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Zhong L, Wang Y, Lin W, Yao Z, Zhang J, Xu H, Feng P, Xu L. Prenatal Genetic Counseling in a Chinese Pregnant Woman With Rare Thalassemia: A Case Report. Front Genet 2021; 12:670168. [PMID: 34122522 PMCID: PMC8194298 DOI: 10.3389/fgene.2021.670168] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 04/14/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Prenatal genetic counseling can be difficult, especially when it is related to fetuses with a rare thalassemia. An intronic variant located far from obvious regulatory sequences in the HBB gene could be very difficult to evaluate as it may affect the mRNA processing or cause β-thalassemia (β-thal). In the present study, a Chinese pregnant woman with HbJ-Bangkok and a very rare change in the second intron of the HBB gene [IVS-II-806(G>C), NM_000518.4, HBB: c.316-45G>C] in combination with α+-thalassemia was reported, which can assist in prenatal genetic counseling. Case Report: A 26-year-old pregnant woman presented at the obstetric clinic for a routine pregnancy check at 12 weeks of gestation. Red blood counts and high-performance liquid chromatography (HPLC) were consistent with clinical manifestations of anemia. Multiplex gap-polymerase chain (gap-PCR) displayed rightward deletion (-α3.7/αα). Direct DNA sequencing of the δ-globin gene showed no mutation. Sanger sequencing of the β-globin gene showed a previously undescribed condition of double heterozygosity for HbJ-Bangkok and a very rare change in the second intron of the HBB gene [IVS-II-806(G>C), NM_000518.4, HBB: c.316-45G>C] that has not been previously reported in the HbVar database. Thus, a rare combination of α+-thal and a compound heterozygosity of HbJ-Bangkok and [IVS-II-806(G>C)] with α+-thal (-α3.7/αα) was finally diagnosed. Prenatal genetic counseling was made based on the genotype and phenotype analyses. Conclusion: This study enlarges the mutation spectrum of β-globin gene and emphasizes DNA analysis in resolving unusual patterns in Hb analysis and the importance of sharing the observed rare undefined mutations and the possible interactions with known molecular defects, which can assist in prenatal genetic counseling.
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Affiliation(s)
- Liangying Zhong
- Department of Laboratory Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ye Wang
- Fetal Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Wenbin Lin
- Department of Laboratory Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhenrong Yao
- Department of Laboratory Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jiang Zhang
- Department of Laboratory Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Hongxu Xu
- Department of Laboratory Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Pinning Feng
- Department of Laboratory Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lijuan Xu
- Department of Endocrinology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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Sripusanapan A, Phusua A, Fanhchaksai K, Charoenkwan P. Compound heterozygosity of a silent beta-thalassemia mutation at the 3'-untranslated region (HBB: c.*132 C>T) and beta-zero thalassemia results in thalassemia intermedia. Pediatr Blood Cancer 2020; 67:e28157. [PMID: 31930713 DOI: 10.1002/pbc.28157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 12/11/2019] [Indexed: 11/05/2022]
Affiliation(s)
- Adivitch Sripusanapan
- Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Arunee Phusua
- Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Kanda Fanhchaksai
- Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Pimlak Charoenkwan
- Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Zhang J, Li P, Yang Y, Yan Y, Zeng X, Li D, Chen H, Su J, Zhu B. Molecular epidemiology, pathogenicity, and structural analysis of haemoglobin variants in the Yunnan province population of Southwestern China. Sci Rep 2019; 9:8264. [PMID: 31164695 PMCID: PMC6547717 DOI: 10.1038/s41598-019-44793-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 05/23/2019] [Indexed: 12/18/2022] Open
Abstract
Abnormal haemoglobin (Hb) variants result in the most commonly inherited disorders in humans worldwide. In this study, we investigated the molecular epidemiology characteristics of Hb variants, along with associated structural and functional predictions in the Yunnan province population of Southwestern China. A total of 41,933 subjects who sought haemoglobinopathy screening were included. Based on bioinformatics and structural analysis, as well as protein modeling, the pathogenesis and type of Hb genetic mutations were characterized. Among all individuals studied, 328 cases (0.78%) were confirmed as carriers of Hb variants, with 13 cases (0.03%) presenting α-globin variants, 313 (0.75%) β-globin variants, and two δ-globin variants. A total of 19 different mutations were identified, including three novel mutations. In addition, 48 cases of ααCS mutations and 14 cases of Hb H or Hb Bart’s were found. The isoelectric point, evolutionary conservation, and genotype-phenotype correlation for these mutations were predicted. Additionally, secondary and tertiary protein structure modeling were performed for three selected mutations. In conclusion, the prevalence of Hb variants in the Yunnan population is much higher than other regions of China. Complete characterization of these Hb variants is essential for generating a rational strategy to control the haemoglobinopathies in this region.
