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Jawed I, Alam MO, Fatima FB, Johar SA, Shah SAM. Case report-unveiling a case of hemoglobin D-Punjab variant with iron deficiency anemia in Sindh (Pakistan). SAGE Open Med Case Rep 2024; 12:2050313X241272516. [PMID: 39161918 PMCID: PMC11331452 DOI: 10.1177/2050313x241272516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 07/18/2024] [Indexed: 08/21/2024] Open
Abstract
Hemoglobin D variations are a group of hemoglobinopathies caused by mutations in the genes that control the synthesis of new globin chains. Hemoglobin D-Punjab is the most prevalent but frequently asymptomatic, it can occasionally cause mild to moderate hemolytic anemia, making diagnosis difficult and raising the risk of misdiagnosis. This article discusses a rare instance of a seventeen-year-old male in Sindh, Pakistan with iron deficiency anemia who was later found to have the Punjab variation of the hemoglobin D. The patient had signs of weakness, exhaustion, and shortness of breath, which were initially alleviated by iron supplementation but eventually became refractory. Hemoglobin electrophoresis demonstrated the distinctive hypochromic, microcytic red blood cell shape, and laboratory tests verified the presence of the Hemoglobin D-Punjab feature. The instance emphasizes how crucial it is to distinguish Hemoglobin D-Punjab from other anemias in order to guarantee proper care. This case underscores the importance of recognizing hemoglobin D-Punjab trait, to provide appropriate genetic counseling and ensure the patient's well-being. Increased awareness among healthcare professionals regarding the diverse spectrum of hemoglobinopathies is essential for accurate diagnosis and management.
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Affiliation(s)
- Inshal Jawed
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Mohammad Omer Alam
- Sindh Medical College, Jinnah Sindh Medical University, Karachi, Pakistan
| | | | - Syeda Alisha Johar
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Syed Adil Mir Shah
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
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Iacomelli I, Giulietti C, Paleari R. Hb D-Iran interference on HbA 1c measurement. Clin Chem Lab Med 2024; 0:cclm-2024-0641. [PMID: 39101479 DOI: 10.1515/cclm-2024-0641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Accepted: 07/28/2024] [Indexed: 08/06/2024]
Affiliation(s)
- Iacopo Iacomelli
- Diabetes and Metabolism Unit, Valdarno Hospital S. Maria alla Gruccia, Montevarchi, AR, Italy
| | - Chiara Giulietti
- Internal Medicine Unit, Valtiberina Hospital, USL Toscana Sud Est, Sansepolcro, AR, Italy
| | - Renata Paleari
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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Seydel GS, Ayan D, Balci T, Bayraktar M, Gunturk I. Prevalence of Hemoglobinopathies in Premarital Screening in the Province of Nigde, Turkey. Hemoglobin 2023:1-6. [PMID: 37184118 DOI: 10.1080/03630269.2023.2206971] [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: 05/16/2023]
Abstract
Hemoglobinopathies are one of the most widespread hereditary disorders in Turkey. The present study aimed to determine the prevalence of hemoglobinopathies in the Nigde province of Turkey. This study was conducted with 2013 individuals who applied for the premarital screening, between January 2019 and December 2021. The complete blood count was measured by an automated hematology analyzer. The types of hemoglobin were determined by high-performance liquid chromatography. A total of 2013 individuals including 951 (47.2%) females and 1062 (52.8%) males, were screened within the premarital screening program, and 67 (3.3%) of them were migrants. 53 out of 2013 (2.63%) individuals were identified as β thalassemia carriers, and five of them were migrants including two from Afghanistan, two from Iran, and one from Georgia. HbC was observed in two cases, a couple from Syria (0.1%), HbD in two cases (0.1%), HbE in one case from Thailand (0.05%), HbS-β-thalassemia in one case (0.05%), delta-β thalassemia in one case (0.05%), and unidentified structural variant in one case (0.05%). Moreover, 183 individuals (9.1%) were considered to have iron deficiency, α-thalassemia, or silent β-thalassemia carrier. These results indicate that the province of Nigde is a relatively risky region regarding hemoglobinopathies. Geographic location and immigrant population may have slightly affected the local prevalence of hemoglobinopathies and could be taken into consideration to ensure the effective implementation of the hemoglobinopathy prevention program.
