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Ukonmaanaho EM, Dell'Anna S, Hakonen A, Wartiovaara-Kautto U, Kakko S, Rab MAE, van Oirschot B, Kraatari-Tiri M, van Wijk R, Rahikkala E. Biallelic hexokinase 1 (HK1) variants causative of non-spherocytic haemolytic anaemia: A case series with emphasis on the HK1 promoter variant and literature review. Br J Haematol 2024; 204:2040-2048. [PMID: 38415930 DOI: 10.1111/bjh.19368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 01/21/2024] [Accepted: 02/16/2024] [Indexed: 02/29/2024]
Abstract
The hexokinase (HK) enzyme plays a key role in red blood cell energy production. Hereditary non-spherocytic haemolytic anaemia (HNSHA) caused by HK deficiency is a rare disorder with only 12 different disease-associated variants identified. Here, we describe the clinical features and genotypes of four previously unreported patients with hexokinase 1 (HK1)-related HNSHA, yielding two novel truncating HK1 variants. The patients' phenotypes varied from mild chronic haemolytic anaemia to severe infantile-onset transfusion-dependent anaemia. Three of the patients had mild haemolytic disease caused by the common HK1 promoter c.-193A>G variant combined with an intragenic HK1 variant, emphasizing the importance of including this promoter variant in the haemolytic disease gene panels. HK activity was normal in a severely affected patient with a homozygous HK1 c.2599C>T, p.(His867Tyr) variant, but the affinity for ATP was reduced, hampering the HK function. In cases of HNSHA, kinetic studies should be considered in the functional studies of HK. We reviewed the literature of previously published patients to provide better insight into this rare disease and add to the understanding of genotype-phenotype correlation.
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Affiliation(s)
- Elli-Maija Ukonmaanaho
- Division of Pediatric Hematology and Oncology, Oulu University Hospital, Oulu, Finland
- University of Helsinki, Helsinki, Finland
| | - Silvia Dell'Anna
- Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Anna Hakonen
- Department of Clinical Genetics, HUSLAB, HUS Diagnostic Center, Helsinki University Hospital, Helsinki, Finland
| | | | - Sakari Kakko
- Department of Hematology, Oulu University Hospital, Oulu, Finland
| | - Minke A E Rab
- Central Diagnostic laboratory, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Brigitte van Oirschot
- Central Diagnostic laboratory, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Minna Kraatari-Tiri
- Department of Clinical Genetics, Oulu University Hospital, Oulu, Finland
- Research Unit of Clinical Medicine and Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Richard van Wijk
- Central Diagnostic laboratory, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Elisa Rahikkala
- Department of Clinical Genetics, Oulu University Hospital, Oulu, Finland
- Research Unit of Clinical Medicine and Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
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Dongerdiye R, Jagadeesh S, Suresh B, Rajendran A, Devendra R, Warang P, Kedar PS. Novel pathogenic variant c.2714C>A (p. Thr905Lys) in the HK1 gene causing severe haemolytic anaemia with developmental delay in an Indian family. J Clin Pathol 2020; 74:620-624. [PMID: 33361148 DOI: 10.1136/jclinpath-2020-206960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 12/01/2020] [Accepted: 12/01/2020] [Indexed: 11/04/2022]
Abstract
Hexokinase (EC 2.7.1.1, Adenosine Tri Phosphate (ATP): D-hexose-6-phosphotransferase) is a crucial regulatory enzyme of the glycolytic pathway (Embden-Meyerhof pathway). Hexokinase deficiency is associated with chronic non-spherocytic haemolytic anaemia (HA) with some exceptional cases showing psychomotor/mental retardation and fetus death. The proband is a four-and-half-year-old female child born of a four-degree consanguineous marriage hailing from South India with autosomal recessive congenital HA associated with developmental delay. She was well till 3 months of her age post an episode of diarrhoea when she was noted to be severely anaemic and requiring regular transfusions. The common causes of HA, haemoglobinopathies, red cell membranopathies and common red cell enzymopathies (G6PD, GPI, PK and P5N) were ruled out. Targeted analysis of whole exome sequencing (WES) using an insilico gene panel for hereditary anaemia was performed to identify pathogenic variants in the patient. Next-generation sequencing revealed a novel homozygous variant in hexokinase gene c.2714C>A (p. Thr905Lys) in exon-18. The pathogenic nature of the variant p. Thr905Lys in the HK1 gene was confirmed collectively by biochemical and molecular studies. Insilico analysis (PolyPhen-2, Provean, Mutation Taster) predicted the variant to be severe disease causing. Multiple sequence alignment demonstrated the conservation of p. Thr905 across the species. The impact of the mutation on the protein structure was studied by PyMOL and Swiss Protein databank viewer.
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Affiliation(s)
- Rashmi Dongerdiye
- Hematogenetics, National Institute of Immunohaematology, Mumbai, Maharashtra, India
| | - Sujatha Jagadeesh
- Department of Clinical Genetics and Genetic Counseling Department, MediScan Systems, Chennai, Tamil Nadu, India
| | - Beena Suresh
- Department of Clinical Genetics and Genetic Counseling Department, MediScan Systems, Chennai, Tamil Nadu, India
| | - Aruna Rajendran
- Department of Hematology, Institute of Child Health and Hospital for Children, Chennai, Tamil Nadu, India
| | - Rati Devendra
- Hematogenetics, National Institute of Immunohaematology, Mumbai, Maharashtra, India
| | - Prashant Warang
- Hematogenetics, National Institute of Immunohaematology, Mumbai, Maharashtra, India
| | - Prabhakar S Kedar
- Hematogenetics, National Institute of Immunohaematology, Mumbai, Maharashtra, India
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Jamwal M, Aggarwal A, Palodi A, Sharma P, Bansal D, Maitra A, Das R. A nonsense variant in the Hexokinase 1 gene (HK1) causing severe non-spherocytic haemolytic anaemia: genetic analysis exemplifies ambiguity due to multiple Isoforms. Br J Haematol 2019; 186:e142-e145. [PMID: 31119733 DOI: 10.1111/bjh.15981] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Manu Jamwal
- Department of Haematology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Anu Aggarwal
- Department of Haematology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Arindam Palodi
- National Institute of Biomedical Genomics, Kalyani, West Bengal, India
| | - Prashant Sharma
- Department of Haematology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Deepak Bansal
- Haematology-Oncology Unit, Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Arindam Maitra
- National Institute of Biomedical Genomics, Kalyani, West Bengal, India
| | - Reena Das
- Department of Haematology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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