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Jomoui W, Tepakhan W. Characterization and identification of Prachinburi β 0 -thalassemia: A novel-60 kb deletion in beta globin gene related to high levels of Hb F in heterozygous state. Int J Lab Hematol 2021; 43:O200-O203. [PMID: 33734585 DOI: 10.1111/ijlh.13511] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 02/22/2021] [Accepted: 02/26/2021] [Indexed: 12/31/2022]
Affiliation(s)
- Wittaya Jomoui
- Department of Pathology, Maha Chakri Sirindhorn Medical Center, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand
| | - Wanicha Tepakhan
- Department of Pathology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
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Surapolchai P, Sirachainan N, So CC, Hongeng S, Pakakasama S, Anurathapan U, Chuansumrit A. Curative Stem Cell Transplantation for Severe Hb H Disease Manifesting From Early Infancy: Phenotypic and Genotypic Analyses. Hemoglobin 2015; 40:70-3. [PMID: 26575104 DOI: 10.3109/03630269.2015.1105815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Most people with Hb H disease live normal lives; however, a minority of cases requires lifelong regular transfusions. An atypical form of nondeletional Hb H disease was reported in a Thai boy, characterized by severe persistent hemolytic anemia since the age of 2 months. Molecular diagnosis revealed the apparent compound heterozygosity for the Southeast Asian (- -(SEA)) and α2 polyadenylation (polyA) signal (AATAAA>AATA- -) deletions. The proband was successfully treated with allogeneic hematopoietic stem cell transplantation (HSCT). Accurate phenotypic and genotypic diagnosis in atypically severe Hb H disease is helpful for the understanding of its pathophysiology, the institution of appropriate management, and provision of genetic counseling and prenatal diagnosis. Hematopoietic stem cell transplantation is a potentially curative treatment option for this severe α-thalassemia (α-thal) syndrome.
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Affiliation(s)
- Pacharapan Surapolchai
- a Department of Pediatrics , Faculty of Medicine, Thammasat University , Pathumthani , Thailand
| | - Nongnuch Sirachainan
- b Department of Pediatrics , Faculty of Medicine, Ramathibodi Hospital, Mahidol University , Bangkok , Thailand
| | - Chi-Chiu So
- c Department of Pathology , Li Ka Shing Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong , Hong Kong SAR , People's Republic of China
| | - Suradej Hongeng
- b Department of Pediatrics , Faculty of Medicine, Ramathibodi Hospital, Mahidol University , Bangkok , Thailand
| | - Samart Pakakasama
- b Department of Pediatrics , Faculty of Medicine, Ramathibodi Hospital, Mahidol University , Bangkok , Thailand
| | - Usanarat Anurathapan
- b Department of Pediatrics , Faculty of Medicine, Ramathibodi Hospital, Mahidol University , Bangkok , Thailand
| | - Ampaiwan Chuansumrit
- b Department of Pediatrics , Faculty of Medicine, Ramathibodi Hospital, Mahidol University , Bangkok , Thailand
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Deshpande P, Kamalanathan N, Sampath E, George B, Shaji RV, Edison ES. Characterization of Clinical and Laboratory Profiles of the Deletional α2-Globin Gene Polyadenylation Signal Sequence (AATAAA > AATA- -) in an Indian Population. Hemoglobin 2015; 39:415-8. [PMID: 26365411 DOI: 10.3109/03630269.2015.1079785] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
α-Thalassemia (α-thal) is characterized by large deletions involving the variable regions of α2 and/or α1 genes. Nondeletional mutations and polyadenylation (polyA) signal sequence motif mutations are less common. In this retrospective study, we describe a fragment length analysis-based polymerase chain reaction (PCR) assay for screening the T(Indian) (AATAAA > AATA- -; HBA2: c.*93_*94delAA) polyA signal deletion along with its clinical and laboratory presentation in 21 patients. Most of the patients were diagnosed in early adulthood with a clinical presentation ranging from asymptomatic in the heterozygous state to severe Hb H disease with a prominent hemolytic component in the homozygous state. On genetic analysis, 14 patients were found to be homozygotes, five were compound heterozygotes and two were heterozygotes. Thus, the T(Indian) polyA signal deletion is common in the Indian population and should be screened for in patients with nondeletional α-thal mutations.
