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Ha Vuong VV, Nguyen PD, Thi NN, Le Thi P, Minh Nguyet DT, Nguyen MH, Tran HA, Dang-Tran NM, Bui TH, Tran TH, Van Ta T, Tran VK. Application of short tandem repeats (STRs) in the preimplantation genetic diagnosis (PGD) of α-thalassemia. Taiwan J Obstet Gynecol 2024; 63:375-380. [PMID: 38802201 DOI: 10.1016/j.tjog.2023.09.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2023] [Indexed: 05/29/2024] Open
Abstract
OBJECTIVES α-thalassemia is an autosomal recessive monogenic blood disorder, affecting up to 5% of the world's population. The occurrence rate of the disease in Vietnam varies up to up to 51.5%, with high rate of mutation carriers, of couples consisting of two carriers at risk of bearing a child with fetal Hb Bart, which can develop into hydrops fetalis syndrome, threatening the well-being of the mother and the child. Our study aims to facilitate birth of healthy/asymptomatic children of α-thalassemia carrier couples who received reproductive service at our centre during the period of 2019-2022. MATERIALS AND METHODS 89 couples at risks of having α-thalassemia offsprings requested IVF procedures and PGD at Post Hospital during 2019-2022 were recruited for investigation. Couple and additional family members' peripheral blood samples of couples and additional family members were subjected to haemoglobin electrophoresis, DNA extraction for α-thalassemia gene mutation detection and STRs linkage analysis. Data were observed and analysed on GeneMarker software. RESULTS 91 cycles of PGD for α-thalassemia were carried out for 89 couples. α-thalassemia large deletion (--SEA/αα) was the most common mutation identified in 88 couples, in which 4 cases also carried β-thalassemia point mutations. Combining results of PGS and PGD, 278/424 amplified embryos were transferable (HBA-mutation free or carriers of single heterozygous HBA mutation, without chromosomal abnormality). 64/89 couples have been transferred with the embryos (prioritizing mutation free ones over carriers), resulting in the birth of 36 α-thalassemia disease-free children, 17 ongoing pregnancies, and 11 with miscarriages. CONCLUSION Successful application of microsatellite-based method in PGD facilitated the birth of 36 healthy children and 17 ongoing pregnancies for 53/64 couples with embryo-transferred. All resulted clinical births displayed confirmation results in line with the PGD results, thus demonstrating the feasibility and credibility of the use of STR markers in PGD.
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Affiliation(s)
- Vu Viet Ha Vuong
- Center for Gene and Protein Research, Hanoi Medical University, Hanoi, Viet Nam; Hospital of Post and Telecommunications, Hanoi, Viet Nam
| | - Phuoc-Dung Nguyen
- Center for Gene and Protein Research, Hanoi Medical University, Hanoi, Viet Nam
| | - Nha Nguyen Thi
- Hospital of Post and Telecommunications, Hanoi, Viet Nam
| | - Phuong Le Thi
- Center for Gene and Protein Research, Hanoi Medical University, Hanoi, Viet Nam
| | | | | | | | - Nhat-Minh Dang-Tran
- High School for Gifted Students, Hanoi University of Science, Vietnam National University, Viet Nam
| | - The-Hung Bui
- Center for Gene and Protein Research, Hanoi Medical University, Hanoi, Viet Nam; Center for Molecular Medicine, Clinical Genetics Unit, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Thinh Huy Tran
- Center for Gene and Protein Research, Hanoi Medical University, Hanoi, Viet Nam; Hanoi Medical University, Hanoi, Viet Nam
| | - Thanh Van Ta
- Center for Gene and Protein Research, Hanoi Medical University, Hanoi, Viet Nam; Hanoi Medical University, Hanoi, Viet Nam
| | - Van-Khanh Tran
- Center for Gene and Protein Research, Hanoi Medical University, Hanoi, Viet Nam.
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Hajimohammadi Z, Alimohammadi-Bidhendi S, Bagheri Amiri F, Karimipoor M, Davoudi-Dehaghani E, Entezam M. Development of a Quantitative Multiplex PCR to Detect Three Common Alpha Thalassemia Deletions. Hemoglobin 2023; 47:163-166. [PMID: 37766586 DOI: 10.1080/03630269.2023.2260744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 09/03/2023] [Indexed: 09/29/2023]
Abstract
Alpha thalassemia is an autosomal recessive genetic disorder with a high prevalence in the Middle East. The severe form of alpha-thalassemia is incompatible with life and can cause significant obstetric complications in the mother. Therefore, it is important to determine the genotype in parents who have a chance of having a fetus with one of the severe forms of this disease. A total of 112 samples that were previously analyzed for common alpha thalassemia mutations in Iran were used in this study. A new multiplex PCR including quantitative polymerase chain reaction to amplify the homologous regions of the alpha-globin gene cluster and fluorescent gap PCR was designed to identify -α3.7, -α4.2, --MED deletions. The ROC curve was used to determine the optimum cutoff points. Statistical analysis showed that there is a significant difference between the peak height ratios for different genotypes. The peak corresponding to the 297 bp fragment resulting from the amplification of the allele with MED-I deletion was detected in all the samples with this deletion. Different cutoffs for a range of sensitivities and specificities were determined by the ROC curve. The suggested method can identify three common large deletions in the alpha-globin gene cluster. A study with a larger sample size can provide more accurate information about the sensitivity and specificity of this test.
