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Kangastupa P, Åkerman K, Risku S, Väisänen M, Kuusela R, Romppanen J, Kouki A, Sneck M, Itkonen O, Niemelä O. The prevalence of hemoglobin Tacoma in Finland detected by HbA1c capillary electrophoresis. Scand J Clin Lab Invest 2023; 83:51-57. [PMID: 36633442 DOI: 10.1080/00365513.2022.2164739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Previous studies have identified occasional cases of heterozygous Hb Tacoma in areas that have attracted Finnish immigrants, especially in Sweden and North America, but large studies of this slightly unstable beta variant in vitro have not been carried out. Here we determined the prevalence of hemoglobin variants across Finland. A total of 5059 samples from 11 different hospital districts were analyzed using HbA1c capillary electrophoresis and reviewed for atypical profiles (HbA1c, Capillarys 3 Tera, Sebia). 38 heterozygous Hb Tacoma cases were found (0.75%). The prevalence was highest in South Ostrobothnia (2.0%), located in western Finland, and second highest in the neighboring provinces (1.0-1.4%), but only two districts were devoid of variants. Heterozygous Hb Tacoma was confirmed by genetic testing (NM_000518.5(HBB):c.93G > T (p.Arg31Ser)). In addition, five other variants were found, suggestive of HbE, Hb Helsinki (two cases) and an alpha variant, as interpreted from the electropherograms. The fifth variant, belonging to the South Ostrobothnian cohort, remained unknown at the time of the initial analyses, but was later interpreted as homozygous Hb Tacoma and confirmed by hemoglobin fraction analysis (Hemoglobin(E), Capillarys 3 Tera). In a subsequent retrospective study of the electropherograms of routine HbA1c diagnostics, altogether nine homozygous Hb Tacoma cases were identified in South Ostrobothnia. While heterozygous Hb Tacoma is usually an incidental finding, it interferes with several HbA1c assays. The present study is the first demonstration of homozygous Hb Tacoma. The clinical presentations of homozygous Hb Tacoma are not known and need to be addressed in future studies.
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Affiliation(s)
- Päivikki Kangastupa
- Department of Clinical Chemistry, Seinäjoki Central Hospital, Seinäjoki, Finland
| | - Kari Åkerman
- Department of Clinical Chemistry, Seinäjoki Central Hospital, Seinäjoki, Finland
| | - Sari Risku
- Department of Internal Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland
| | - Matti Väisänen
- Department of Clinical Chemistry, Vaasa Central Hospital, Vaasa, Finland
| | | | | | - Annika Kouki
- City of Turku, Welfare Division, Health Care Services, Turku, Finland.,Turku University Hospital, Tykslab, Turku, Finland
| | - Mia Sneck
- Department of Clinical Chemistry, Helsinki University Hospital, Helsinki, Finland
| | - Outi Itkonen
- Department of Clinical Chemistry, Helsinki University Hospital, Helsinki, Finland
| | - Onni Niemelä
- Department of Clinical Chemistry, Seinäjoki Central Hospital, Seinäjoki, Finland.,Department of Laboratory Medicine, University of Tampere, Tampere, Finland
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Merkeley H, Sandercock N, Halchuk L, Braga M, Verhovsek M. A novel means of identifying hemoglobin Tacoma utilizing capillary electrophoresis with a hemoglobin A 1c software platform. COGENT MEDICINE 2021. [DOI: 10.1080/2331205x.2021.2002502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Hayley Merkeley
- Department of Medicine, University of British Columbia, Vancouver, Canada
- Department of Medicine, University of Toronto, Toronto, Canada
| | - Nicholas Sandercock
- Hamilton Regional Laboratory Medicine Program, Hamilton, Canada
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Canada
| | - Linda Halchuk
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Canada
- Department of Medicine, McMaster University, Hamilton, Canada
| | - Manoela Braga
- Department of Medicine, McMaster University, Hamilton, Canada
| | - Madeleine Verhovsek
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Canada
- Department of Medicine, McMaster University, Hamilton, Canada
