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Rashid N. Addison's disease in a lady with hemoglobin H disease. IRAQI JOURNAL OF HEMATOLOGY 2022. [DOI: 10.4103/ijh.ijh_42_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Genetic epidemiology of hemoglobinopathies among Iraqi Kurds. J Community Genet 2020; 12:5-14. [PMID: 33222097 DOI: 10.1007/s12687-020-00495-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 11/08/2020] [Indexed: 10/22/2022] Open
Abstract
Hemoglobinopathies are major health problems among Iraqi Kurds, who are a distinct ethnic group inhabiting North and Northeastern Iraq. We reviewed published literature on these disorders in this part of the world, and it was revealed that the most prevalent is β-thalassemia with carrier rates of 3.7-6.9%. Alpha thalassemia is less prevalent with carrier rates of 0.03-1.22%, while the sickle cell gene is variably distributed with carrier rates of 0.06-1.2%. Other structural hemoglobinopathies and δβ-thalassemia are sporadic. Twenty-seven different β-thalassemia mutations were identified, with seven constituting 82% of 1039 chromosomes characterized, namely: IVS-II-1 (G>A), IVS-I-6 (T>C), IVS-I-I (G>A), codon 8 (-AA), codon 8/9 (+G), IVS-I-110 (G>A), and codon 5 (-CT). There were notable regional variations in the distribution of β-thalassemia mutations, with Cd44 being mainly prevalent in the North, while IVS-I-110 is mainly prevalent in the East. In relevance to α-thalassemia, ten different mutations were detected, with the four most frequent constituting 92.4% of 262 alleles characterized being: -α3.7, --MED, α-5ntα, and αPolyA1α. In relevance to sickle cell gene, it is seen in the northern part of the region bordering Turkey, with comparable prevalence rates, and is associated, similar to Turkey, mainly with the Benin haplotype, unlike that in Southern Iraq where it is associated with the Arab-Indian haplotype, similar to Eastern Arabian Peninsula. Given the high prevalence of hemoglobinopathies in the region, and the high rates of consanguineous marriages, a preventive program was initiated in 2008, and results of its first 5 years were promising, though there are still many outstanding challenges that require addressing.
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Shamoon RP, Yassin AK, Polus RK, Ali MD. Genotype-phenotype correlation of HbH disease in northern Iraq. BMC MEDICAL GENETICS 2020; 21:203. [PMID: 33059634 PMCID: PMC7559146 DOI: 10.1186/s12881-020-01141-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 10/08/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND HbH disease results from dysfunction of three, less commonly two, α-globin genes through various combinations of deletion and non-deletion mutations. Characterization of the mutations and the underlying genotypes is fundamental for proper screening and prevention of thalassaemia in any region. The aim of this study was to explore the genetic arrangements of HbH disease and to correlate the genotypes with the clinical phenotypes. METHODS A total of 44 HbH disease patients were enrolled in this study. They were clinically and haematologically assessed. The patients were tested for 21 common α-globin gene mutations using multiplex PCR and reverse hybridization. According to the genotype, the patients were categorized into two separate sub-groups, deletion and non-deletion types HbH disease. RESULTS Within the studied HbH disease patients, eight different α-globin gene mutations were detected in nine different genetic arrangements. The --MED and -α3.7 deletions were the two most frequently encountered mutations (37.5 and 35.2% respectively). Patients with deletion genotypes constituted 70.4%. The most common detected genotype was --MED/-α3.7 (59.1%), followed by αpoly-A1α/αpoly-A1α (13.6%). For the first time, coinheritance of two relatively mild mutations (-α3.7/ααAdana) was unpredictably detected in a 1.5 year-old child with Hb of 7.1 g/dL. CONCLUSION The HbH disease patients' clinical characteristics were variable with no ample difference between the deletion and non-deletion types. These results can be of benefit for the screening and management of thalassaemia in this region.
