scholarly journals TALASEMIA BETA HEMOGLOBIN E (Hemoglobin E Beta Thalassemia)

Author(s):  
Viviyanti Zainuddin ◽  
Agus Alim Abdullah ◽  
Mansyur Arif

Thalassemia is a quantitative abnormality of the hemoglobin marked by inadequate hemoglobin synthesis due to the lack orabsence of synthesis of one or more globin polypeptide chains. Hemoglobin variant is a qualitative abnormality due to the presence ofthe abnormal amino acid sequence of one or more globin polypeptide chains. HbE β thalassemia is a disorder of hemoglobin that resultsfrom the fusion between the gene β-thalassemia allele from one parent with a gene HbE allele from another parent. In this case, HbEβ-Thalassemia patient was a 4.8 year girl diagnosed with hemoglobin E-beta thalassemia based on history and clinical manifestations;pale, the presence of splenomegaly and hepatomegaly. Laboratory tests were Hb: 7.7 g/dL, MCV: 52.9 fl, MCH: 17.7 pg, MCHC: 33.5g/dL and ferritin: 1012 ng/mL. Peripheral blood smear evaluation showed a microcytic hypochromic anemia with hemolytic signs andinfected features of leukocytes. Hb electrophoresis using HPLC showed a Hb F: 37.7% and HbA2 52.4%, indicating that HbA2 was falsehigh due to coeluating with HbE. The patient was treated by blood transfusion and received additional therapy such as folic acid, ironchelation and vitamin E.

Author(s):  
Viviyanti Zainuddin ◽  
Agus Alim Abdullah ◽  
Mansyur Arif

Thalassemia is a quantitative abnormality of the hemoglobin marked by inadequate hemoglobin synthesis due to the lack or absence of synthesis of one or more globin polypeptide chains. Hemoglobin variant is a qualitative abnormality due to the presence of the abnormal amino acid sequence of one or more globin polypeptide chains. HbE β thalassemia is a disorder of hemoglobin that results from the fusion between the gene β-thalassemia allele from one parent with a gene HbE allele from another parent. In this case, HbE β-Thalassemia patient was a 4.8 year girl diagnosed with hemoglobin E-beta thalassemia based on history and clinical manifestations; pale, the presence of splenomegaly and hepatomegaly. Laboratory tests were Hb: 7.7 g/dL, MCV: 52.9 fl, MCH: 17.7 pg, MCHC: 33.5 g/dL and ferritin: 1012 ng/mL. Peripheral blood smear evaluation showed a microcytic hypochromic anemia with hemolytic signs andinfected features of leukocytes. Hb electrophoresis using HPLC showed a Hb F: 37.7% and HbA2 52.4%, indicating that HbA2 was false high due to coeluating with HbE. The patient was treated by blood transfusion and received additional therapy such as folic acid, iron chelation and vitamin E


2021 ◽  
Author(s):  
Nishat Mahzabin ◽  
Md. Abdul Aziz ◽  
Md. Akhlak-Ul Islam ◽  
Nusrat Jahan ◽  
Md. Kamrul Hasan Sajib ◽  
...  

Abstract Background: Hemoglobin E/β-thalassemia is a common inherited hemoglobin disorder among South Asian countries. The phenotypically diverse presentation of the disease is often attributed to coinheritance of β-globin (HBB) gene mutations. The current study described the phenotype and genetic basis of Hb E/β-thalassemia patients and assessed its relation with clinical severity.Methods: A total of 32 patients were included in this cross-sectional study. Cases were confirmed by using capillary hemoglobin electrophoresis or high-performance liquid chromatography. Those with positive findings were further analyzed with clinical information and ancestral data either from the interview or medical records. Data collection was confined to May 2019 and July 2020. Gene sequencing was performed using Sanger’s sequencing method for mutational analysis, and Mahidol scoring was used to grade clinical severity.Result: A total of 13 heterozygous mutations were identified in the HBB gene. Of all, IVS-1-5 (G>C) (n=17, 53.1%) was the most common, and codon 30 (G>C) (n=4, 12.5%) was the second most common mutations. According to the Mahidol scoring system, 37.5% (n=12) were classified as phenotypically mild, 43.8% (n=14) as moderate and 18.8% (n=6) as severe. The IVS-1-5(G>C) mutation was found to be frequently associated with severe disease and showed no mild form.Conclusion: The present study described the clinical severity and its association with genetic mutations in hemoglobin E/β-thalassemia patients. This finding could guide individually tailored management strategies for this particular group of patients.


