Current problems in haematology. 2: Hereditary spherocytosis

The Correlation Between Clinical Phenotype and Genotype of Hereditary Spherocytosis

Objective: Hereditary spherocytosis (HS) is a common hereditary hemolytic disease. This study aimed to explore the correlation between the phenotype and mutant genotype of HS to improve the clinical understanding of HS. Methods: This study reported a case of spontaneous mutation of the ANK1 gene in HS, reviewed previous studies on the genotype-phenotype correlation of HS, statistically analyzed the main types of gene mutations in HS, and summarized the clinical data of patients. Results: This patient had clinical manifestations of anemia, splenomegaly, peripheral blood smear with increased spherocytosis, and bilirubin, confirmed as ANK1 gene mutant HS by gene detection. In addition, this study included 14 previous studies on genotype-phenotype correlation, collected data, and determined that the ANK1 and SPTB genes were the most common types of gene mutations in HS patients. The mutant HS of the ANK1 gene would lead to lower hemoglobin levels. Conclusion: The results of this study showed that ANK1 and SPTB were the most common types of gene mutations in HS patients. Compared with patients with the SPTB genotype HS, patients with ANK1 mutant HS had more severe extravascular hemolysis, and a higher proportion needed splenectomy in early childhood.

Excessive arterial thrombus in spherocytosis. A case report

Spherocytosis is the most common of the hereditary hemolytic anemias, with characteristically shaped erythrocytes. An unusually large amount of arterial thrombus was documented in a dissected artery after angioplasty in a patient with spherocytosis. It is hypothesized that the excessive arterial thrombus may have been linked to the spherocytosis.

Anemia

OBJECTIVES

To provide an overview of the disorders that cause anemia and to review clinical and laboratory assessment and medical and nursing management of the anemic patient.

DATA SOURCES

Published articles and book chapters that pertain to red blood cell physiology and the major causes and types of anemia.

CONCLUSIONS

Advances in molecular and genetic aspects of anemia are leading to new developments in the diagnosis and management of all types of anemia. Symptomatic relief to maintain quality of life is essential for all anemic patients.

IMPLICATIONS FOR NURSING PRACTICE

Nurses can play a major role in the supportive care of patients with anemia through interventions related to pharmacological therapy, blood transfusions, nutritional counseling, and symptom management.