1
|
Hemoglobin F Only Syndrome at Birth: A Case of Maternal HbA2' Complicating the Diagnosis of β-Thalassemia. J Pediatr Hematol Oncol 2016; 38:e32-4. [PMID: 26583619 DOI: 10.1097/mph.0000000000000477] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
An asymptomatic infant of Ghanaian descent had hemoglobin F only detected on newborn screening. β-globin gene sequencing identified the intervening sequence (IVS)-II-849 (A → G) mutation with no normal β-globin gene. β-globin/δ-globin gene sequencing showed that both parents were heterozygous for the IVS-II-849 (A → G) mutation. The mother was heterozygous for the HbA2' δ-globin mutation (δ16 (A13) Gly → Arg), thus β-thalassemia trait was unrecognized due to coinheritance of HbA2'. The infant developed anemia, splenomegaly, and began transfusion therapy by the age 6 of months. This is the first report of β-thalassemia major with homozygous IVS-II-849 (A → G) mutations. This case highlights the importance of δ-globin gene mutations in prenatal testing.
Collapse
|
2
|
Giambona A, Damiani G, Vinciguerra M, Jakil C, Cannata M, Cassarà F, Picciotto F, Schillaci G, Cigna V, Renda D, Leto F, Passarello C, Maggio A. Incidence of haemoglobinopathies in Sicily: the impact of screening and prenatal diagnosis. Int J Clin Pract 2015; 69:1129-38. [PMID: 25727926 DOI: 10.1111/ijcp.12628] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Haemoglobinopathies are a major public health problem in Sicily: it was estimated a frequency of 1/245 couples are at risk of haemoglobinopathies. This paper reviews legislative actions, prevention activities, carrier screening, genetic counselling, foetal sampling and laboratory methodology analysis evolution reporting the results of 30 years of prevention actions to assess the efficiency of our preventative programme in the control of haemoglobinopathies in Sicily. METHODS This programme consisted principally of five phases: legislative actions, public awareness campaign, carrier screening, genetic counselling and prenatal diagnosis. RESULTS These programmes have been very effective, which we can see from a greater public awareness of thalassaemia and its prevention in the target population furthermore by a marked decline in the incidence of thalassaemia major and sickle cell anaemia from 1 in 245 live births in the absence of prevention to 1 in 2000, with a reduction in about 85%. The residual cases were because of a conscious choice by expecting parents in relation to improved life expectancy as well as improved quality of life of the affected patients. CONCLUSION The study suggests that public health authorities should act and invest in a similar programme for prevention of thalassaemia, as well as in relation to the increased survival of patients and the consequent organ complications.
Collapse
Affiliation(s)
- A Giambona
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Prenatal of Hemoglobinipathies, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - G Damiani
- U.O.C. of Gynecology and Obstetrics, U.O.S. Prenatal Diagnosis, A.O.R. Villa Sofia-Cervello Hospital, Palermo, Italy
| | - M Vinciguerra
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Prenatal of Hemoglobinipathies, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - C Jakil
- U.O.C. of Gynecology and Obstetrics, U.O.S. Prenatal Diagnosis, A.O.R. Villa Sofia-Cervello Hospital, Palermo, Italy
| | - M Cannata
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Prenatal of Hemoglobinipathies, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - F Cassarà
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Prenatal of Hemoglobinipathies, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - F Picciotto
- U.O.C. of Gynecology and Obstetrics, U.O.S. Prenatal Diagnosis, A.O.R. Villa Sofia-Cervello Hospital, Palermo, Italy
| | - G Schillaci
- U.O.C. of Gynecology and Obstetrics, U.O.S. Prenatal Diagnosis, A.O.R. Villa Sofia-Cervello Hospital, Palermo, Italy
| | - V Cigna
- U.O.C. of Gynecology and Obstetrics, U.O.S. Prenatal Diagnosis, A.O.R. Villa Sofia-Cervello Hospital, Palermo, Italy
| | - D Renda
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Prenatal of Hemoglobinipathies, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - F Leto
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Prenatal of Hemoglobinipathies, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - C Passarello
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Prenatal of Hemoglobinipathies, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - A Maggio
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Prenatal of Hemoglobinipathies, Villa Sofia-Cervello Hospital, Palermo, Italy
| |
Collapse
|