Clinical variability and molecular characterization of Hbs/Gγ (Aγδß)0-thal and Hbs/HPFH in Indian sickle cell disease patients: AIIMS experience.
Hematology
; 24(1): 349-352, 2019 Dec.
Article
in En
| MEDLINE
| ID: mdl-30777489
ABSTRACT
INTRODUCTION:
In sickle cell disease (SCD) patients, among the predictors of survival, HbF levels play a significant role in lowering the morbidity and mortality. Coinheritance of 뫧 thalassemia and hereditary persistence of fetal hemoglobin (HPFH) may contribute to variable HbF levels in SCD patients, thus influencing their clinicopathological profile. Such cases are sparsely documented in the literature and thus, we screened the presence of 뫧 thalassemia and HPFH in 126 cases of SCD with high HbF. MATERIAL ANDMETHODS:
A total 126 SCD individuals with raised HbF levels were the study subject. Capillary zone electrophoresis (CZE) was done for the quantitative assessment of hemoglobin variants. HbSC, HbSD, HbAS and HbSE cases were excluded. Asian Indian Gγ(Aγδß)0-thal, δß0-thal (Sicilian, 13.4â kb), (Chinese, 100â kb), HPFH-1 (Black, 106â kb), HPFH-2 (Ghanaian, 105â kb), HPFH-3 (Indian, 48.5â kb) were done by GAP-PCR.RESULTS:
Out of 126, 78 cases (62%) were homozygous for SCD. The remaining 48 cases suspected to be heterozygous were furthered screened and 6/48 cases (12.5%) were found to be compound heterozygous. Out of these 6 cases,4(66.66%) had HbS/ δß- Gγ(Aγδß)0 and 2(33%) had HbS/HPFH compound heterozygous condition. None of the patients had δß0-thal (Sicilian, 13.4â kb), (Chinese, 100â kb), HPFH-1 (Black, 106â kb), HPFH-2 (Ghanaian, 105â kb).CONCLUSION:
This study highlights the importance of understanding the complex patho-physiology of compound heterozygous cases of HbS/HPFH and HbS/뫧 thalassemia, as these infrequent conditions lead to change in phenotype and clinical severity of the disease. Insight into more such cases will open the window to better analyze the disease pathogenesis in these rare compound heterozygous conditions, as this will be beneficial to formulate proper management protocol in these patients.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Fetal Hemoglobin
/
Hemoglobins, Abnormal
/
Beta-Thalassemia
/
Delta-Thalassemia
/
Heterozygote
/
Anemia, Sickle Cell
Type of study:
Guideline
/
Prognostic_studies
Limits:
Adolescent
/
Adult
/
Child
/
Female
/
Humans
/
Male
Country/Region as subject:
Asia
Language:
En
Journal:
Hematology
Journal subject:
HEMATOLOGIA
Year:
2019
Document type:
Article
Affiliation country: