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Kalai M, Moumni I, Ouragini H, Chaouechi D, Boudriga I, Menif S. Coinheritance of HbO Arab/β0-thalassemia with Severe Manifestation in Newborn. Am J Perinatol 2024; 41:594-597. [PMID: 35189650 DOI: 10.1055/s-0042-1743185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE In this study, we report a Tunisian newborn boy referred for neonatal hemolytic anemia with yellowish skin and enlarged spleen due to coinheritance of hemoglobin O (HbO) Arab and β-thalassemia. STUDY DESIGN Hematological parameters were collected using an automated blood cell counter. The amounts of Hb fractions were measured by capillary electrophoresis of Hb. Amplification and sequencing of the HBB gene were performed by Sanger's method. RESULTS Family study and genetic analysis revealed that the proband was a carrier of two hemoglobinopathies: HbO Arab and β0-thalassemia. CONCLUSION The coexistence of these two pathologies complicated the general state of the newborn boy and led to a severe anemia at birth. KEY POINTS · Severe neonatal anemia can be caused by hemoglobinopathy.. · Coinheritance of HbO Arab/β0-thalassemia complicated the general state of the newborn.. · Diagnosing hemoglobinopathy at an early age improves patient care..
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Affiliation(s)
- Miniar Kalai
- Laboratory of Molecular and Cellular Hematology, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Imen Moumni
- Laboratory of Molecular and Cellular Hematology, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Houyem Ouragini
- Laboratory of Molecular and Cellular Hematology, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Dorra Chaouechi
- Laboratory of Molecular and Cellular Hematology, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Imen Boudriga
- Laboratory of Molecular and Cellular Hematology, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Samia Menif
- Laboratory of Molecular and Cellular Hematology, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
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Kalai M, Moumni I, Ouragini H, Ben Fraj I, Mellouli F, Ouederni M, Chaouachi D, Boudriga I, Menif S. Molecular characterization of a novel homozygous deletion in β-globin cluster causing (δβ) 0-Thalassemia among Tunisian family. Ann Clin Biochem 2023; 60:81-85. [PMID: 36214153 DOI: 10.1177/00045632221134688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Deletions in the β-globin cluster are uncommon and cause thalassemia (thal) with hereditary persistence of fetal hemoglobin. They constitute a heterogenous group of disorders characterized by absent or reduced synthesis of adult hemoglobin (Hb A) and increased synthesis of fetal hemoglobin (Hb F). Although the clinical severity of these disorders are asymptomatic owing to the increased Hb F levels, the molecular basis is very heterogenous due to the large deletions in the β-globin cluster spanning both HBD and HBB genes. Here, we describe a Tunisian family carrying a novel deletion mutation causing (δβ)°-thalassemia. METHODS The amounts of hemoglobin fractions were measured by capillary electrophoresis of hemoglobin. Amplification and sequencing of different regions on the β-gene cluster were performed by Sanger method. RESULTS Family study and genetic analysis revealed a large deletion mutation in the β-globin cluster of 14.5 kb (NG_000,007.3:g. 58,253 to g.72837del14584) at the homozygous state in the patient and at heterozygous state at the other members of the family. This deletion removes the HBD and HBB genes. CONCLUSIONS In our knowledge, this new large deletion is described for the first time in the Tunisian population and in the world, designed Tunisian(δβ)0 in Ithanet database (IthaID: 3971). Therefore, it is important to identify the deletion leading to δβ-thalassemia carriers at the molecular level, to highlight the importance of recognizing the clinical features and implementing appropriate testing to clarify the diagnosis and manage the condition.