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Affiliation(s)
- Zahra Hajimohammadi
- Department of Medical Genetics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Molecular Medicine, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran
| | - Sara Alimohammadi-Bidhendi
- Department of Molecular Medicine, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran
| | - Fahimeh Bagheri Amiri
- Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
| | - Morteza Karimipoor
- Department of Molecular Medicine, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran
| | - Elham Davoudi-Dehaghani
- Department of Molecular Medicine, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran
| | - Mona Entezam
- Department of Medical Genetics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Abolghasemi H, Kamfar S, Azarkeivan A, Karimi M, Keikhaei B, Abolghasemi F, Radfar MH, Eshghi P, Alavi S. Clinical and genetic characteristics of hemoglobin H disease in Iran. Pediatr Hematol Oncol 2022; 39:489-499. [PMID: 34951342 DOI: 10.1080/08880018.2021.2017529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Hemoglobin H (Hb H) disease is a subtype of α-thalassemia caused by deletional and/or non-deletional mutations in three alpha-globin genes in which the various genotypes determine the disease severity. This study was aimed to investigate the frequency of alpha gene mutations and genotypes and their correlation with hematological and clinical characteristics in Iran. Among 202 patients diagnosed with Hb H disease through a national study in Iran according to standard methods, we had access to the hematologic and clinical findings and genetic data of 101 patients in whom genetic study was performed. Genomic DNA from peripheral blood was extracted and analyzed for identification of α-globin gene mutations using Multiplex Gap Polymerase Chain Reaction, Reverse Hybridization Assay, and finally Direct DNA Sequencing method. Twenty-one different mutations and thirty genotypes were detected in 101 patients with Hb H disease. In total, 39 patients (38.6%) were deletional and 62 patients (61.4%) were non-deletional type of the disease. The --MED mutation was highly prevalent in almost half of the patients (56.4%). Among various genotypes, -MED/-a3.7 (29.7%) and -α20.5/-α5NT (6.9%) were the most prevalent genotypes found in the studied group. Patients with non-deletional type presented with more severe hematological and clinical findings. Hb H percentage and serum ferritin levels were significantly higher in non-deletional patients in comparison to the deletional group (p < 0.05). 12 (11.9%) and 40 (39.6%) out of 101 patients were on regular and occasional transfusions, respectively. 83% of those with regular transfusion belonged to the non-deletional group. Among transfusion-dependent patients, -MED/αCSα and α20.5/-α5NT were the most common genotypes. In this study, two patients with -α20.5/αCSα and -MED/α-5NT genotypes experienced thrombotic events. This study indicated that although non-deletional genotypes of Hb H disease were responsible for more clinical severity of the disease, due to the presence of severe phenotypes even in deletional types, no definite correlation was found between genotype and phenotype.
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Affiliation(s)
- Hassan Abolghasemi
- Pediatric Congenital Hematologic Disorders Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sharareh Kamfar
- Pediatric Congenital Hematologic Disorders Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azita Azarkeivan
- Research Center of Iranian Blood Transfusion Organization, Thalassemia Clinic, Tehran, Iran
| | - Mehran Karimi
- Hematology Research Center, Shiraz University of Medical Sciences, Nemazee Hospital, Shiraz, Iran
| | - Bijan Keikhaei
- Research Center for Thalassemia and Hemoglobinopathy, Health Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Fahimeh Abolghasemi
- Pediatric Congenital Hematologic Disorders Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad H Radfar
- Department of Urology, School of Medicine, Shahid Labbafinezhad Hospital Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Peyman Eshghi
- Pediatric Congenital Hematologic Disorders Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Samin Alavi
- Pediatric Congenital Hematologic Disorders Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Sawakwongpra K, Tangmansakulchai K, Ngonsawan W, Promwan S, Chanchamroen S, Quangkananurug W, Sriswasdi S, Jantarasaengaram S, Ponnikorn S. Droplet-based digital PCR for non-invasive prenatal genetic diagnosis of α and β-thalassemia. Biomed Rep 2021; 15:82. [PMID: 34512970 PMCID: PMC8411484 DOI: 10.3892/br.2021.1458] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 07/15/2021] [Indexed: 12/16/2022] Open
Abstract
Non-invasive prenatal diagnosis (NIPD) of isolated cell-free DNA from maternal plasma has been applied to detect monogenic diseases in the fetus. Droplet digital PCR (ddPCR) is a sensitive and quantitative technique for NIPD. In the present study, the development and evaluation of ddPCR-based assays for common α and β-thalassemia variants amongst the Asian population was described; specifically, Southeast Asian (SEA) deletion, HbE, and 41/42 (-CTTT). SEA is caused by deletion of a 20 kb region surrounding the α-globin gene, whilst HbE and 41/42 (-CTTT) are caused by point mutations on the β-globin gene. Cell-free DNA samples from 46 singleton pregnant women who were carriers of these mutations were isolated and quantified using ddPCR with specially designed probes for each target allele. Allelic copy number calculation and likelihood ratio tests were used to classify fetal genotypes. Classification performances were evaluated against ground truth fetal genotypes obtained from conventional amniocentesis. Copy number variation analysis of SEA deletion accurately classified fetal genotypes in 20 out of 22 cases with an area under the receiver operating characteristic curve of 0.98 for detecting Hb Bart's hydrops fetalis. For HbE cases, 10 out of 16 samples were correctly classified, and three were inconclusive. For 41/42 (-CTTT) cases, 2 out of 8 were correctly classified, and four were inconclusive. The correct genotype was not rejected in any inconclusive case and may be resolved with additional ddPCR experiments. These results indicate that ddPCR-based analysis of maternal plasma can become an accurate and effective NIPD for SEA deletion α-(0) thalassemia. Although the performance of ddPCR on HbE and 41/42 (-CTTT) mutations were not sufficient for clinical application, these results may serve as a foundation for future works in this field.