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Abdullah UYH, Ibrahim HM, Mahmud NB, Salleh MZ, Teh LK, Noorizhab MNFB, Zilfalil BA, Jassim HM, Wilairat P, Fucharoen S. Genotype-Phenotype Correlation of β-Thalassemia in Malaysian Population: Toward Effective Genetic Counseling. Hemoglobin 2020; 44:184-189. [PMID: 32586164 DOI: 10.1080/03630269.2020.1781652] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Effective prevention of β-thalassemia (β-thal) requires strategies to detect at-risk couples. This is the first study attempting to assess the prevalence of silent β-thal carriers in the Malaysian population. Hematological and clinical parameters were evaluated in healthy blood donors and patients with β-thal trait, Hb E (HBB: c.79G>A)/β-thal and β-thal major (β-TM). β-Globin gene sequencing was carried out for 52 healthy blood donors, 48 patients with Hb E/β-thal, 34 patients with β-TM and 38 patients with β-thal trait. The prevalence of silent β-thal carrier phenotypes found in 25.0% of healthy Malaysian blood donors indicates the need for clinician's awareness of this type in evaluating β-thal in Malaysia. Patients with β-TM present at a significantly younger age at initial diagnosis and require more blood transfusions compared to those with Hb E/β-thal. The time at which genomic DNA was extracted after blood collection, particularly from patients with β-TM and Hb E/β-thal, was found to be an important determinant of the quality of the results of the β-globin sequencing. Public education and communication campaigns are recommended as apparently healthy individuals have few or no symptoms and normal or borderline hematological parameters. β-Globin gene mutation characterization and screening for silent β-thal carriers in regions prevalent with β-thal are recommended to develop more effective genetic counseling and management of β-thal.
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Affiliation(s)
- Uday Y H Abdullah
- Department of Pathology, Faculty of Medicine, Universiti Sultan Zainal Abidin, Kuala Terengganu, Malaysia
| | - Hishamshah M Ibrahim
- Paediatric Haematology, Oncology and Haemopoietic Stem Cell Transplant Unit, Hospital Kuala Lumpur (HKL) Jalan Pahang, Kuala Lumpur, Malaysia
| | - Noraesah Binti Mahmud
- Department of Pathology, Hospital Kuala Lumpur (HKL) Jalan Pahang, Kuala Lumpur, Malaysia
| | - Mohamad Zaki Salleh
- Integrative Pharmacogenomics Institute (iPROMISE), Universiti Teknologi Mara (UiTM), Bandar Puncak Alam, Malaysia
| | - Lay Kek Teh
- Integrative Pharmacogenomics Institute (iPROMISE), Universiti Teknologi Mara (UiTM), Bandar Puncak Alam, Malaysia
| | | | - Bin Alwi Zilfalil
- Department of Paediatric, School of Medical Science, Health Campus, Univesiti Sains Malaysia (USM), Kelantan, Malaysia
| | - Haitham Muhammed Jassim
- Department of Emergency, Rockingham Peel Group, South Metropolitan Health Service, Rockingham, Australia
| | - Prapin Wilairat
- National Doping Control Centre, Mahidol University, Bangkok, Thailand
| | - Suthat Fucharoen
- Thalassaemia Research Centre, Institute of Molecular Biosciences, Mahidol University, Nakornpathom, Thailand
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Wolf A, Rohr JM, Amador C, Starr LJ, Hoyer JD, Ford JB. Hb Gibbon [β124(H2)Pro→Thr ( HBB: c.373C>A, p.P125T)], an Asymptomatic Novel Hemoglobin Variant Detected by Newborn Screening. Hemoglobin 2019; 43:207-209. [PMID: 31387435 DOI: 10.1080/03630269.2019.1634591] [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: 10/26/2022]
Abstract
We describe here a previously unreported hemoglobin (Hb) variant, Hb Gibbon [β124(H2)Pro→Thr (HBB: c.373C>A, p.P125T)] detected by newborn Hb screening in a term male with no family history for hemoglobinopathy or other screening abnormalities. This missense mutation produces a β-globin chain variant that was detected by high performance liquid chromatography (HPLC) methods, but is silent by capillary electrophoresis (CE). DNA sequencing studies revealed that his father was also a heterozygote for this mutation. Neither has abnormalities on complete blood count (CBC) or any symptomatology.