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Affiliation(s)
- Rawand P Shamoon
- Department of Pathology, College of Medicine, Hawler Medical University, Erbil, Iraq. .,Lab. Section, Thalassemia Care Center, Erbil, Iraq.
| | - Ahmed K Yassin
- Department of Internal Medicine, College of Medicine, Hawler Medical University, Erbil, Iraq.,Department of Clinical Hematology, Nanakali Hemato-Oncology Teaching Center, Erbil, Iraq
| | - Ranan K Polus
- Department of Pathology, College of Medicine, Hawler Medical University, Erbil, Iraq
| | - Mohamad D Ali
- Department of Clinical Hematology, Nanakali Hemato-Oncology Teaching Center, Erbil, Iraq
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Shamoon RP. Molecular spectrum of α-thalassemia mutations in Erbil province of Iraqi Kurdistan. Mol Biol Rep 2020; 47:6067-6071. [PMID: 32712856 DOI: 10.1007/s11033-020-05681-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 07/19/2020] [Indexed: 02/06/2023]
Abstract
α-Thalassemia is a globally prevalent genetic disorder of hemoglobin (Hb) structure where the rate of α-globin chain synthesis is reduced or absent based on the underlying α-globin mutation(s). This study aimed to define the spectrum of α-globin gene mutations and assess their relative frequency within a group of α-thalassemia carriers. A total of 96 young subjects with unexplained hypochromia and microcytosis were recruited. They were referred from the premarital hemoglobinopathy screening and genetic counseling center in Erbil. All subjects were genetically tested for 21 common α-globin gene mutations using multiplex PCR and reverse hybridization. Six different α-globin gene mutations and nine different genotypes were detected in 84 carrier subjects. Their mean Hb was 12.9 (± 1.29) g/dL, of whom 49 subjects (58.3%) had a normal Hb level. The two most frequently encountered mutations were -α3.7 deletion (62.86%) and α2-5nt mutation (20%). Deletions were encountered in 71.43% of the mutated alleles. The most commonly observed genotype was -α3.7/αα (46.43%), followed by -α3.7/-α3.7 and α-5ntα/αα genotypes (10.72% each). Carriers of αpoly-A1α/αα and -α3.7/-α-5ntα genotypes showed significantly lower Hb, mean cell volume, and mean cell Hb values comparing to carriers of most other genotypes. In our population, the spectrum of α-globin mutations was confined to a limited number of mutations with deletions being mostly observed.
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Affiliation(s)
- Rawand P Shamoon
- Department of Pathology, College of Medicine, Hawler Medical University, Erbīl, Iraq. .,Department of Hematopathology, Nanakali Hemato-Oncology Teaching Center, Erbīl, Iraq. .,Unit of Hematopathology, Erbil Thalassemia Care Center, Erbīl, Iraq. .,Laboratory Division, PAR Hospital, Erbīl, Iraq.
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Alibakhshi R, Moradi K, Aznab M, Dastafkan Z, Tahmasebi S, Ahmadi M, Omidniakan L. The Spectrum of α-Thalassemia Mutations in Kurdistan Province, West Iran. Hemoglobin 2020; 44:156-161. [PMID: 32588682 DOI: 10.1080/03630269.2020.1768863] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
In order to identify the α-thalassemia (α-thal) mutation spectrum in Kurdistan Province, West Iran, a total of 217 individuals, including 154 α-thal carriers and 63 normal subjects were investigated in this study. Molecular analysis of α1- and α2-globin genes using multiplex gap-polymerase chain reaction (gap-PCR), amplification refractory mutation system (ARMS)-PCR or direct DNA sequencing, showed 11 different α-globin variants. The -α3.7 (rightward) deletion (NG_000006.1: g.34164_37967del3804) (70.32%), polyadenylation signal (polyA2) site (AATAAA>AATGAA) (αpolyA2α) (HBA2: c.*92A>G) (7.74%), -α4.2 (leftward) deletion (6.45%) and codon 59 (or Hb Adana) (G>A) (ααcodon 59) (HBA1: c.179G>A) (4.52%) were the most frequent mutations in the present study. In conclusion, the spectrum of α-thal mutations in Kurdistan Province is closest to that in western provinces of Iran (Kurdish and Laki populations). In addition, it was revealed that the codon 59 mutation is common in the Kurdish population. On the other hand, despite the same ethnic background of Kurds in Iran and Iraq, the - -MED I double gene deletion and polyA2 point mutation have different distributions in these two populations. Therefore, further studies are needed to identify the cause of these differences.