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Affiliation(s)
- Kritchakorn Sawakwongpra
- Chulabhorn International College of Medicine, Thammasat University, Khlong Luang, Pathum Thani 12120, Thailand
| | | | | | | | - Sujin Chanchamroen
- Next Generation Genomic, Pathum Wan, Bangkok 10330, Thailand.,SAFE Fertility Center, Pathum Wan, Bangkok 10330, Thailand
| | - Wiwat Quangkananurug
- Next Generation Genomic, Pathum Wan, Bangkok 10330, Thailand.,SAFE Fertility Center, Pathum Wan, Bangkok 10330, Thailand
| | - Sira Sriswasdi
- Research Affairs, Faculty of Medicine, Chulalongkorn University, Pathum Wan, Bangkok 10330, Thailand.,Computational Molecular Biology Group, Faculty of Medicine, Chulalongkorn University, Pathum Wan, Bangkok 10330, Thailand
| | - Surasak Jantarasaengaram
- Department of Obstetrics and Gynecology, Rajavithi Hospital, Ratchathewi, Bangkok 10400, Thailand
| | - Saranyoo Ponnikorn
- Chulabhorn International College of Medicine, Thammasat University, Khlong Luang, Pathum Thani 12120, Thailand
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5
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Marouf R, Adekile AD, El-Muzaini H, Abdulla R, Mojiminiyi OA. Neutrophil gelatinase-associated lipocalin as a biomarker of nephropathy in sickle cell disease. Ann Hematol 2021; 100:1401-1409. [PMID: 33796899 PMCID: PMC8116283 DOI: 10.1007/s00277-021-04500-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 03/17/2021] [Indexed: 11/05/2022]
Abstract
Sickle cell nephropathy (SCN) develops via altered hemodynamics and acute kidney injury, but conventional screening tests remain normal until advanced stages. Early diagnostic biomarkers are needed so that preventive measures can be taken. This study evaluates the role of neutrophil gelatinase–associated lipocalin (NGAL) as a biomarker of SCN in steady state and vaso-occlusive crisis (VOC). In this case-control study, 74 sickle cell disease (SCD) patients (37 in steady state and 37 in VOC) and 53 control subjects had hematological and biochemical measurements including plasma and urine NGAL. Univariate and logistic regression analyses were used to find the associations between variables. The receiver operating characteristic (ROC) curve was used to determine the diagnostic performance characteristics of plasma and urine NGAL for detection of VOC. Plasma and urine NGAL, urine microalbumin:creatinine ratio, and urine protein:creatinine ratio were significantly higher in VOC. Microalbuminuria was present in 17.1% steady state and 32.0% VOC patients. Microalbuminuria showed significant correlations with age, plasma NGAL, WBC, and hemolytic parameters. Area under the ROC curve for plasma NGAL was 0.69 (95%CI = 0.567–0.813; p = 0.006) and 0.86 (95%CI = 0.756–0.954; p < 0.001) for urine NGAL. Urine NGAL cut-off value of 12.0 ng/mL had 95% sensitivity and 65% specificity. These results confirm the presence of nephropathy during VOC and suggest that plasma and urine NGAL would be useful in the identification of SCN. Urine NGAL should be used as the screening biomarker, and patients with VOC and urine NGAL > 12.0 ng/mL should be selected for aggressive management to prevent progression of renal damage.