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Affiliation(s)
- Miniar Kalai
- Laboratory of Molecular and Cellular Hematology, 37965Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Imen Moumni
- Laboratory of Molecular and Cellular Hematology, 37965Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Houyem Ouragini
- Laboratory of Molecular and Cellular Hematology, 37965Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Ilhem Ben Fraj
- Laboratory of Molecular and Cellular Hematology, 37965Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Department of Pediatrics: Immuno-Hematology and Stem Cell Transplantation, Bone Marrow Transplant Center, Tunis, Tunisia
| | - Fethi Mellouli
- Laboratory of Molecular and Cellular Hematology, 37965Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Department of Pediatrics: Immuno-Hematology and Stem Cell Transplantation, Bone Marrow Transplant Center, Tunis, Tunisia
| | - Monia Ouederni
- Laboratory of Molecular and Cellular Hematology, 37965Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Department of Pediatrics: Immuno-Hematology and Stem Cell Transplantation, Bone Marrow Transplant Center, Tunis, Tunisia
| | - Dorra Chaouachi
- Laboratory of Molecular and Cellular Hematology, 37965Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Imen Boudriga
- Laboratory of Molecular and Cellular Hematology, 37965Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Samia Menif
- Laboratory of Molecular and Cellular Hematology, 37965Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
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Bouguerra G, Talbi K, Trabelsi N, Chaouachi D, Boudriga I, Abbès S, Menif S. Enhanced Eryptosis in Glucose-6-Phosphate Dehydrogenase Deficiency. Cell Physiol Biochem 2021; 55:761-772. [PMID: 34894207 DOI: 10.33594/000000474] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND/AIMS Defects in the Glucose-6-Phosphate Dehydrogenase (G6PD) enzyme enhance cellular oxidative damage, thus impairing erythrocytes and radically shortening their lifespan. We aimed to study programmed erythrocyte cell death in G6PD-deficient patients, describe the molecular genetics basis of G6PD and investigate phenotype-genotype correlations. METHODS We explored eryptosis using the annexin V-binding assay, taken as an indicator of PS exposure at the erythrocyte surface. We assessed reactive oxygen species (ROS) production, intracellular calcium concentrations and ceramide formation at the cell surface. Prior to and following treatments, cells were analyzed by flow cytometry. Finally, we explored G6PD gene mutations through PCR-Sanger sequencing. RESULTS Before stimulation, PS-exposing erythrocytes were significantly higher in G6PD-deficient patients than in healthy volunteers. This was paralleled by a significant increase in reactive oxygen species production, suggesting that oxidative stress is the main trigger of PS exposure in G6PD-deficient erythrocytes. Five previously described mutations were detected in our patients. Two genotypes correlated with a significantly higher percentage of PS-exposing cells. CONCLUSION Our study uncovers a novel effect detected in G6PD-deficient erythrocytes which is cell membrane scrambling with PS translocation to the erythrocyte surface. Our findings shed a light on the mechanisms of premature erythrocyte clearance in G6PD deficiency.
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Affiliation(s)
- Ghada Bouguerra
- Université de Tunis El Manar, Faculté de Médecine de Tunis, Tunis, Tunisie, .,Université de Tunis El Manar, Laboratoire d'Hématologie Moléculaire et Cellulaire, Institut Pasteur de Tunis, Tunis, Tunisie
| | - Khaoula Talbi
- Université de Tunis El Manar, Laboratoire d'Hématologie Moléculaire et Cellulaire, Institut Pasteur de Tunis, Tunis, Tunisie.,Université de Tunis El Manar, Faculté des Sciences de Tunis, Tunis, Tunisie
| | - Nawel Trabelsi
