzi
- a Dipartimento di Medicina, Ematologia , Università degli Studi di Perugia , Perugia , Italia
| | - Cecilia Adami
- d Servizio Immunotrasfusionale , Ospedale Santa Maria della Misericordia , Terni , Italia
| | - Mauro Marchesi
- e Servizio Immunotrasfusionale , Ospedale Santa Maria della Misericordia , Perugia , Italia
| | - Antonella Angius
- f Clinica Pediatrica , Ospedale Santa Maria della Misericordia , Perugia , Italia
| | - Olivia Minelli
- e Servizio Immunotrasfusionale , Ospedale Santa Maria della Misericordia , Perugia , Italia
| | - Marina Onorato
- e Servizio Immunotrasfusionale , Ospedale Santa Maria della Misericordia , Perugia , Italia
| | - Antonio Piga
- c Dipartimento di Scienze Cliniche e Biologiche , Università degli Studi di Torino, Azienda Ospedaliera Universitaria San Luigi Gonzaga , Torino , Italia
| | - Maurizio Caniglia
- b Oncoematologia Pediatrica , Ospedale Santa Maria della Misericordia , Perugia , Italia
| | - Cristina Mecucci
- a Dipartimento di Medicina, Ematologia , Università degli Studi di Perugia , Perugia , Italia
| | - Antonella Roetto
- c Dipartimento di Scienze Cliniche e Biologiche , Università degli Studi di Torino, Azienda Ospedaliera Universitaria San Luigi Gonzaga , Torino , Italia
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Carlice-dos-Reis T, Viana J, Moreira FC, Cardoso GDL, Guerreiro J, Santos S, Ribeiro-dos-Santos Â. Investigation of mutations in the HBB gene using the 1,000 genomes database. PLoS One 2017; 12:e0174637. [PMID: 28379995 PMCID: PMC5381778 DOI: 10.1371/journal.pone.0174637] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 03/13/2017] [Indexed: 11/19/2022] Open
Abstract
Mutations in the HBB gene are responsible for several serious hemoglobinopathies, such as sickle cell anemia and β-thalassemia. Sickle cell anemia is one of the most common monogenic diseases worldwide. Due to its prevalence, diverse strategies have been developed for a better understanding of its molecular mechanisms. In silico analysis has been increasingly used to investigate the genotype-phenotype relationship of many diseases, and the sequences of healthy individuals deposited in the 1,000 Genomes database appear to be an excellent tool for such analysis. The objective of this study is to analyze the variations in the HBB gene in the 1,000 Genomes database, to describe the mutation frequencies in the different population groups, and to investigate the pattern of pathogenicity. The computational tool SNPEFF was used to align the data from 2,504 samples of the 1,000 Genomes database with the HG19 genome reference. The pathogenicity of each amino acid change was investigated using the databases CLINVAR, dbSNP and HbVar and five different predictors. Twenty different mutations were found in 209 healthy individuals. The African group had the highest number of individuals with mutations, and the European group had the lowest number. Thus, it is concluded that approximately 8.3% of phenotypically healthy individuals from the 1,000 Genomes database have some mutation in the HBB gene. The frequency of mutated genes was estimated at 0.042, so that the expected frequency of being homozygous or compound heterozygous for these variants in the next generation is approximately 0.002. In total, 193 subjects had a non-synonymous mutation, which 186 (7.4%) have a deleterious mutation. Considering that the 1,000 Genomes database is representative of the world’s population, it can be estimated that fourteen out of every 10,000 individuals in the world will have a hemoglobinopathy in the next generation.