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Affiliation(s)
- Rajaa Marouf
- Department of Clinical Pathology, Faculty of Medicine, Kuwait University, PO Box 24923, Safat 13110, Kuwait City, Kuwait.
| | - Adekunle D Adekile
- Department of Clinical Pathology, Faculty of Medicine, Kuwait University, PO Box 24923, Safat 13110, Kuwait City, Kuwait.,Department of Pediatrics, Faculty of Medicine, Kuwait University, PO Box 24923, Safat 13110, Kuwait City, Kuwait
| | - Hadeel El-Muzaini
- Department of Clinical Pathology, Faculty of Medicine, Kuwait University, PO Box 24923, Safat 13110, Kuwait City, Kuwait
| | - Rasha Abdulla
- Department of Clinical Pathology, Faculty of Medicine, Kuwait University, PO Box 24923, Safat 13110, Kuwait City, Kuwait
| | - Olusegun A Mojiminiyi
- Department of Clinical Pathology, Faculty of Medicine, Kuwait University, PO Box 24923, Safat 13110, Kuwait City, Kuwait
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Detection of Common Deletional of α-Thalassemia 3.7 Kb from Metropolitan Region of Manaus, Amazonas, Brazil. Mediterr J Hematol Infect Dis 2021; 13:e2021001. [PMID: 33489040 PMCID: PMC7813276 DOI: 10.4084/mjhid.2021.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 12/07/2020] [Indexed: 11/08/2022] Open
Abstract
Background Alpha Thalassemia (α-thal) is a heterogeneous group of hereditary alterations caused by deletions that affect alpha regulatory genes, and the 3.7Kb deletion is the most frequent worldwide. The prevalence ranges from 20% and 35% in Brazil, depending mainly on race, predominant in Afro-descendants. Purpose The aim was to determine α-thal -α3.7Kb and -α4.2Kb deletions, estimating their frequency in individuals from six regions of Amazonas State. Methods Volunteers age between 18-59 years old of both genders participated in the study. Blood was collected from March 2014 to September 2017 at the health centers of each participant city. α-thal3.7Kb was performed by GAP-PCR, while α-thal4.2Kb by Multiplex-PCR. The total samples collected from each city were: Manaus (capital), 356 (19.7%); Iranduba 232 (12.8%); Manacapuru, 287 (15.9%); Presidente Figueiredo, 370 (20.5%); Itacoatiara, 301 (16.6%); and Coari, 263 (14.5%). Results The average age among males was 35.3±14.8, while for females, it was 36.7±14.9 years old. Microcytosis (MCV <80fL) was found in 158 individuals (8,46%) and α-thal diagnosed in 143 individuals (7.9%), and all of these individuals carried the 3.7Kb deletion 5.95% in heterozygous and 1.95% in homozygous. α-thal4.2kb was not found in any volunteer. The association analyses to the α-thal3.7kb genotypes were statistically significant for all hematological parameters (p<.001), except serum iron and serum ferritin analyses. Conclusion This study highlights α-thal 3.7kb deletion as an important public health problem, especially in a population not yet characterized about this disease. Thus, epidemiological studies using molecular tools become relevant in regions where the disease is underestimated, contributing to a better understanding of thalassemia incidence and iron deficiency anemias incidence of the participating cities. We reinforce that future molecular studies in North Region from Brazil can be utilized to describe other genetic anemias as structural hemoglobinopathies that have already proven to be highly prevalent in Brazil.
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Forouzesh Pour F, Karimi K, Ghaderi Z, Tavakoli Koudehi A, Najmabadi H. Heterozygosity for the Novel HBA2: c.*91_*92delTA Polyadenylation Site Variant on the α2-Globin Gene Expanding the Genetic Spectrum of α-Thalassemia in Iran. Hemoglobin 2020; 44:423-426. [PMID: 33054440 DOI: 10.1080/03630269.2020.1831529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
There are four copy numbers of α-globin genes (16p13.3) in the human genome and the number of defective α-globin genes dictates the severity of α-thalassemia (α-thal). Mutations that occur in the 3' untranslated region (3'UTR), and especially at the polyadenylation (polyA) sites, affect the translation, stability and export of mRNA. A patient with hypochromic microcytic anemia was referred to the Kariminejad-Najmabadi Pathology & Genetics Center, Tehran, Iran by the health network. Molecular analysis of genomic DNA for the evaluation of mutations on the α- and β-globin genes was performed. Direct sequencing of the hemoglobin (Hb) subunit α2 (HBA2) gene revealed a two nucleotide deletion between +816 and +817 in the 3'UTR, located at the polyA site, which seems to be a novel pathogenic variant. This novel variant expands the genetic spectrum of α-thal in the 3'UTR of the HBA2 gene.
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Affiliation(s)
| | - Keyvan Karimi
- Kariminejad-Najmabadi Pathology & Genetics Center, Tehran, Iran
| | - Zhila Ghaderi
- Kariminejad-Najmabadi Pathology & Genetics Center, Tehran, Iran
| | | | - Hossein Najmabadi
- Kariminejad-Najmabadi Pathology & Genetics Center, Tehran, Iran.,Genetics Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Adekile A, Sukumaran J, Thomas D, D'Souza T, Haider M. Alpha thalassemia genotypes in Kuwait. BMC MEDICAL GENETICS 2020; 21:170. [PMID: 32831051 PMCID: PMC7444039 DOI: 10.1186/s12881-020-01105-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 08/10/2020] [Indexed: 12/04/2022]
Abstract
Background The frequency of the alpha thalassemia trait is approximately 40% in the Kuwaiti population, but there has been no comprehensive study of the prevalent alleles. This is a report of patients who were referred for molecular diagnosis over a 20-year period. Methods This is a retrospective study of the α-globin genotypes obtained in the Hemoglobin Research Laboratory of the Department of Pediatrics, Kuwait University from 1994 to 2015. Genotyping was performed by a combination of PCR, allele-specific oligonucleotide hybridization and reverse dot blot hybridization (Vienna Lab Strip Assay). Results Four hundred samples were characterized and analyzed from individuals aged < 1 month to 80 years, with a median of 6 years from 283 unrelated families. Most (90.8%) were Kuwaiti nationals. The commonest genotype was homozygosity for the polyadenylation-1 mutation (αPA-1α/α PA-1α) in 33.3% of the samples, followed by heterozygosity (αα/α PA-1α) for the same mutation in 32.3%. PA-1 was therefore the most frequent allele (0.59). The frequency of the α0 (−-MED) allele was 0.017. Rare alleles that were found in very low frequencies included α0 (−-FIL) in a Filipino child, Hb Constant Spring, Hb Adana, and Hb Icaria. Conclusion There is a wide variety of alpha thalassemia alleles among Kuwaitis, but nondeletional PA-1 is by far the most common cause of the moderate to severe HbH (β4 tetramer) disease phenotype. The α0 (−MED) allele is also encountered, which has implications for premarital counseling, especially for the possibility of having babies with alpha thalassemia major (Barts hydrops fetalis).
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Affiliation(s)
- Adekunle Adekile
- Department of Pediatrics, Faculty of Medicine, Kuwait University, PO Box 24923, 13110, Safat, Kuwait.
| | - Jalaja Sukumaran
- Department of Pediatrics, Faculty of Medicine, Kuwait University, PO Box 24923, 13110, Safat, Kuwait
| | - Diana Thomas
- Department of Pediatrics, Faculty of Medicine, Kuwait University, PO Box 24923, 13110, Safat, Kuwait
| | - Thomas D'Souza
- Department of Pediatrics, Faculty of Medicine, Kuwait University, PO Box 24923, 13110, Safat, Kuwait
| | - Mohammad Haider
- Department of Pediatrics, Faculty of Medicine, Kuwait University, PO Box 24923, 13110, Safat, Kuwait
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Azarkeivan A, Cohan N, Niazkar HR, Azizi A, Rad F. Hb S (HBB: c.20A>T) and α- and β-Thalassemia Coinheritance in Iranian Patients. Hemoglobin 2020; 44:109-112. [DOI: 10.1080/03630269.2020.1757462] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Azita Azarkeivan
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Nader Cohan
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamid Reza Niazkar
- Student Research Committee, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Arsalan Azizi
- Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Fariba Rad
- Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
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Hashemi-Soteh SMB, Karami H, Mousavi SS, Farazmandfar T, Tamadoni A. Alpha-globin gene mutation spectrum in patients with microcytic hypochromic anemia from Mazandaran Province, Iran. J Clin Lab Anal 2019; 34:e23018. [PMID: 31478238 PMCID: PMC6977355 DOI: 10.1002/jcla.23018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Revised: 08/04/2019] [Accepted: 08/05/2019] [Indexed: 12/20/2022] Open
Abstract
Background It is estimated about 7% of the world population is carriers of hemoglobin diseases. Alpha‐thalassemia is one of the most common hereditary hemoglobin disorders in the world. This study investigated alpha‐globin mutations in potential carriers with hypochromic and microcytic anemia from Mazandaran, in northern Iran. Methods A total of 859 subjects were selected; genomic DNA was extracted and examined for the presence of mutations in the alpha‐globin genes. Results Mutation analysis of alpha‐globin genes revealed 27 different mutations. Seven variants were seen in 91.45% of all alpha‐1 and alpha‐2 mutations among patients in this study. The 3.7 kb deletion is the most frequent mutation with a frequency of 49.53%, followed by PolyA2 (15.19%), −4.2 deletion (8.76%), ‐‐MED (5.84%), IVSI‐5nt deletion (5.49%), Hb constant spring (3.62%), and Cd 19 (−G; 3.04%), respectively. There are also seven new variants which were reported for the first time either in alpha‐1 or alpha‐2 genes, including codon 9 (C > A; α2), deletion of codon 60 (AAG deletion; α2), duplication of codon 94‐100 plus 3 base pairs of intron 2 (IVSII + 3; α1), codon 99 (C > A; α2), codon 108 (A > G; α2), codon 128 (A > T; α2), and codon 129 (T > G; α2), respectively. The MLPA method also revealed three rare and novel deletions in alpha‐cluster region with about 30 kilobases long. Conclusion This study showed an efficient identification of α‐thalassemia can be achieved using standard hematological indices in our population. The details of these variations will help local genetic services for diagnostic and prenatal diagnosis services.