Blood ◽  
1986 ◽  
Vol 67 (4) ◽  
pp. 957-961
Author(s):  
F Baklouti ◽  
E Dorleac ◽  
L Morle ◽  
P Laselve ◽  
D Peyramond ◽  
...  

Abstract Hb Knossos (beta 27 (B9) Ala----Ser) is a recently discovered hemoglobin variant endowed with beta-thalassemic properties (1,2) We present the first homozygous cases. The propositus, a 19-year-old man is originally from northeast Algeria, but is unrelated to other Algerians who have hemoglobin Knossos. He has a beta+-thalassemia intermedia syndrome, including microcytic, hypochromic anemia, enlargement of the spleen, and an increase in the number of reticulocytes. The reduction of beta-chain synthesis is pronounced (alpha/non alpha:2.76). Whole cells containing Hb Knossos have a dramatically low oxygen affinity (P50:38 mm Hg). The propositus also has homozygous delta degrees-thalassemia. The chromosome carrying these mutations is characterized by the DNA haplotype I.


2016 ◽  
Vol 9 (4) ◽  
pp. 214
Author(s):  
Mohammad Mizanur Rahman ◽  
Lutfunnahar Khan ◽  
Masuda Begum ◽  
Debashish Saha ◽  
Arif Ahmed Khan

<p>We present two cases of compound heterozygous state for hemoglobin (Hb) D and HbE who reported to the hospital for fever and incidentally found moderate microcytic hypochromic anemia. Later on they were investigated by capillary hemoglobin electrophoresis. Capillary Hb electrophoresis revealed compound heterozygous state for hemoglobin D and hemoglobin E. On family screening, father of one patient turned out to be HbD trait and mother as HbE trait. Due to unavailability of parents and siblings of other patient, family screening was not possible. Compound or double heterozygous state for HbD and HbE is rare. There are only six published reported cases of such double heterozygous state for HbD and HbE in Southeast Asia. Marriage between third degree relatives, which are more common among Muslims as well as inter caste marriages, common in some states of India have resulted into this compound heterozygous condition. Such double heterozygous case is clinically silent as compared to HbE/beta thalassemia or HbD/beta thalassemia.</p>


Blood ◽  
1986 ◽  
Vol 67 (4) ◽  
pp. 957-961 ◽  
Author(s):  
F Baklouti ◽  
E Dorleac ◽  
L Morle ◽  
P Laselve ◽  
D Peyramond ◽  
...  

Hb Knossos (beta 27 (B9) Ala----Ser) is a recently discovered hemoglobin variant endowed with beta-thalassemic properties (1,2) We present the first homozygous cases. The propositus, a 19-year-old man is originally from northeast Algeria, but is unrelated to other Algerians who have hemoglobin Knossos. He has a beta+-thalassemia intermedia syndrome, including microcytic, hypochromic anemia, enlargement of the spleen, and an increase in the number of reticulocytes. The reduction of beta-chain synthesis is pronounced (alpha/non alpha:2.76). Whole cells containing Hb Knossos have a dramatically low oxygen affinity (P50:38 mm Hg). The propositus also has homozygous delta degrees-thalassemia. The chromosome carrying these mutations is characterized by the DNA haplotype I.


2018 ◽  
Vol 9 (1) ◽  
Author(s):  
Methichit Wattanapanitch ◽  
Nattaya Damkham ◽  
Ponthip Potirat ◽  
Kongtana Trakarnsanga ◽  
Montira Janan ◽  
...  

2020 ◽  
Vol 7 (10) ◽  
pp. 1582
Author(s):  
Malini Garg ◽  
Prakas K. Mandal ◽  
Prakash S. Shekhawat ◽  
Tuphan K. Dolai

Hemorrhagic joint effusions are rarely seen in patients with haemoglobinopathies. Joint effusions often develop in association with deferiprone-related arthropathy in beta thalassaemia patients. Here we report a very rare case of bilateral knee and hip joint effusions in a case of hemoglobin E (HbE) beta thalassemia patient.