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Affiliation(s)
- Tânia Carlice-dos-Reis
- Laboratory of Human and Medical Genetics, Institute of Biological Sciences, Federal University of Pará, Belém, PA, Brazil
| | - Jaime Viana
- Laboratory of Human and Medical Genetics, Institute of Biological Sciences, Federal University of Pará, Belém, PA, Brazil
- Federal Rural University of the Amazon, Capanema Campus, PA, Brazil
| | - Fabiano Cordeiro Moreira
- Laboratory of Human and Medical Genetics, Institute of Biological Sciences, Federal University of Pará, Belém, PA, Brazil
- Research Center of Oncology, Federal University of Pará, Belém, PA, Brazil
| | - Greice de Lemos Cardoso
- Laboratory of Human and Medical Genetics, Institute of Biological Sciences, Federal University of Pará, Belém, PA, Brazil
| | - João Guerreiro
- Laboratory of Human and Medical Genetics, Institute of Biological Sciences, Federal University of Pará, Belém, PA, Brazil
| | - Sidney Santos
- Laboratory of Human and Medical Genetics, Institute of Biological Sciences, Federal University of Pará, Belém, PA, Brazil
- Research Center of Oncology, Federal University of Pará, Belém, PA, Brazil
| | - Ândrea Ribeiro-dos-Santos
- Laboratory of Human and Medical Genetics, Institute of Biological Sciences, Federal University of Pará, Belém, PA, Brazil
- Research Center of Oncology, Federal University of Pará, Belém, PA, Brazil
- * E-mail:
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Interference of Hb D-Los Angeles on the measurement of glycated hemoglobin. A case report. ENDOCRINOL DIAB NUTR 2017; 64:57-58. [DOI: 10.1016/j.endinu.2016.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 09/26/2016] [Indexed: 11/17/2022]
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Torres LS, Okumura JV, Silva DGH, Mimura KKO, Belini-Júnior É, Oliveira RG, Lobo CLC, Oliani SM, Bonini-Domingos CR. Inflammation in Sickle Cell Disease: Differential and Down-Expressed Plasma Levels of Annexin A1 Protein. PLoS One 2016; 11:e0165833. [PMID: 27802331 PMCID: PMC5089686 DOI: 10.1371/journal.pone.0165833] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 10/18/2016] [Indexed: 01/09/2023] Open
Abstract
Sickle cell disease (SCD) is an inherited hemolytic anemia whose pathophysiology is driven by polymerization of the hemoglobin S (Hb S), leading to hemolysis and vaso-occlusive events. Inflammation is a fundamental component in these processes and a continuous inflammatory stimulus can lead to tissue damages. Thus, pro-resolving pathways emerge in order to restore the homeostasis. For example there is the annexin A1 (ANXA1), an endogenous anti-inflammatory protein involved in reducing neutrophil-endothelial interactions, accelerating neutrophil apoptosis and stimulating macrophage efferocytosis. We investigated the expression of ANXA1 in plasma of SCD patients and its relation with anemic, hemolytic and inflammatory parameters of the disease. Three SCD genotypes were considered: the homozygous inheritance for Hb S (Hb SS) and the association between Hb S and the hemoglobin variants D-Punjab (Hb SD) and C (Hb SC). ANXA1 and proinflammatory cytokines were quantified by ELISA in plasma of SCD patients and control individuals without hemoglobinopathies. Hematological and biochemical parameters were analyzed by flow cytometry and spectrophotometer. The plasma levels of ANXA1 were about three-fold lesser in SCD patients compared to the control group, and within the SCD genotypes the most elevated levels were found in Hb SS individuals (approximately three-fold higher). Proinflammatory cytokines were higher in SCD groups than in the control individuals. Anemic and hemolytic markers were higher in Hb SS and Hb SD genotypes compared to Hb SC patients. White blood cells and platelets count were higher in Hb SS genotype and were positively correlated to ANXA1 levels. We found that ANXA1 is down-regulated and differentially expressed within the SCD genotypes. Its expression seems to depend on the inflammatory, hemolytic and vaso-occlusive characteristics of the diseased. These data may lead to new biological targets for therapeutic intervention in SCD.