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Affiliation(s)
- Seyed Mohammad Bagher Hashemi-Soteh
- Biochemistry and Genetic Department, Immunogenetic Research Center, Molecular and Cell Biology Research Center, Medical Faculty, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hossein Karami
- Department of Pediatrics, Hematology & Oncology, Thalassemia Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Touraj Farazmandfar
- Medical Cellular and Molecular Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Ahmad Tamadoni
- Amir Kola Hospital, Babol University of Medical Sciences, Babol, Iran
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Adekile AD, Al-Sherida S, Marouf R, Mustafa N, Thomas D. The Sub-Phenotypes of Sickle Cell Disease in Kuwait. Hemoglobin 2019; 43:83-87. [PMID: 31144996 DOI: 10.1080/03630269.2019.1610427] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Kuwaiti patients with sickle cell disease generally have a mild phenotype, but exhibit considerable heterogeneity, in spite of high Hb F levels. We have carried out a cross-sectional study of patients with sickle cell disease in the five major hospitals in Kuwait. Details of their hemoglobin (Hb) genotypes, clinical presentations and complications are presented. The study was over a span of 3 years and involved 396 patients, made up of 351 (88.6%) Kuwaitis and 45 (11.4%) expatriates. They were aged <1 to 73 years. Hb SS (βS/βS) was the most common (in 246 patients, i.e. 62.1%) followed by Hb S (HBB: c.20A>T)-β-thalassemia (Hb S-β-thal) in 138 (34.8%) and 11 (2.8%) Hb S/Hb D-Punjab (HBB: c.364G>C). Hb F ranged from 1.0 to 55.0%, with a mean of 21.2 ± 9.8%. The most common presentation was vaso-occlusive crises (VOCs), with 230 (54.8%) having had at least one prior to the study with 54 (13.2%) and 74 (18.9%) having between 2-3 and >3 VOCs, respectively. Hydroxyurea (HU) was prescribed to 157 (39.6%) patients. The most common complication was gallstones in 131 (33.1%), followed by acute splenic sequestration in 26.8% and avascular necrosis of the femoral head in 21.2% patients, respectively. Stroke, priapism and leg ulcers were rare. Gallstones, splenic sequestration and osteonecrosis were significantly more common in patients aged >16 years. Patients with Hb S-β-thal were similar to those with Hb SS in their clinical profiles. The phenotypic expression of sickle cell disease in Kuwaitis is unique in many respects. The role(s) of Hb F and other genetic modifiers require further elucidation.
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Affiliation(s)
- Adekunle D Adekile
- a Department of Pediatrics, Faculty of Medicine , Kuwait University , Safat , Kuwait.,b Pediatric Hematology Unit , Mubarak Al-Kabeer Hospital , Jabriya , Kuwait
| | - Sondus Al-Sherida
- b Pediatric Hematology Unit , Mubarak Al-Kabeer Hospital , Jabriya , Kuwait
| | - Rajaa Marouf
- c Department of Pathology, Faculty of Medicine , Kuwait University , Jabriya , Kuwait
| | - Nada Mustafa
- a Department of Pediatrics, Faculty of Medicine , Kuwait University , Safat , Kuwait
| | - Diana Thomas
- a Department of Pediatrics, Faculty of Medicine , Kuwait University , Safat , Kuwait
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Adekile AD, Gupta R, Al-Khayat A, Mohammed A, Atyani S, Thomas D. Risk of avascular necrosis of the femoral head in children with sickle cell disease on hydroxyurea: MRI evaluation. Pediatr Blood Cancer 2019; 66:e27503. [PMID: 30345708 DOI: 10.1002/pbc.27503] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Revised: 09/03/2018] [Accepted: 09/21/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND There are conflicting reports on the role of hydroxyurea (HU) in the pathogenesis of avascular necrosis of the femoral head (AVNFH) in patients with sickle cell disease (SCD). PROCEDURE The present study is a prospective cohort study of Kuwaiti children with SCD who were treated with HU. They had magnetic resonance imaging of the hips before starting HU and at regular intervals during a follow-up period, ranging from 1 to 15 years. RESULTS There were 40 patients (18 SS, 19 Sβ0-thalassemia, and three SD genotypes), aged 6-20 years. Pre-HU, 11 (27.5%) had varying grades of AVNFH, while post HU, the prevalence was 32.5%. Two patients developed new lesions during the study, while five (45.5%) that had lesions pre-HU remained static, another five (45.5%) progressed, and one (9%) improved radiologically. The older patients who had been on HU the longest were more likely to deteriorate. The only hematological parameter that was consistently associated with AVNFH was the reticulocyte count. CONCLUSIONS The frequency and rate of progression of AVNFH in this study is much less than that previously reported for our patients not treated with HU. There is no evidence that HU therapy is a risk factor for AVNFH. It may, in fact, prevent new lesions and deter the progression of existing AVNFH.