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Affiliation(s)
- Gonul Seyda Seydel
- Department of Health Care Services, Nigde Zubeyde Hanım Vocational School of Health Service, Nigde Omer Halisdemir University, Nigde, Turkey
| | - Durmus Ayan
- Department of Medical Biochemistry, Faculty of Medicine, Nigde Omer Halisdemir University, Nigde, Turkey
- Department of Medical Biochemistry, Nigde Training and Research Hospital, Nigde, Turkey
| | - Tevfik Balci
- Department of Medical Biochemistry, Nigde Training and Research Hospital, Nigde, Turkey
| | - Muhammet Bayraktar
- Department of Public Health, Faculty of Medicine, Nigde Omer Halisdemir University, Nigde, Turkey
| | - Inayet Gunturk
- Department of Midwifery, Zubeyde Hanım Faculty of Health Sciences, Nigde Omer Halisdemir University, Nigde, Turkey
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Heaton C, Witt M, Cole L, Eyre J, Tazzyman S, McColm R, Francese S. Detection and mapping of haemoglobin variants in blood fingermarks by MALDI MS for suspect "profiling". Analyst 2021; 146:4290-4302. [PMID: 34105523 DOI: 10.1039/d1an00578b] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Over the past seven years Matrix Assisted Laser Desorption Ionisation Mass Spectrometry Profiling (MALDI MSP) and Imaging (MALDI MSI) have proven to be feasible tools for the detection of blood and its provenance in stains and fingermarks. However, whilst this capability as a confirmatory test addresses the primary questions at the scene of a violent crime, additional intelligence recoverable from blood can also prove important for investigations. A DNA profile is the most obvious and important example of such intelligence; however, it is not always suitable for identification purposes, depending on quantity, age and environmental conditions. Proteins are much more stable and determining the presence of haemoglobin variants in blood recovered at a crime scene may provide associative and possibly corroborating evidence on the presence of an individual at a particular location. This evidence gains more incriminatory value, the lower the incidence of the variant in a certain geographical area or population and may contribute to narrowing down the pool of suspects. In this study, a MALDI based mass spectrometric method has been developed and tested on six haemoglobin variants for their fast and reliable identification and mapping in blood fingermarks.
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Affiliation(s)
- Cameron Heaton
- Biomolecular Science Research Centre, Centre for Mass Spectrometry Imaging, Sheffield Hallam University, Sheffield, UK.
| | | | - Laura Cole
- Biomolecular Science Research Centre, Centre for Mass Spectrometry Imaging, Sheffield Hallam University, Sheffield, UK.
| | - Jason Eyre
- Sheffield Teaching Hospitals, Sheffield, UK
| | | | - Richard McColm
- Defence Science and Technology Laboratory, Porton Down, UK
| | - Simona Francese
- Biomolecular Science Research Centre, Centre for Mass Spectrometry Imaging, Sheffield Hallam University, Sheffield, UK.