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Affiliation(s)
- Alejandro Wolf
- Department of Pathology and Microbiology, University of Nebraska Medical Center , Omaha , NE , USA
| | - Joseph M Rohr
- Department of Pathology and Microbiology, University of Nebraska Medical Center , Omaha , NE , USA
| | - Catalina Amador
- Department of Pathology and Microbiology, University of Nebraska Medical Center , Omaha , NE , USA
| | - Lois J Starr
- Department of Pediatrics, Children's Hospital and Medical Center, University of Nebraska Medical Center , Omaha , NE , USA
| | - James D Hoyer
- Department of Laboratory Medicine and Pathology, Mayo Clinic , Rochester , MN , USA
| | - James B Ford
- Department of Pediatrics, Children's Hospital and Medical Center, University of Nebraska Medical Center , Omaha , NE , USA
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Jia W, Wang W, Zhu H, Chen P. A Novel Mutation at HBB: c.91delA (Codon 30, -A) Causing β-Thalassemia in a Chinese Family. Acta Haematol 2019; 142:249-252. [PMID: 31108495 DOI: 10.1159/000499860] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 03/22/2019] [Indexed: 12/28/2022]
Abstract
β-Thalassemia is a genetic disease characterized by the defective synthesis of the hemoglobin tetramer β-globin chains. So far, a number of mutations have been identified and associated with this genetic disease. A high incidence of thalassemia has been found in Guangxi (China). Herein, we report a case of a patient with slightly increased HbA2 levels (4.6%). Based on the clinical data and laboratory findings, the patient was diagnosed with β-thalassemia. Routine genetic screening tests were negative. Sequencing revealed an A deletion at codon 30 (HBB: c.91delA) and the genotype of this patient was βCD30M/β. This mutation changes the splice receptor site of intron 1 from AG to GG, which likely abolishes splicing at the normal 5' splicing site and may cause β0-thalassemia. Based on hematological and clinical evaluations, this novel mutation was regarded as a β0-thalassemia allele. A homozygosity or compound heterozygosity of this mutation and other β0-thalassemia alleles can lead to severe thalassemia disease.
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Affiliation(s)
- Wenguang Jia
- Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Guangxi Key Laboratory of Thalassemia Research, Nanning, China
| | | | - Hengying Zhu
- The First Affiliated Hospital of Guangxi Medical University, Guangxi Key Laboratory of Thalassemia Research, Nanning, China
| | - Ping Chen
- The First Affiliated Hospital of Guangxi Medical University, Guangxi Key Laboratory of Thalassemia Research, Nanning, China,
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Saechan V, Nopparatana C, Nopparatana C, Fucharoen S. Molecular basis and hematological features of hemoglobin variants in Southern Thailand. Int J Hematol 2010; 92:445-50. [DOI: 10.1007/s12185-010-0682-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2010] [Revised: 08/19/2010] [Accepted: 08/25/2010] [Indexed: 11/25/2022]
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Chan OTM, Westover KD, Dietz L, Zehnder JL, Schrijver I. Comprehensive and efficient HBB mutation analysis for detection of beta-hemoglobinopathies in a pan-ethnic population. Am J Clin Pathol 2010; 133:700-7. [PMID: 20395516 DOI: 10.1309/ajcp7hq2kwghecio] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Current methods that assay hemoglobin beta-globin chain variants can have limited clinical sensitivity when applied techniques identify only a predefined panel of mutations. Even sequence-based assays may be limited depending on which gene regions are investigated. We sought to develop a clinically practical yet inclusive molecular assay to identify beta-globin mutations in multicultural populations. We highlight the beta-globin mutation detection assay (beta-GMDA), an extensive gene sequencing assay. The polymerase chain reaction (PCR) primers are located to encompass virtually all hemoglobin beta locus (HBB) mutations. In addition, this assay is able to detect, by gap PCR, a common large deletion (Delta619 base pair), which would be missed by sequencing alone. We describe our 5-year experience with the beta-GMDA and indicate its capability for detecting homozygous, heterozygous, and compound heterozygous sequence changes, including previously unknown HBB variants. The beta-GMDA offers superior sensitivity and ease of use with comprehensive detection of HBB mutations that result in beta-globin chain variants.
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