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Affiliation(s)
- Adekunle D Adekile
- Department of Pediatrics, Faculty of Medicine, Kuwait University, Safat, Kuwait.,Pediatric Hematology Unit, Mubarak Al-Kabeer Hospital, Safat, Kuwait
| | - Renu Gupta
- Department of Radiology, Faculty of Medicine, Kuwait University, Safat, Kuwait.,Department of Radiology, Mubarak Al-Kabeer Hospital, Safat, Kuwait
| | - Abdullah Al-Khayat
- Department of Radiology, Faculty of Medicine, Kuwait University, Safat, Kuwait
| | - Ahmed Mohammed
- Center for Medical Education, Faculty of Medicine, Kuwait University, Safat, Kuwait
| | - Said Atyani
- Department of Radiology, Faculty of Medicine, Kuwait University, Safat, Kuwait
| | - Diana Thomas
- Department of Pediatrics, Faculty of Medicine, Kuwait University, Safat, Kuwait
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Abedini SS, Forouzesh Pour F, Karimi K, Ghaderi Z, Farashi S, Tavakoli Koudehi A, Javadi Pirouz H, Mobini Nejad SB, Azarkeivan A, Najmabadi H. Frequency of α-Globin Gene Triplications and Coinheritance with β-Globin Gene Mutations in the Iranian Population. Hemoglobin 2018; 42:252-256. [PMID: 30451045 DOI: 10.1080/03630269.2018.1526192] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Numerical variation in α-globin genes is very important due to their roles as an effective factor for phenotype presentation. An unequal crossover from misalignment of a homologous sequence of an α-globin gene during meiosis can produce a numerical alteration. A single α-globin gene deletion is the most frequent mutation in α-thalassemia (α-thal) worldwide, while the additional α-globin chain is relatively common. The excess α-globin gene plays a critical role in pathophysiology of thalassemia, especially when in coinherited with β-thalassemia (β-thal). α-Globin triplication leads to an imbalanced ratio between α- and β-globin chains, thus, it can exacerbate the clinical and hematological features of β-thal. Different studies have been performed in various countries to determine the frequency of α-globin triplication and its genotype-phenotype correlation with β-thal. In this study, we focused on the frequency of α-globin gene triplication and its characterization, either solely or in coexistence with β-globin gene mutations in Iranian populations. We have investigated the α-globin gene rearrangements in 4010 individuals from different provinces of Iran with normal to abnormal hematological parameters. In total, the frequency of the αααanti 3.7 triplication was 1.7% and phenotype aggravation was observed in α-globin triplication patients who were carriers of β-thal. Therefore, identification of genotype-phenotype correlation of α-globin triplication with β-thal can be very useful for predicting the severity of clinical manifestations during genetic counseling.
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Affiliation(s)
- Seyedeh Sedigheh Abedini
- a Genetics Research Center, University of Social Welfare and Rehabilitation Sciences , Tehran , Iran
| | | | - Keyvan Karimi
- b Kariminejad-Najmabadi Pathology & Genetics Center , Tehran , Iran
| | - Zhila Ghaderi
- b Kariminejad-Najmabadi Pathology & Genetics Center , Tehran , Iran
| | - Samaneh Farashi
- a Genetics Research Center, University of Social Welfare and Rehabilitation Sciences , Tehran , Iran.,b Kariminejad-Najmabadi Pathology & Genetics Center , Tehran , Iran
| | | | | | | | - Azita Azarkeivan
- b Kariminejad-Najmabadi Pathology & Genetics Center , Tehran , Iran.,c Department of Thalassemia Clinic , Transfusion Research Center Organization, High Institute for Research and Education in Transfusion Medicine , Tehran , Iran
| | - Hossein Najmabadi
- a Genetics Research Center, University of Social Welfare and Rehabilitation Sciences , Tehran , Iran.,b Kariminejad-Najmabadi Pathology & Genetics Center , Tehran , Iran
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Nittayaboon K, Nopparatana C. Molecular characterization of Hb H disease in southern Thailand. Int J Hematol 2018; 108:384-389. [DOI: 10.1007/s12185-018-2494-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 06/27/2018] [Accepted: 07/05/2018] [Indexed: 01/20/2023]
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Pandey H, Ranjan R, Singh K, Sharma A, Kishor K, Seth T, Saxena R. Contrasting co-inheritance of alpha and beta mutations in delta beta thalassemia and hereditary persistence of fetal hemoglobin: a study from India. Hematology 2018; 23:692-696. [DOI: 10.1080/10245332.2018.1458934] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Affiliation(s)
| | - Ravi Ranjan
- Department of Hematology, AIIMS, New Delhi, India
| | | | - Amit Sharma
- Department of Hematology, AIIMS, New Delhi, India
| | - Kamal Kishor
- Department of Hematology, AIIMS, New Delhi, India