- Université de Tunis El Manar, Laboratoire d'Hématologie Moléculaire et Cellulaire, Institut Pasteur de Tunis, Tunis, Tunisie.,Université de Tunis El Manar, Faculté des Sciences de Tunis, Tunis, Tunisie
| | - Dorra Chaouachi
- Université de Tunis El Manar, Laboratoire d'Hématologie Moléculaire et Cellulaire, Institut Pasteur de Tunis, Tunis, Tunisie
| | - Imen Boudriga
- Université de Tunis El Manar, Laboratoire d'Hématologie Moléculaire et Cellulaire, Institut Pasteur de Tunis, Tunis, Tunisie
| | - Salem Abbès
- Université de Tunis El Manar, Faculté de Médecine de Tunis, Tunis, Tunisie.,Université de Tunis El Manar, Laboratoire d'Hématologie Moléculaire et Cellulaire, Institut Pasteur de Tunis, Tunis, Tunisie
| | - Samia Menif
- Université de Tunis El Manar, Faculté de Médecine de Tunis, Tunis, Tunisie.,Université de Tunis El Manar, Laboratoire d'Hématologie Moléculaire et Cellulaire, Institut Pasteur de Tunis, Tunis, Tunisie
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Haddad F, Trabelsi N, Chaouch L, Darragi I, Oueslati M, Boudriga I, Chaouachi D, El-Borgi W, Hafsia R, Abbes S, Ouragini H. Homozygous Mutation on the β-Globin Polyadenylation Signal in a Tunisian Patient with β-Thalassemia Intermedia and Coinheritance of Gilbert's Syndrome. Hemoglobin 2017; 41:147-150. [PMID: 28592168 DOI: 10.1080/03630269.2017.1322610] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We report here the clinical, hematological and molecular data in a 50-year-old patient with β-thalassemia intermedia (β-TI) caused by a homozygous β+ mutation on the β-globin gene polyadenylation (polyA) signal (AATAAA>AAAAAA). β Haplotype analysis was accomplished by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Haplotype and framework analysis showed that this mutation is associated with the [- - - - + + +] β haplotype and framework 1 (CCGCT) (FW1). This mutation was previously reported in the heterozygous state in association with the codon 9 (+TA) mutation in a β-TI patient originating from Tunisia. To the best of our knowledge, this is the first report describing this mutation in the homozygous state. The case reported here, coinherited Gilbert's syndrome, which is characterized by hyperbilirubinemia. This conclusion was reached by the investigation of the promoter region [A(TA)nTAA] motif of the UGT1A1 gene, showing the (TA)6/(TA)7 genotype.
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Affiliation(s)
- Faten Haddad
- a Laboratory of Molecular and Cellular Hematology , Pasteur Institute of Tunis-Tunis El Manar University , Tunis , Tunisia
| | - Nawel Trabelsi
- a Laboratory of Molecular and Cellular Hematology , Pasteur Institute of Tunis-Tunis El Manar University , Tunis , Tunisia
| | - Leila Chaouch
- a Laboratory of Molecular and Cellular Hematology , Pasteur Institute of Tunis-Tunis El Manar University , Tunis , Tunisia
| | - Imen Darragi
- a Laboratory of Molecular and Cellular Hematology , Pasteur Institute of Tunis-Tunis El Manar University , Tunis , Tunisia
| | - Meriem Oueslati
- b Laboratory of Biological Hematology , Aziza Othmana Hospital-Tunis El Manar University , Tunis , Tunisia
| | - Imen Boudriga
- a Laboratory of Molecular and Cellular Hematology , Pasteur Institute of Tunis-Tunis El Manar University , Tunis , Tunisia
| | - Dorra Chaouachi
- a Laboratory of Molecular and Cellular Hematology , Pasteur Institute of Tunis-Tunis El Manar University , Tunis , Tunisia
| | - Wijdene El-Borgi
- b Laboratory of Biological Hematology , Aziza Othmana Hospital-Tunis El Manar University , Tunis , Tunisia
| | - Raouf Hafsia
- b Laboratory of Biological Hematology , Aziza Othmana Hospital-Tunis El Manar University , Tunis , Tunisia
| | - Salem Abbes
- a Laboratory of Molecular and Cellular Hematology , Pasteur Institute of Tunis-Tunis El Manar University , Tunis , Tunisia
| | - Houyem Ouragini
- a Laboratory of Molecular and Cellular Hematology , Pasteur Institute of Tunis-Tunis El Manar University , Tunis , Tunisia