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Affiliation(s)
- Lidiane S. Torres
- Laboratory of Hemoglobin and Hematologic Genetic Diseases, Department of Biology, São Paulo State University (UNESP), São José do Rio Preto, São Paulo, Brazil
- * E-mail: (LST); (SMO)
| | - Jéssika V. Okumura
- Laboratory of Hemoglobin and Hematologic Genetic Diseases, Department of Biology, São Paulo State University (UNESP), São José do Rio Preto, São Paulo, Brazil
| | - Danilo G. H. Silva
- Laboratory of Hemoglobin and Hematologic Genetic Diseases, Department of Biology, São Paulo State University (UNESP), São José do Rio Preto, São Paulo, Brazil
| | - Kallyne K. O. Mimura
- Laboratory of Immunomorphology, Department of Biology, São Paulo State University (UNESP), São José do Rio Preto, São Paulo, Brazil
| | - Édis Belini-Júnior
- Laboratory of Hemoglobin and Hematologic Genetic Diseases, Department of Biology, São Paulo State University (UNESP), São José do Rio Preto, São Paulo, Brazil
| | - Renan G. Oliveira
- Laboratory of Hemoglobin and Hematologic Genetic Diseases, Department of Biology, São Paulo State University (UNESP), São José do Rio Preto, São Paulo, Brazil
| | - Clarisse L. C. Lobo
- Institute of Hematology Arthur de Siqueira Cavalcanti (HEMORIO), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Sonia M. Oliani
- Laboratory of Immunomorphology, Department of Biology, São Paulo State University (UNESP), São José do Rio Preto, São Paulo, Brazil
- * E-mail: (LST); (SMO)
| | - Claudia R. Bonini-Domingos
- Laboratory of Hemoglobin and Hematologic Genetic Diseases, Department of Biology, São Paulo State University (UNESP), São José do Rio Preto, São Paulo, Brazil
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Del Orbe Barreto R, Arrizabalaga B, De la Hoz AB, García-Orad Á, Tejada MI, Garcia-Ruiz JC, Fidalgo T, Bento C, Manco L, Ribeiro ML. Detection of new pathogenic mutations in patients with congenital haemolytic anaemia using next-generation sequencing. Int J Lab Hematol 2016; 38:629-638. [PMID: 27427187 DOI: 10.1111/ijlh.12551] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 06/07/2016] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Congenital haemolytic anaemia (CHA) refers to a group of genetically heterogeneous disorders, mainly caused by changes in genes encoding globin chains, cytoskeletal proteins and red cell enzymes, in which accurate diagnosis can be challenging with conventional techniques. METHODS To set-up a comprehensive assay for detecting mutations that could improve aetiological diagnosis, we designed a custom panel for sequencing coding regions from 40 genes known to be involved in the pathogenesis of CHA, using the Ion Torrent™ (Thermo Fisher Scientific, S.L. Waltham, MA, USA) Personal Genome Machine (PGM) Sequencer. A control group of 16 samples with previously known mutations and a test group of 10 patients with unknown mutations were included for assay validation and application, respectively. RESULTS In the test group, we identified pathogenic mutations in all cases: four patients had novel mutations in genes related to membrane defects (SPTB, ANK1, SLC4A1 and EPB41), four were homozygous or compound heterozygous for mutations in genes related to enzyme deficiencies (GPI, TPI1 and GSS), one had a mutation in the HBB gene and another presented a homozygous mutation in the ADAMTS13 gene. CONCLUSIONS Ion PGM sequencing with our custom panel is a highly efficient way to detect mutations causing haemolytic anaemia, including new variations. It is a high-throughput detection method that is ready for application in clinical laboratories.