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Affiliation(s)
- Prashant Deshpande
- a Department of Haematology , Christian Medical College , Vellore , Tamil Nadu , India
| | | | - Eswari Sampath
- a Department of Haematology , Christian Medical College , Vellore , Tamil Nadu , India
| | - Biju George
- a Department of Haematology , Christian Medical College , Vellore , Tamil Nadu , India
| | - Ramachandran V Shaji
- a Department of Haematology , Christian Medical College , Vellore , Tamil Nadu , India
| | - Eunice S Edison
- a Department of Haematology , Christian Medical College , Vellore , Tamil Nadu , India
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Nair SB, Nadkarni AH, Ghosh K, Colah RB. Variable Presentation of HB H Disease Due to Homozygosity for the Rare Polyadenylation Signal A TIndian(AATAAA>AATA– –) Mutation in Four Indian Families. Hemoglobin 2013; 37:277-84. [DOI: 10.3109/03630269.2013.774284] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Sroymora S, Jindadamrongwech S, Butthep P, Chuncharunee S. Nondeletional Hb Queens Park [α32(B13)Met→Lys]/Hb H (β4) disease. Hemoglobin 2012; 36:293-8. [PMID: 22384838 DOI: 10.3109/03630269.2012.658939] [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
A rare nondeletional α-thalassemia-2 (α-thal-2) allele was identified in a Thai boy with Hb H (β4) disease. The proband has α-thal-1 (- -(SEA) type) together with a non productive Hb Queens Park (HBA1:c.98T>A) [α32(B13)Met→Lys] α1-globin variant. No abnormal hemoglobin (Hb) fraction was detected by high performance liquid chromatography (HPLC). The clinical effect of this mutation in the proband was comparable to that of deletional α-thal-2 present in Hb H disease.
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Affiliation(s)
- Suravee Sroymora
- Blood Disease Diagnostic Center, Hematology Division, Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama 6 Road, Bangkok, Thailand
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Bhattacharya G, Sarkar AA, Banerjee D, Chandra S, Das M, Dasgupta UB. Polymerase Chain Reaction-Based Search for Two α-Globin Gene Mutations in India. Hemoglobin 2009; 32:485-90. [DOI: 10.1080/03630260802341620] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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7
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Laosombat V, Viprakasit V, Chotsampancharoen T, Wongchanchailert M, Khodchawan S, Chinchang W, Sattayasevana B. Clinical features and molecular analysis in Thai patients with HbH disease. Ann Hematol 2009; 88:1185-92. [DOI: 10.1007/s00277-009-0743-5] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2008] [Accepted: 04/01/2009] [Indexed: 11/28/2022]
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Henderson S, Chapple M, Rugless M, Fisher C, Kinsey S, Old J. Haemoglobin H hydrops fetalis syndrome associated with homozygosity for the ?2-globin gene polyadenylation signal mutation AATAAA?AATA?�? Br J Haematol 2006; 135:743-5. [PMID: 17054428 DOI: 10.1111/j.1365-2141.2006.06362.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Viprakasit V, Chinchang W, Glomglao W, Tanphaichitr VS. A rare association of alphaO-thalassemia (--SEA) and an initiation codon mutation (ATG-->A-G) of the alpha2 gene causes Hb H disease in Thailand. Hemoglobin 2005; 29:235-40. [PMID: 16116675 DOI: 10.1081/hem-200066339] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Several rare and hitherto unidentified non deletional alpha-thalassemias (alphaTalpha or alphaalphaT) have been reported from Thailand within the past few years. Interactions of these determinants with alphaO-thalassemia (thal) (--/), which is highly prevalent in this region, give rise to various genotypes (--/ alphaTalpha or --/alphaalphaT) underlying Hb H disease. We report herein the interaction of a rare initiation codon mutation of the alpha2 gene and alphaO-thal in a Thai boy with Hb H disease. This finding highlights a wide variety of molecular pathology of the alpha-globin genes underlying alpha-thal syndrome in Southeast Asia.
