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Fotzi I, Pegoraro F, Chiocca E, Casini T, Mogni M, Veltroni M, Favre C. Case Report: Clinical and Hematological Characteristics of ε γδβ Thalassemia in an Italian Patient. Front Pediatr 2022; 10:839775. [PMID: 35372167 PMCID: PMC8969019 DOI: 10.3389/fped.2022.839775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 02/07/2022] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION εγδβ thalassemia is a rare form of β-thalassemia mostly described in children originating from Northern Europe. Only anecdotic cases from the Mediterranean area are reported. The diagnosis is challenging, considering the rarity of the disease and its heterogeneous clinical presentation. Most patients have neonatal microcytic anemia, sometimes requiring in utero and/or neonatal transfusions, and typically improving with age. CASE DESCRIPTION We report on an Italian newborn presenting with severe neonatal anemia that required red blood cell transfusion. After the first months of life, hemoglobin levels improved with residual very low mean corpuscular volume. β and α thalassemia, IRIDA syndrome, and sideroblastic anemia were excluded. Finally, a diagnosis of εγδβ thalassemia was made after microarray analysis of single nucleotide polymorphisms revealed a 26 kb single copy loss of chromosome 11p15.4, including the HBD, HBBP1, HBG1, and HBB genes. CONCLUSIONS Despite its rarity, the diagnosis of εγδβ thalassemia should be considered in newborns with severe neonatal anemia requiring in utero and/or neonatal transfusions, but also in older infants with microcytic anemia, after excluding more prevalent red blood cell disorders.
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Affiliation(s)
- Ilaria Fotzi
- Department of Pediatric Hematology/Oncology and Hematopoietic Stem Cell Transplantation (HSCT), Meyer Children's University Hospital, Florence, Italy
| | - Francesco Pegoraro
- Department of Pediatric Hematology/Oncology and Hematopoietic Stem Cell Transplantation (HSCT), Meyer Children's University Hospital, Florence, Italy.,Department of Health Science, University of Florence, Florence, Italy
| | - Elena Chiocca
- Department of Pediatric Hematology/Oncology and Hematopoietic Stem Cell Transplantation (HSCT), Meyer Children's University Hospital, Florence, Italy
| | - Tommaso Casini
- Department of Pediatric Hematology/Oncology and Hematopoietic Stem Cell Transplantation (HSCT), Meyer Children's University Hospital, Florence, Italy
| | - Massimo Mogni
- Human Genetics Laboratory, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Giannina Gaslini, Genoa, Italy
| | - Marinella Veltroni
- Department of Pediatric Hematology/Oncology and Hematopoietic Stem Cell Transplantation (HSCT), Meyer Children's University Hospital, Florence, Italy
| | - Claudio Favre
- Department of Pediatric Hematology/Oncology and Hematopoietic Stem Cell Transplantation (HSCT), Meyer Children's University Hospital, Florence, Italy
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Makis A, Georgiou I, Traeger-Synodinos J, Storino MR, Giuliano M, Andolfo I, Hatzimichael E, Chaliasos N, Giapros V, Izzo P, Iolascon A, Grosso M. A Novel εγδβ-Thalassemia Deletion Associated with Severe Anemia at Birth and a β-Thalassemia Intermedia Phenotype Later in Life in Three Generations of a Greek Family. Hemoglobin 2019; 45:351-354. [PMID: 31829079 DOI: 10.1080/03630269.2019.1699568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
We describe a novel deletion causing heterozygous εγδβ-thalassemia (εγδβ-thal) across three generations of a Greek family. The Greek deletion is about 72 kb in length, spanning from the hypersensitive site 4 (HS4) in the locus control region (LCR) to the 3' end of the β-globin gene, thus encompassing the entire β-globin gene cluster. The deletion caused severe but transient neonatal anemia and a non transfusion-dependent chronic hemolytic anemia state later in life, resembling mild β-thalassemia intermedia (β-TI) rather than β-thalassemia (β-thal) trait, as had been previously reported. Apart from the presentation of clinical and laboratory characteristics, the challenges involving clinical management are also discussed.
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Affiliation(s)
- Alexandros Makis
- Department of Pediatrics, Faculty of Medicine, University of Ioannina, Ioannina, Greece
| | - Ioannis Georgiou
- Genetics and In Vitro Fertilization Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, University of Ioannina, Ioannina, Greece
| | - Jan Traeger-Synodinos
- Laboratory of Medical Genetics, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Rosaria Storino
- Department of Molecular Medicine and Medical Biotechnology, CEINGE, Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Mariarosaria Giuliano
- Department of Molecular Medicine and Medical Biotechnology, CEINGE, Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Immacolata Andolfo
- Department of Molecular Medicine and Medical Biotechnology, CEINGE, Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | | | - Nikolaos Chaliasos
- Department of Pediatrics, Faculty of Medicine, University of Ioannina, Ioannina, Greece
| | - Vasileios Giapros
- Neonatal Intensive Care Unit, Faculty of Medicine, University of Ioannina, Ioannina, Greece
| | - Paola Izzo
- Department of Molecular Medicine and Medical Biotechnology, CEINGE, Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Achille Iolascon
- Department of Molecular Medicine and Medical Biotechnology, CEINGE, Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Michela Grosso
- Department of Molecular Medicine and Medical Biotechnology, CEINGE, Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
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