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Affiliation(s)
| | - B Arrizabalaga
- BioCruces Health Research Institute, Barakaldo, Spain.,Department of Haematology, Cruces University Hospital, Barakaldo, Spain
| | - A B De la Hoz
- BioCruces Health Research Institute, Barakaldo, Spain
| | - Á García-Orad
- BioCruces Health Research Institute, Barakaldo, Spain.,Department of Genetics, Physical Anthropology and Animal Physiology, Faculty of Medicine and Odontology, University of the Basque Country (UPV/EHU), Bilbao, Spain
| | - M I Tejada
- BioCruces Health Research Institute, Barakaldo, Spain.,Molecular Genetics Laboratory, Genetics Service, Cruces University Hospital, Barakaldo, Spain
| | - J C Garcia-Ruiz
- BioCruces Health Research Institute, Barakaldo, Spain.,Department of Haematology, Cruces University Hospital, Barakaldo, Spain
| | - T Fidalgo
- Serviço de Hematologia Clínica, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - C Bento
- Serviço de Hematologia Clínica, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - L Manco
- Research Centre for Anthropology and Health (CIAS), Department of Life Sciences, University of Coimbra, Coimbra, Portugal
| | - M L Ribeiro
- Serviço de Hematologia Clínica, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
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Figueiredo MS. Comments on: “Clinical, hematological and genetic data of a cohort of children with hemoglobin SD”. Rev Bras Hematol Hemoter 2016; 38:190-2. [PMID: 27521855 PMCID: PMC4997905 DOI: 10.1016/j.bjhh.2016.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 05/31/2016] [Indexed: 11/27/2022] Open
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Rezende PDV, Costa KDS, Domingues Junior JC, Silveira PB, Belisário AR, Silva CM, Viana MB. Clinical, hematological and genetic data of a cohort of children with hemoglobin SD. Rev Bras Hematol Hemoter 2016; 38:240-6. [PMID: 27521862 PMCID: PMC4997897 DOI: 10.1016/j.bjhh.2016.05.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Revised: 04/30/2016] [Accepted: 05/02/2016] [Indexed: 11/16/2022] Open
Abstract
Introduction The hemoglobin FSD is very uncommon in newborn screening programs for sickle cell disease. In the program of Minas Gerais, Brazil, the clinical course of children with hemoglobin SD was observed to be heterogeneous. The objective of this study was to estimate the incidence (1999–2012) and to describe the natural history of a cohort of newborns with hemoglobin SD. Methods Isoelectric focusing was the primary method used in newborn screening. Polymerase chain reaction-restriction fragment length polymorphism and gene sequencing were used to identify mutant alleles and for haplotyping. Gap-polymerase chain reaction was used to detect alpha-thalassemia. Results Eleven cases of hemoglobin S/D-Punjab and eight of Hb S-Korle Bu were detected. Other variants with hemoglobin D mobility were not identified. All hemoglobin D-Punjab and hemoglobin Korle Bu alleles were associated with haplotype I. Among the children with hemoglobin S/D-Punjab, there were four with the βS CAR haplotype, six with the Benin haplotype, and one atypical. Results of laboratory tests for hemoglobin S/D-Punjab and hemoglobin S-Korle Bu were: hemoglobin 8.0 and 12.3 g/dL (p-value <0.001), leukocyte count 13.9 × 109/L and 10.5 × 109/L (p-value = 0.003), reticulocytes 7.5% and 1.0% (p-value <0.001), hemoglobin F concentration 16.1% and 6.9% (p-value = 0.001) and oxygen saturation 91.9% and 97% (p-value = 0.002), respectively. Only hemoglobin S/D-Punjab children had acute pain crises and needed blood transfusions or hydroxyurea. Those with the Benin βS haplotype had higher total hemoglobin and hemoglobin F concentrations compared to the CAR haplotype. Transcranial Doppler was normal in all children. Conclusion The clinical course and blood cell counts of children with hemoglobin S/D-Punjab were very similar to those of hemoglobin SS children. In contrast, children with hemoglobin S-Korle Bu had clinical course and blood cell counts like children with the sickle cell trait.