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Affiliation(s)
- Jie Zhang
- Genetic Diagnosis Center, Yunnan Provincial Key Laboratory for Birth Defects and Genetic Diseases, The First People's Hospital of Yunnan Province, Yunnan Province, China. .,Department of Hematology, The First People's Hospital of Yunnan Province, Yunnan Province, China. .,Department of Pediatrics, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China.
| | - Peng Li
- Genetic Diagnosis Center, Yunnan Provincial Key Laboratory for Birth Defects and Genetic Diseases, The First People's Hospital of Yunnan Province, Yunnan Province, China.,Department of Pediatrics, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Yang Yang
- Genetic Diagnosis Center, Yunnan Provincial Key Laboratory for Birth Defects and Genetic Diseases, The First People's Hospital of Yunnan Province, Yunnan Province, China.,Department of Pediatrics, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Yuanlong Yan
- Genetic Diagnosis Center, Yunnan Provincial Key Laboratory for Birth Defects and Genetic Diseases, The First People's Hospital of Yunnan Province, Yunnan Province, China
| | - Xiaohong Zeng
- Genetic Diagnosis Center, Yunnan Provincial Key Laboratory for Birth Defects and Genetic Diseases, The First People's Hospital of Yunnan Province, Yunnan Province, China
| | - Dongmei Li
- Genetic Diagnosis Center, Yunnan Provincial Key Laboratory for Birth Defects and Genetic Diseases, The First People's Hospital of Yunnan Province, Yunnan Province, China
| | - Hong Chen
- Genetic Diagnosis Center, Yunnan Provincial Key Laboratory for Birth Defects and Genetic Diseases, The First People's Hospital of Yunnan Province, Yunnan Province, China
| | - Jie Su
- Genetic Diagnosis Center, Yunnan Provincial Key Laboratory for Birth Defects and Genetic Diseases, The First People's Hospital of Yunnan Province, Yunnan Province, China
| | - Baosheng Zhu
- Genetic Diagnosis Center, Yunnan Provincial Key Laboratory for Birth Defects and Genetic Diseases, The First People's Hospital of Yunnan Province, Yunnan Province, China. .,Department of Hematology, The First People's Hospital of Yunnan Province, Yunnan Province, China. .,Department of Pediatrics, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China.
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Vinciguerra M, Passarello C, Cassarà F, Leto F, Cannata M, Calvaruso G, Renda D, Maggio A, Giambona A. Coheredity of a new silent mutation: c.-29G>T, with a severe β-thal mutation in a patient with β-thalassemia intermediate. Int J Lab Hematol 2018; 40:e17-e20. [PMID: 29405650 DOI: 10.1111/ijlh.12777] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 12/21/2017] [Indexed: 11/29/2022]
Affiliation(s)
- M Vinciguerra
- Laboratory for Molecular Diagnosis of rare Diseases, Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - C Passarello
- Laboratory for Molecular Diagnosis of rare Diseases, Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - F Cassarà
- Laboratory for Molecular Diagnosis of rare Diseases, Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - F Leto
- Laboratory for Molecular Diagnosis of rare Diseases, Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - M Cannata
- Laboratory for Molecular Diagnosis of rare Diseases, Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - G Calvaruso
- Laboratory for Molecular Diagnosis of rare Diseases, Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - D Renda
- Laboratory for Molecular Diagnosis of rare Diseases, Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - A Maggio
- Laboratory for Molecular Diagnosis of rare Diseases, Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - A Giambona
- Laboratory for Molecular Diagnosis of rare Diseases, Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Villa Sofia-Cervello Hospital, Palermo, Italy
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Vinciguerra M, Cannata M, Cassarà F, Passarello C, Leto F, Calvaruso G, Renda D, Maggio A, Giambona A. HBB: c.316-125A>G and HBB: c.316-42delC: Phenotypic Evaluations of Two Rare Changes in the Second Intron of the HBB Gene. Hemoglobin 2017; 41:234-238. [DOI: 10.1080/03630269.2017.1397014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Margherita Vinciguerra
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Monica Cannata
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Filippo Cassarà
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Cristina Passarello
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Filippo Leto
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Giuseppina Calvaruso
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Disma Renda
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Aurelio Maggio
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Antonino Giambona
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases, Villa Sofia-Cervello Hospital, Palermo, Italy
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Paglietti ME, Satta S, Sollaino MC, Barella S, Ventrella A, Desogus MF, Demartis FR, Manunza L, Origa R. The Problem of Borderline Hemoglobin A2 Levels in the Screening for β-Thalassemia Carriers in Sardinia. Acta Haematol 2016; 135:193-9. [PMID: 26794457 DOI: 10.1159/000442194] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 11/04/2015] [Indexed: 01/08/2023]
Abstract
BACKGROUND The increase in HbA2 is the most important parameter for the identification of thalassemia carriers. However, in routine screening for hemoglobinopathies, some cases are difficult to classify because the level of HbA2 is not typically elevated. In this work, we report the results of a molecular investigation on a cohort of subjects with borderline HbA2. METHODS All subjects with a β-thalassemia carrier partner and a borderline percentage level of HbA2 were investigated for the presence of a pathological mutation in the β-globin gene. All negative subjects were screened for both the KLF1 mutation and the presence of ααα/ or αααα/ alleles. The subjects with reduced MCV and/or MCH were also screened for deletional and nondeletional α-globin gene defects. RESULTS Various β-globin mutations and KLF1 gene defects are the most common genetic determinants responsible for this phenotype in our population. CONCLUSION KLF1 mutations are important in a screening program for hemoglobinopathies. An increase in HbF in association with borderline HbA2 levels is a useful but not exclusive marker that suggests the investigation of this gene. On the basis of our findings, we are able to suggest the molecular procedure to use in a population characterized by a high prevalence of thalassemia carriers.
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Affiliation(s)
- Maria Elisabetta Paglietti
- Dipartimento di Sanitx00E0; Pubblica, Medicina Clinica e Molecolare, Universitx00E0; degli Studi di Cagliari, Ospedale Microcitemico, Cagliari, Italy
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