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Affiliation(s)
- Reza Alibakhshi
- Department of Biochemistry, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Keivan Moradi
- Department of Biochemistry, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mozaffar Aznab
- Department of Hematology Oncology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Zahra Dastafkan
- Medical Genetics Laboratory, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Susan Tahmasebi
- Medical Genetics Laboratory, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mahsa Ahmadi
- Medical Genetics Laboratory, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Leila Omidniakan
- Medical Genetics Laboratory, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Moradi K, Aznab M, Azimi A, Biglari M, Shafieenia S, Alibakhshi R. α-Thalassemia Mutations in Ilam Province, West Iran. Hemoglobin 2020; 46:147-152. [PMID: 32072847 DOI: 10.1080/03630269.2019.1694033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Despite several studies performed in different provinces of Iran to identify the spectrum of α-globin gene mutations, no such study has so far been carried out in Ilam Province. A total of 274 individuals, including 201 α-thalassemia (α-thal) carriers and 73 normal subjects, originating from the northern counties of Ilam Province, participated in this study. Analysis of α-globin defects was performed using multiplex gap-polymerase chain reaction (gap-PCR), amplification refractory mutation system (ARMS)-PCR and direct sequencing, which revealed a total of 11 different mutations and 22 different genotypes. The -α3.7 (rightward) (NG_000006.1: g.34164_37967del3804), α-5 ntα (HBA2: c.95 + 2_95 + 6delTGAGG), and -α4.2 (leftward) deletions were the most prevalent mutations identified in our study, with frequencies of 66.23, 10.09 and 8.33%, respectively. In conclusion, the present study showed that the α-thal mutation spectrum in Ilam Province, at least in the northern part of the province, is different from that in other geographical regions of Iran. These results increase our knowledge about the spectrum and distribution of α-globin gene mutations in Iran.
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Affiliation(s)
- Keivan Moradi
- Department of Biochemistry, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mozaffar Aznab
- Department of Hematology, Oncology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Azam Azimi
- Medical Genetics Laboratory, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mostafa Biglari
- Medical Genetics Laboratory, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Samaneh Shafieenia
- Medical Genetics Laboratory, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Reza Alibakhshi
- Department of Biochemistry, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Eftekhari H, Tamaddoni A, Mahmoudi Nesheli H, Vakili M, Sedaghat S, Banihashemi A, Azizi M, Youssefi Kamangar R, Akhavan-Niaki H. A Comprehensive Molecular Investigation of α-Thalassemia in an Iranian Cohort from Different Provinces of North Iran. Hemoglobin 2017; 41:32-37. [PMID: 28385057 DOI: 10.1080/03630269.2017.1299753] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
α-Thalassemia (α-thal) is the most common monogenic disease that is caused by the absence or reduced expression of α-globin genes. The aim of this study was to investigate common α-globin mutations and their associated haplotypes in four northern provinces of Iran (Gilan, Mazandaran, Golestan, Khorasan). One thousand, one hundred and ninety-one persons were tested for α-thal mutations by gap-polymerase chain reaction (PCR), reverse dot-blot hybridization, restriction fragment length polymorphism (RFLP) analysis and sequencing. Of the nine different mutations found, the most frequent were -α3.7 (rightward deletion) (45.6%), polyadenylation site (αp°lyA2α) (α2) (AATAAA>AATGAA; HBA2: c.*92 A>G) (15.27%), - -MED (Mediterranean deletion) (6.86%), -α4.2 (leftward deletion), (6.17%), αCSα [Hb Constant Spring (Hb CS) (HBA2: c.427 T>C)] (4.62%), -α-5 nt (HBA2: c.95+2_95+6delTGAGG) (3.70%). All chromosomes bearing an α-globin point mutation [αp°lyA2α, -α-5 ntα, αCSα, αp°lyA1α (AATAAA> AATAAG; HBA2: c.*94 A>G)] showed only one haplotype that was present in most normal chromosomes, while the -α3.7 deletion was associated with three distinct haplotypes. Our results indicate that α-thal mutations are heterogeneous and -α3.7 and αp°lyA2α are the most prevalent mutations in this region. The presence of -α3.7 with three different haplotypes suggests an older history for this mutation. The high prevalence of αp°lyA2α in Mazandaran Province, Iran compared to other parts of the country and the world, suggests a founder effect. Altogether, we here provide further data confirming the heterogeneity of the northern population of Iran. These data may contribute to the establishment of a national mutation database, more accurate genetic counseling and prenatal diagnosis (PND).