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Torres LDS, Okumura JV, da Silva DGH, Belini Júnior É, de Oliveira RG, Mimura KKO, Lobo CLDC, Oliani SM, Bonini Domingos CR. Plasma levels of TGF-β1 in homeostasis of the inflammation in sickle cell disease. Cytokine 2016; 80:18-25. [PMID: 26928604 DOI: 10.1016/j.cyto.2016.02.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Revised: 02/20/2016] [Accepted: 02/23/2016] [Indexed: 01/02/2023]
Abstract
Sickle cell disease (SCD) represents a chronic inflammatory condition with complications triggered by the polymerization of hemoglobin S (Hb S), resulting in a series of cellular interactions mediated by inflammatory cytokines, as the transforming growth factor beta (TGF-β), which plays an important role in inflammation resolution. This study assessed the relation between SCD inflammation and the plasma concentration of TGF-β1, and also checked the influence of the presence of -509C/T polymorphism in TGFB1 gene on TGF-β1 plasma values. The plasma levels of TGF-β1 were quantified by ELISA in 115 patients with SCD (genotypes SS, SD-Los Angeles, Sβ-thalassemia and SC) and in 58 individuals with no hemoglobinopathies (Hb AA), as the control group. The -509C/T polymorphism in TGFB1 gene was screened by PCR-RFLP. The correlation between TGF-β1 plasma levels and the inflammation was based on its association with the count of platelets, total white blood cells (WBC) and neutrophils in the peripheral blood. Patients with SCD showed plasma levels of TGF-β1 higher than the control group, especially the Hb SS genotype, followed by the group with Hb SD. Polymorphism investigation showed no interference in the values obtained for the cytokine in the groups evaluated. All SCD groups showed TGF-β1 levels positively correlated to the platelets and WBC counts. The original data obtained in this study for SCD support the involvement of TGF-β1 in regulating of the inflammatory response and suggest that this marker possibly may become a potential therapeutic target in the treatment of the disease.
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Affiliation(s)
- Lidiane de Souza Torres
- Laboratory of Hemoglobin and Hematologic Genetic Diseases, Department of Biology, Sao Paulo State University (Unesp), Rua Cristóvão Colombo, 2265, São Jose do Rio Preto, SP 15054-000, Brazil.
| | - Jéssika Viviani Okumura
- Laboratory of Hemoglobin and Hematologic Genetic Diseases, Department of Biology, Sao Paulo State University (Unesp), Rua Cristóvão Colombo, 2265, São Jose do Rio Preto, SP 15054-000, Brazil
| | - Danilo Grünig Humberto da Silva
- Laboratory of Hemoglobin and Hematologic Genetic Diseases, Department of Biology, Sao Paulo State University (Unesp), Rua Cristóvão Colombo, 2265, São Jose do Rio Preto, SP 15054-000, Brazil
| | - Édis Belini Júnior
- Laboratory of Hemoglobin and Hematologic Genetic Diseases, Department of Biology, Sao Paulo State University (Unesp), Rua Cristóvão Colombo, 2265, São Jose do Rio Preto, SP 15054-000, Brazil
| | - Renan Garcia de Oliveira
- Laboratory of Hemoglobin and Hematologic Genetic Diseases, Department of Biology, Sao Paulo State University (Unesp), Rua Cristóvão Colombo, 2265, São Jose do Rio Preto, SP 15054-000, Brazil
| | - Kallyne Kioko Oliveira Mimura
- Laboratory of Imunomorphology, Department of Biology, Sao Paulo State University (Unesp), Rua Cristovão Colombo, 2265, São Jose do Rio Preto, SP 15054-000, Brazil
| | - Clarisse Lopes de Castro Lobo
- Institute of Hematology Arthur de Siqueira Cavalcanti (Hemorio), Rua Frei Caneca, 08, Rio de Janeiro, RJ 20211-030, Brazil
| | - Sonia Maria Oliani
- Laboratory of Imunomorphology, Department of Biology, Sao Paulo State University (Unesp), Rua Cristovão Colombo, 2265, São Jose do Rio Preto, SP 15054-000, Brazil
| | - Claudia Regina Bonini Domingos
- Laboratory of Hemoglobin and Hematologic Genetic Diseases, Department of Biology, Sao Paulo State University (Unesp), Rua Cristóvão Colombo, 2265, São Jose do Rio Preto, SP 15054-000, Brazil
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