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Affiliation(s)
- Vip Viprakasit
- Department of Paediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
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Boonsa S, Sanchaisuriya K, Fucharoen G, Wiangnon S, Jetsrisuparb A, Fucharoen S. The diverse molecular basis and hematological features of Hb H and AEBart's diseases in Northeast Thailand. Acta Haematol 2004; 111:149-54. [PMID: 15034236 DOI: 10.1159/000076523] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2003] [Accepted: 10/27/2003] [Indexed: 11/19/2022]
Abstract
We defined the molecular basis and correlated the hematological phenotypes with the globin genotypes in 52 patients with Hb H disease and 29 patients with AEBart's disease of northeast Thailand. Among the former group, the most prevalent molecular defect was found to be the interaction of alpha-thalassemia 1 (SEA type) with the Hb Constant Spring (Hb CS; 35 of 52 patients), followed by the deletion of three alpha-globin genes with the SEA type alpha-thalassemia 1 and the 3.7- or 4.2-kb deletion of alpha-thalassemia 2 (14 of 52 patients) and the interaction of the SEA alpha-thalassemia 1 with the Hb Paksé which was found in the remaining 3 patients. Among the 29 patients of the latter group, in 18 disease was caused by interactions of Hb E heterozygotes with the SEA alpha-thalassemia 1 and Hb CS. Interaction of Hb E heterozygotes with a deletional form of Hb H disease was detected in 7 patients and the Hb Paksé AEBart's disease was found in another 3 patients. A remaining patient with an unusually severe form of AEBart's disease with a lower Hb E level and observable Hb H was associated with a hitherto undescribed condition, the interaction of Hb E heterozygote with alpha-thalassemia 1 and an alpha2 codon 30 (GAG) deletion. Hematological characterization of the patients demonstrated that although disease in most of them was associated with thalassemia intermedia phenotypes, it was apparent that association with the nondeletional form of alpha-thalassemia 2 produced a more severe phenotype than that of the deletional one. Therefore, alpha-globin gene analysis of Hb H and AEBart's disease patients would be useful for predicting the clinical outcome and improving genetic counseling.
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Affiliation(s)
- Supap Boonsa
- Department of Clinical Chemistry, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
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Traeger-Synodinos J, Papassotiriou I, Karagiorga M, Premetis E, Kanavakis E, Stamoulakatou A. Unusual phenotypic observations associated with a rare HbH disease genotype (- -Med/alphaTSaudialpha): implications for clinical management. Br J Haematol 2002; 119:265-7. [PMID: 12358934 DOI: 10.1046/j.1365-2141.2002.03777.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A single patient with a rare Haemoglobin H (HbH) disease genotype (- -Med/alphaTSaudialpha) was observed to have exceptionally high levels of HbH (> 60%) and paradoxically high total haemoglobin levels. Studies of haematological parameters, blood biochemistry and oxygen transport properties revealed a severe functional anaemia, associated with marked erythropoietic stimulation and a markedly raised cardiac output. This rare case illustrates the complexity of interactions that may be associated with the clinical course of HbH disease, highlighting that haematological parameters alone may lead to spurious evaluation of clinical status. Issues related to the therapeutic management of unusual cases are raised.
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Affiliation(s)
- Joanne Traeger-Synodinos
- Medical Genetics, Athens University, Department of Clinical Biochemistry, Thalassaemia Unit and Haematology Laboratory, Aghia Sophia Children's Hospital, Athens, Greece
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