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Wang G, Deng H, Peng P, Zheng H, Tian B, Zhu C. Compound heterozygosity for Southeast Asian hereditary persistence of fetal hemoglobin and β0-thalassemia results in thalassemia intermedia: Pedigree analysis and genetic research in a family from South China. A case report. Medicine (Baltimore) 2024; 103:e37446. [PMID: 38457547 PMCID: PMC10919527 DOI: 10.1097/md.0000000000037446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 02/09/2024] [Indexed: 03/10/2024] Open
Abstract
RATIONALE Compound heterozygotes for deletional β-thalassemia can be difficult to diagnose due to its diverse clinical presentations and no routine screenings. This can lead to disease progression and delay in treatment. PATIENT CONCERNS We reported pedigree analysis and genetic research in a family with rare β-thalassemia. DIAGNOSIS Pedigree analysis and genetic research demonstrated that the patient was a compound heterozygote for β-thalassemia CD17/Southeast Asian hereditary persistence of fetal hemoglobin deletion, inherited from the parents. Magnetic resonance imaging T2* examination revealed severe iron deposition in the liver. Echocardiography revealed endocardial cushion defect. INTERVENTIONS The patient was treated with Deferasirox after receiving the final molecular genetic diagnosis. The initial once-daily dose of Deferasirox was 20 mg/kg/d. OUTCOMES The patient discontinued the medication three months after the first visit. Two years later, the patient visited the Department of Hepatobiliary and Pancreatic Diseases. He was recommended to undergo splenectomy after surgical repair of the congenital heart disease. However, the patient refused surgical treatment because of the economic burden. LESSONS We report that fetal hemoglobin is a sensitive indicator for screening large deletions of the β-globin gene, which can be effectively confirmed by the multiplex ligation-dependent probe amplification assay. In non-transfusion-dependent thalassemia patients, iron status assessment should be regularly performed, and iron chelation treatment should be initiated early. This case will provide insights for the diagnosis of rare genotypes of β-thalassemia and has important implications for genetic counseling.
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Affiliation(s)
- Guangli Wang
- Genetics and Precision Medicine Laboratory, Affiliated Hospital of Guilin Medical University, Guilin, China
| | - Huiping Deng
- Genetics and Precision Medicine Laboratory, Affiliated Hospital of Guilin Medical University, Guilin, China
- Department of Neonatology, The Third People’s Hospital of Hubei province, Wuhan, China
| | - Peng Peng
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Haiqing Zheng
- Genetics and Precision Medicine Laboratory, Affiliated Hospital of Guilin Medical University, Guilin, China
| | - Baodong Tian
- Genetics and Precision Medicine Laboratory, Affiliated Hospital of Guilin Medical University, Guilin, China
| | - Chunjiang Zhu
- Genetics and Precision Medicine Laboratory, Affiliated Hospital of Guilin Medical University, Guilin, China
- Department of Pediatrics, Affiliated Hospital of Guilin Medical University, Guilin, China
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Huang H, Chen M, Chen L, Zhang M, Wang Y, Lin N, Xu L. Prenatal diagnosis of thalassemia in 695 pedigrees from southeastern China: a 10-year follow-up study. J Clin Lab Anal 2021; 35:e23982. [PMID: 34480509 DOI: 10.1002/jcla.23982] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 08/16/2021] [Accepted: 08/18/2021] [Indexed: 01/01/2023] Open
Abstract
Thalassaemia is highly prevalent in southeastern China. This 10-year follow-up study aimed to characterize the genotype and karyotype of thalassaemia in fetal samples derived from thalassemia carriers in Fujian province, southeastern China. A total of 476 prenatal samples from 472 couples carrying α-thalassaemia traits and 224 samples from 223 couples carrying β-thalassaemia traits were collected for STR analysis, detection of thalassemia genotypes and karyotyping. The common deletional α-thalassemias and rare thalassemia genotypes were detected using Gap-PCR assay, and the common β-globin gene mutations were detected using PCR-RDB assay. We detected 43.49% prevalence of α-thalassaemia minor, 26.05% prevalence of α-thalassaemia intermediate and major and 1.89% prevalence of rare form among the 476 prenatal samples from couples with α-thalassaemia, and 85 fetuses with β-thalassemia heterozygote, 16 with homozygote and 21 with double heterozygote, and a rare βIVS-2-654(C→T) /Chinese Gγ (A γδβ)0 genotype among the 224 prenatal samples from couples with β-thalassemia. Karyotyping showed 7 fetuses with abnormal karyotypes. Totally 153 pregnancies were terminated, and genetic diagnosis of thalassemia using fetal umbilical cord blood following induction of labor showed consistent results with prenatal diagnosis. No thalassemia phenotypes were identified in normal infants half a year after birth, and the infants with α-thalassemia and β-thalassemia minor had no or mild anemia symptoms, but normal development, while 15 babies with hemoglobin H disease presented moderate anemia symptoms. Our data suggest the pregestational screening of thalassemia, notably compound and rare forms of thalassemia, for couples carrying thalassemia traits.
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Affiliation(s)
- Hailong Huang
- Center for Medical Genetic Diagnosis and Therapy, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian Province, China.,Fujian Key Laboratory for Prenatal Diagnosis and Birth Defect, Fuzhou, Fujian Province, China
| | - Meihuan Chen
- Center for Medical Genetic Diagnosis and Therapy, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian Province, China.,Fujian Key Laboratory for Prenatal Diagnosis and Birth Defect, Fuzhou, Fujian Province, China
| | - Lingji Chen
- Center for Medical Genetic Diagnosis and Therapy, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian Province, China.,Fujian Key Laboratory for Prenatal Diagnosis and Birth Defect, Fuzhou, Fujian Province, China
| | - Min Zhang
- Center for Medical Genetic Diagnosis and Therapy, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian Province, China.,Fujian Key Laboratory for Prenatal Diagnosis and Birth Defect, Fuzhou, Fujian Province, China
| | - Yan Wang
- Center for Medical Genetic Diagnosis and Therapy, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian Province, China.,Fujian Key Laboratory for Prenatal Diagnosis and Birth Defect, Fuzhou, Fujian Province, China
| | - Na Lin
- Center for Medical Genetic Diagnosis and Therapy, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian Province, China.,Fujian Key Laboratory for Prenatal Diagnosis and Birth Defect, Fuzhou, Fujian Province, China
| | - Liangpu Xu
- Center for Medical Genetic Diagnosis and Therapy, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian Province, China.,Fujian Key Laboratory for Prenatal Diagnosis and Birth Defect, Fuzhou, Fujian Province, China
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