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Affiliation(s)
- Hajar Eftekhari
- a Department of Genetics, Cellular and Molecular Biology Research Centre , Babol University of Medical Sciences , Babol , Iran.,b Department of Genetics, Faculty of Medicine , Babol University of Medical Sciences , Babol , Iran
| | - Ahmad Tamaddoni
- c Department of Hematology, Non-Communicable Pediatric Diseases Research Centre , Babol University of Medical Sciences , Babol , Iran
| | - Hassan Mahmoudi Nesheli
- c Department of Hematology, Non-Communicable Pediatric Diseases Research Centre , Babol University of Medical Sciences , Babol , Iran
| | - Mohsen Vakili
- d Department of Internal Medicine, Ayatollah Roohani Hospital, Babol University of Medical Sciences , Babol , Iran
| | - Sadegh Sedaghat
- d Department of Internal Medicine, Ayatollah Roohani Hospital, Babol University of Medical Sciences , Babol , Iran
| | - Ali Banihashemi
- e Genetic Laboratory of Amirkola Children Hospital, Babol University of Medical Sciences , Babol , Iran
| | - Mandana Azizi
- e Genetic Laboratory of Amirkola Children Hospital, Babol University of Medical Sciences , Babol , Iran
| | - Reza Youssefi Kamangar
- e Genetic Laboratory of Amirkola Children Hospital, Babol University of Medical Sciences , Babol , Iran
| | - Haleh Akhavan-Niaki
- a Department of Genetics, Cellular and Molecular Biology Research Centre , Babol University of Medical Sciences , Babol , Iran.,b Department of Genetics, Faculty of Medicine , Babol University of Medical Sciences , Babol , Iran.,e Genetic Laboratory of Amirkola Children Hospital, Babol University of Medical Sciences , Babol , Iran
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Molecular spectrum of α-globin gene mutations in the Aegean region of Turkey: first observation of three α-globin gene mutations in the Turkish population. Int J Hematol 2015; 102:1-6. [PMID: 25939702 DOI: 10.1007/s12185-015-1796-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 04/13/2015] [Accepted: 04/14/2015] [Indexed: 10/23/2022]
Abstract
Molecular test results of 231 individuals referred to our molecular genetics laboratory for analysis of α-globin gene mutations between the years 2007 and 2013 were evaluated. Analysis of α-thalassemia gene mutations was performed using reverse dot-blot hybridisation, which includes 21 common mutations. Twelve distinct α-thalassemia mutations and 23 different genotypes have been detected in the Aegean region of Turkey. The most frequent mutations were -α3.7 (52.28 %), -(α)20.5 (14.74 %), --MED (10.53 %), and αPA-1α (8.77 %). Three α-thalassemia mutations (αcd142α, --SEA, and αICα), which are more prevalent in Southeast Asia, are identified for the first time in Turkey in this study. We find that a broad spectrum of α-thalassemia mutations is present in the Aegean region of Turkey. The results obtained in this study may help inform decisions in the design and implementation of prevention strategies and diagnostic approaches.
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Farra C, Badra R, Fares F, Muwakkit S, Dbaibo G, Dabbous I, Ashkar H, Mounsef C, Abboud MR. Alpha thalassemia allelic frequency in Lebanon. Pediatr Blood Cancer 2015; 62:120-2. [PMID: 25284125 DOI: 10.1002/pbc.25242] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 08/12/2014] [Indexed: 11/06/2022]
Abstract
BACKGROUND Hemoglobinopathies are the most common reported monogenic disorders worldwide. It is well established that Mediterranean and Arab countries are high risk areas for thalassemia in general, and for alpha thalassemia in particular. Reports of alpha thalassemia gene mutations from the Lebanese population are limited. PROCEDURE We investigated the spectrum of alpha thalassemia mutations in a sample of 70 unrelated Lebanese families. Six different mutations of alpha thalassemia gene were identified. RESULTS The most prevalent mutations were the single gene deletion -α(3.7) (43%) and the non-gene deletion α2 IVS1 [-5nt] (37%). The double deletional determinant -(MED) was detected only in 14% of thalassemic chromosomes. CONCLUSION We determined the mutational spectrum of alpha thalassemia which might be used in the future for molecular investigations of the disease in susceptible patients in our population.
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Affiliation(s)
- Chantal Farra
- Department of Pathology & Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon; Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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Borgio JF, AbdulAzeez S, Al-Nafie AN, Naserullah ZA, Al-Jarrash S, Al-Madan MS, Al-Muhanna F, Steinberg MH, Al-Ali AK. A novel HBA2 gene conversion in cis or trans: “α12 allele” in a Saudi population. Blood Cells Mol Dis 2014; 53:199-203. [DOI: 10.1016/j.bcmd.2014.07.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 07/03/2014] [Indexed: 02/04/2023]
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