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Jaouani M, Manco L, Kalai M, Chaouch L, Douzi K, Silva A, Macedo S, Darragi I, Boudriga I, Chaouachi D, Fitouri Z, Van Wijk R, Ribeiro ML, Abbes S. Molecular basis of pyruvate kinase deficiency among Tunisians: description of new mutations affecting coding and noncoding regions in the PKLR gene. Int J Lab Hematol 2017; 39:223-231. [PMID: 28133914 DOI: 10.1111/ijlh.12610] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 10/26/2016] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Pyruvate kinase (PK) deficiency is one of the most common hereditary nonspherocytic hemolytic anemias worldwide with clinical manifestations ranging from mild to severe hemolysis. However, investigation of this enzymopathy is lacking in Tunisia. We report here a pioneer investigation of PK deficiency among Tunisian cases referred to our laboratory for biological analysis of unknown cause of hemolytic anemia. METHODS Two hundred and fifty-three patients with unknown cause of hemolytic anemia have been addressed to our laboratory in order to investigate for red blood cells genetic disorders. Red cell enzyme activities were measured by standard methods, and molecular analysis was performed by DNA sequencing. The interpretation of mutation effect and the molecular modeling were performed by using specific software. RESULTS Six different PKLR mutations were found (c.966-1G>T; c.965+1G>A; c.721G>T; c.1163C>A; c.1456C>T; c.1537T>A), among which four are described for the first time. Genotype-phenotype correlations for the novel missense mutations were investigated by three-dimensional structure analysis. CONCLUSION This study provides important data of PK deficiency among Tunisians. It might be followed by a large neonatal screening to determine the spectrum of PK mutations and identify potential deficient patients for an early medical follow-up.
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Affiliation(s)
- M Jaouani
- Laboratoire d'Hématologie Moléculaire et Cellulaire, Institut Pasteur de Tunis, Université de Tunis El Manar, Tunis, Tunisia
| | - L Manco
- Unidade de Hematlogia Molecular, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal.,Research Centre for Anthropology and Health (CIAS), Department of Life Sciences, Universidade de Coimbra, Coimbra, Portugal
| | - M Kalai
- Laboratoire d'Hématologie Moléculaire et Cellulaire, Institut Pasteur de Tunis, Université de Tunis El Manar, Tunis, Tunisia
| | - L Chaouch
- Laboratoire d'Hématologie Moléculaire et Cellulaire, Institut Pasteur de Tunis, Université de Tunis El Manar, Tunis, Tunisia
| | - K Douzi
- Laboratoire d'Hématologie Moléculaire et Cellulaire, Institut Pasteur de Tunis, Université de Tunis El Manar, Tunis, Tunisia
| | - A Silva
- Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - S Macedo
- Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - I Darragi
- Laboratoire d'Hématologie Moléculaire et Cellulaire, Institut Pasteur de Tunis, Université de Tunis El Manar, Tunis, Tunisia
| | - I Boudriga
- Laboratoire d'Hématologie Moléculaire et Cellulaire, Institut Pasteur de Tunis, Université de Tunis El Manar, Tunis, Tunisia
| | - D Chaouachi
- Laboratoire d'Hématologie Moléculaire et Cellulaire, Institut Pasteur de Tunis, Université de Tunis El Manar, Tunis, Tunisia
| | - Z Fitouri
- Service de pédiatrie-urgences-consultations, Hôpital d'Enfants de Tunis, Tunis, Tunisia
| | - R Van Wijk
- Laboratory for Red Blood Cell Research, Department of Clinical Chemistry and Hematology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - M L Ribeiro
- Unidade de Hematlogia Molecular, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
| | - S Abbes
- Laboratoire d'Hématologie Moléculaire et Cellulaire, Institut Pasteur de Tunis, Université de Tunis El Manar, Tunis, Tunisia
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