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Alhazidou E, Androulaki M, Panagiotopoulos M, Boudouvas D, Lampropoulou D, Yfanti E, Delaki EE, Repa K, Petrakos G. Fetal heterozygosity for both Hb G-Hsi-Tsou and beta thalassemia: A case report. Case Rep Womens Health 2020; 28:e00265. [PMID: 33163367 PMCID: PMC7607242 DOI: 10.1016/j.crwh.2020.e00265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 10/12/2020] [Accepted: 10/14/2020] [Indexed: 11/27/2022] Open
Abstract
Introduction This case report describes a fetus with compound heterozygosity for Hb G-Hsi-Tsou and beta thalassemia, diagnosed in a healthy pregnancy. To the best of our knowledge, this is the first documented case of compound heterozygosity and the woman is the second known case of heterozygosity for Hb G-Hsi-Tsou. Case presentation A 34-year-old woman during her first pregnancy underwent hemoglobin electrophoresis which revealed heterozygosity for Hb G-Hsi-Tsou. Hemoglobin G-Hsi-Tsou constitutes a hemoglobin variant with a structural abnormality of the beta chain, first described in 1972, but since then no other cases have been reported. After finding out that her husband was heterozygous for beta thalassemia, chorionic villus sampling revealed the embryo's heterozygosity for both Hb G-Hsi-Tsou and beta thalassemia. Due to lack of scientific data, the couple decided to end the pregnancy. Conclusion It was not possible to determine whether the fetus would present serious deficiencies in hematopoiesis, as Hb G-Hsi-Tsou is a variant which is not yet fully understood. What made this case even more complex was the simultaneous presence of the beta thalassemia allele. Electrophoresis can be used to reveal heterozygosity for Hb G-Hsi-Tsou. Chorionic villus sampling was performed in the case described, revealing heterozygosity for both Hb G-Hsi-Tsou and beta thalassemia. Hb G-Hsi-Tsou occurs due to a substitution of aspartic acid for glycine at position 79, creating an anomalous βT9 peptide. It was not possible to determine whether the fetus would present serious deficiencies in hematopoiesis.
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Affiliation(s)
- Elena Alhazidou
- General Hospital of Messinia, Department of Obstetrics and Gynecology, Kalamata, Greece
| | - Maria Androulaki
- General Hospital of Messinia, Department of Obstetrics and Gynecology, Kalamata, Greece
| | | | - Dimitrios Boudouvas
- 2nd Department of Obstetrics and Gynecology, University of Athens - Aretaieon Hospital, Athens, Greece
| | | | - Eleni Yfanti
- General Hospital of Nikaia, Department of Pediatrics, Athens, Greece
| | | | - Konstantina Repa
- Center of Expertise of Hemoglobinopathies, Laiko General Hospital, Athens, Greece
| | - Georgios Petrakos
- General Hospital of Messinia, Department of Obstetrics and Gynecology, Kalamata, Greece
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Kundrapu S, Janaki N, Meyerson HJ. Compound Heterozygosity for Hb D-Ibadan (HBB: c.263C>A) and Hb C (HBB: c.19G>A). Hemoglobin 2019; 42:269-271. [PMID: 30604644 DOI: 10.1080/03630269.2018.1523799] [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: 10/27/2022]
Abstract
We report an individual with a compound heterozygosity for Hb D-Ibadan (HBB: c.263C>A) and Hb C (HBB: c.19G>A), a hemoglobin (Hb) combination not previously identified. The compound hemoglobinopathy was detected in a young woman during routine prenatal screening. Variant Hbs were identified and confirmed by high performance liquid chromatography (HPLC) and capillary electrophoresis (CE) followed by Sanger DNA sequencing. Hb D-Ibadan was present in significant excess over Hb C (70.3 to 24.4%). A complete blood count (CBC) revealed moderate microcytosis with slight anemia. The history suggests the Hb combination is clinically silent. The findings indicate the compound hemoglobinopathy demonstrates thalassemia minor-like red cell indices with an unequal distribution of the variant Hbs. Comparison with other Hb D-like heterozygous conditions is reviewed.
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Affiliation(s)
- Sirisha Kundrapu
- a Department of Pathology , University Hospitals Cleveland Medical Center and Case Western Reserve University , Cleveland , OH , USA
| | - Nafiseh Janaki
- a Department of Pathology , University Hospitals Cleveland Medical Center and Case Western Reserve University , Cleveland , OH , USA
| | - Howard J Meyerson
- a Department of Pathology , University Hospitals Cleveland Medical Center and Case Western Reserve University , Cleveland , OH , USA
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