The human hemoglobins in health and disease

Milestones in the history of hemoglobin research (in memory of professor Titus H.J. Huisman)

Professor Titus H.J. Huisman is best known for his work on hemoglobin (Hb) variants. To date, more than 1,000 Hb variants have been discovered and characterized, of which about one-third were discovered in Titus Huisman's laboratory at the Medical College of Georgia, Augusta, GA, USA. A registry of these Hb variants and other information, a legacy from Professor Huisman, is now available online, at HbVar database (hhtp://globin.bx.psu.edu/hbvar). During the last century, major developments in Hb research have been made using physical, chemical, physiological and genetic methods. This review highlights the milestones and key developments in Hb research most relevant to hematologists, and that have impacted our understanding and management of the thalassemias and sickle cell disease.

Splenic infarction, splenic sequestration, and functional hyposplenism in hemoglobin S-C disease

Splenic atrophy or evidence of hyposplenism occurs in as many as one third of all patients with S-C hemoglobinopathy. Yet there are few reports in the literature of clinically apparent splenic infarction in this disease. We describe four instances of acute splenic infarction in three patients with hemoglobin S-C disease which illustrate a wide spectrum of clinical manifestations and severity. Of particular interest were the observations of coincident occurrences of splenic sequestration and functional hyposplenism with splenic infarction, suggesting a close pathophysiological relationship among these syndromes.

Target cells in haemoglobinopathies

A semi-quantitative method of estimating the number of target cells in blood films has been developed. It has been applied to 250 films from normal persons, pregnant women, and patients with a variety of haemoglobinopathies. Allowing for the frequency of target cells found in normal films the results show that such an examination is of value in eliminating or suggesting certain haemoglobinopathies, but not in excluding the majority of the traits.

Sickle-cell haemoglobin C disease in London

The manifestations of the sickling disorders are becoming increasingly familiar to clinicians in Great Britain. One of these disorders, sickle-cell haemoglobin disease, has hitherto received little attention, being regarded as a relatively mild condition. This paper describes some of the distinctive clinical features of the disease as seen in a series of nine cases which have recently presented in London, two of which were fatal. The special hazards of the condition in relation to pregnancy, air travel, and general anaesthesia are discussed.

Haemoglobin E in Burmese; two cases of haemoglobin E disease

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