Author(s):  
Anadi Roy Chowdhury ◽  
Manas Talukdar

Background: Iron deficiency anemia (IDA) and Beta thalassemia (BT) are two most common causes of microcytic hypochromic anemia in our country affecting the reproductive age group. It is important to discriminate between these two entities to prevent treatment with iron of individuals with thalassemia trait as well as prevent homozygous transmission of B thalassemia trait (BTT). Aim of the study was to investigate causes of microcytic anemia in antenatal mothers and to find out the role of Cell Counter and High Performance Liquid Chromatography (HPLC) so as to screen BTT and other hemoglobinopathies.Methods: This study was done over a period of six months (May 2017 to October 2017) in the Department of Pathology in R. G. Kar Medical College. We analyzed the blood samples of all antenatal mothers attending Department of Pathology for blood tests and a complete hemogram and hemoglobin A2 (Hb A2) quantitation was done.Results: Total cases evaluated were 2200 of which 442 patients were found to have microcytic hypochromic anemia (MCV<80%, MCH<27). Rest that is 1758 was normal. Of 442 cases of microcytic hypochromic anemia, 205 were found to have IDA, 115 BTT, 112 E trait, 1 case each of Hemoglobin E disease, E-Beta thalassemia and hereditary persistence of fetal hemoglobin (HPFH). Hemoglobinopathies like S trait and Hemoglobin J (Hb J) was found in 4 and 3 cases respectively.Conclusions: In India, Microcytic hypochromic anemia is common and may be due to IDA, BTT or other hemoglobinopathies Cell counter-based parameters and formulas, along with HPLC can be an effective method of thalassemia screening in a society. 


Blood ◽  
1955 ◽  
Vol 10 (5) ◽  
pp. 389-404 ◽  
Author(s):  
PHILLIP STURGEON ◽  
HARVEY A. ITANO ◽  
WILLIAM R. BERGREN

Abstract A clinical and hematologic description is presented of the family demonstrating the existence of the genetically determined hemoglobin-D originally described by Itano. The interaction of hemoglobin-D with hemoglobin-S in two members of this family has resulted in a hemolytic process and a mild anemia. Clinically, one of the patients is asymptomatic. The other has repeated painful episodes characteristic of those seen in sickle cell crises. Clinical and hematologic evaluations of two members of the family inheriting normal hemoglobin and hemoglobin-D revealed no abnormalities. The only feature of hemoglobin-D which distinguishes it from normal hemoglobin is its electrophoretic mobility which is similar to that of hemoglobin-S. Hemoglobin-D is distinguished from hemoglobin-S by a higher solubility and by a failure to sickle and from hemoglobin-C by a lack of target cell formation and a different electrophoretic mobility. Clinical, hematologic and special hemoglobin studies are presented of a family exhibiting a new abnormal hemoglobin (hemoglobin-E). Its interaction with thalassemia trait in one of its members also is described. Hemoglobin-E does not sickle; under alkaline conditions it migrates slowly at a rate comparable to hemoglobin-C, while at an acid pH it migrates at a rate similar to hemoglobin-S. The result of its interaction with thalassemia is a microcytic, hypochromic anemia clinically resembling thalassemia major of an intermediate degree of severity. The major defect appears to be in hemoglobin synthesis, although the slight persistent reticulocytosis suggests a mild hemolytic process.


2021 ◽  
Vol 0 ◽  
pp. 1-4
Author(s):  
Uttam Kumar Mondal ◽  
Pritikar Dowerah ◽  
Ranajit Mukherjee

Objectives: The objectives of the study were to find out the prevalence, epidemiology, and clinicohematological profile of hemoglobinopathies. Material and Methods: During the period of September 2010–August 2011, an observational study was done in the Department of Pediatrics, Assam Medical College and Hospital, Dibrugarh. Children (<12 years) suffering from chronic anemia were the study population. Results: Hemoglobinopathies were noted in 72 (35.0%) out of 206 chronic anemia cases, of which sickle cell disease (SCD) was found in 23 cases (11.2%), beta-thalassemia major (BTM) in 21 cases (10.2%), hemoglobin E (HbE)-β thalassemia in 12 cases (5.8%), HbE disease was seen in 10 cases (4.8%), and HbE trait and sickle cell trait (SCT) in 3 cases each. Overall hemoglobinopathy was most commonly seen among teagarden community in Assam. Clinical presentation ranged from completely asymptomatic to congestive heart failure. In majority cases, decreased mean Hb (%) and mean corpuscular volume were found. Anisopoikilocytosis, reticulocytosis, and target cells were frequently noted in peripheral blood smear. Conclusion: Chronic anemia cases should be screened for hemoglobinopathies as these genetic disorders are commonly seen in Assam. SCD and BTM are the major types of hemoglobinopathies. Heterozygous hemoglobinopathies (HbE trait and SCT) had lesser clinical manifestations. As the definitive treatment of hemoglobinopathies is still difficult to avail in this region, genetic counseling should be considered for hemoglobinopathy patients and their families as well, to prevent new cases.


Sign in / Sign up

Export Citation Format

Share Document