| | - Tulika Seth
- Department of Hematology, AIIMS, New Delhi, India
| | - Renu Saxena
- Department of Hematology, AIIMS, New Delhi, India
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Abstract
Sβ-thalassemia (Sβ-thal) is common among Gulf Arab patients with sickle cell disease, but the phenotype of this group had not been well-documented. We have studied a group of Kuwaiti patients and compared the phenotype in the homozygotes (SS) and Sβ-thal patients. Complete blood count, hemoglobin quantitation, serum bilirubin, and lactate dehydrogenase were determined with standard techniques. The patients were screened for α-globin genotype. The Sβ-thal patients were also screened for the HBG2 Xmn-1 polymorphism. β-Thal mutations were determined by arrayed primer extension or direct sequencing. There were 70 SS and 32 Sβ-thal patients with mean ages of 14.8±5.9 and 14.2±5.9 years, respectively. The Sβ-thal patients had more frequent, severe pain episodes per year compared with the SS, while the patterns among Sβ-thal and Sβ-thal patients were not significantly different. There were no differences in the frequencies of acute chest syndrome, gallstones, and blood transfusion in the SS and Sβ-thal patients. However, none of the Sβ-thal patients had been transfused. Among the Sβ-thal patients, 25 had β-thal and 7 had β-thal mutations, the most common being cd39 (C→T) and IVS-I-110 (G→A), respectively. Sβ-thal shows a severe phenotype in Kuwait, even among those with Sβ-thal, in whom the IVS-I-110 (G→A) mutation is predominant.
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Pharephan S, Sirivatanapa P, Makonkawkeyoon S, Tuntiwechapikul W, Makonkawkeyoon L. Prevalence of α-thalassaemia genotypes in pregnant women in northern Thailand. Indian J Med Res 2017; 143:315-22. [PMID: 27241645 PMCID: PMC4892078 DOI: 10.4103/0971-5916.182622] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND & OBJECTIVES Alpha-thalassaemias are genetic disorders with high prevalence in northern Thailand. However, common genotypes and current data on the prevalence of α-thalassaemias have not been reported in this region. Therefore, the objective of the present study was to determine the prevalence of α-thalassaemia genotypes in pregnant women in northern Thailand. METHODS Genomic DNA was extracted from blood samples of pregnant women who came to Maharaj Nakorn Chiang Mai University Hospital during July 2009 to 2010. The common deletion and point mutation genotypes of α-thalassaemia were evaluated by gap- polymerase chain reaction (PCR) and PCR with restriction fragment length polymorphism (RFLP). RESULTS Genotypes of 638 pregnant women were: 409 samples (64.11%) being normal subjects (αα/αα) and 229 samples (35.89%) with α-thalassaemias. these 229 samples could be classified into deletional HbH disease (--SEA/-α3.7) for 18 samples (2.82%); heterozygous α0-thalassaemia --SEA type (--SEA/αα)) for 78 (12.23%); heterozygous α+-thalassaemia - α3.7 type (-α3.7/αα) for 99 (15.52%); homozygous α+-thalassaemia - α3.7 type (-α3.7/- α3.7) for five (0.78%); heterozygous α+-thalassaemia - α4.2 type (-α4.2/αα) for two (0.31%); and heterozygous HbCS (αCSα/αα) for 27 (4.23%) cases. INTERPRETATION & CONCLUSIONS The prevalence of α-thalassaemias in pregnant women in northern Thailand was high. This finding supports the implementation of the prevention and control of this common genetic disorder by screening for α-thalassaemia genotypes.
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Affiliation(s)
- Somphon Pharephan
- Department of Biochemistry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Pannee Sirivatanapa
- Department of Obstetrics & Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Sanit Makonkawkeyoon
- Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Wirote Tuntiwechapikul
- Department of Biochemistry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Luksana Makonkawkeyoon
- Department of Biochemistry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Abuamer S, Shome DK, Jaradat A, Radhi A, Bapat JP, Sharif KA, Al-Touq J, Al-Asheeri A, Al-Ajami A. Frequencies and phenotypic consequences of association of α- and β-thalassemia alleles with sickle-cell disease in Bahrain. Int J Lab Hematol 2016; 39:76-83. [DOI: 10.1111/ijlh.12577] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 08/05/2016] [Indexed: 12/25/2022]
Affiliation(s)
- S. Abuamer
- Department of Pathology and Al Jawhara Centre for Molecular Medicine and Inherited Disorders; College of Medicine and Medical Sciences; Arabian Gulf University; Manama Kingdom of Bahrain
| | - D. K. Shome
- Department of Pathology and Al Jawhara Centre for Molecular Medicine and Inherited Disorders; College of Medicine and Medical Sciences; Arabian Gulf University; Manama Kingdom of Bahrain
| | - A. Jaradat
- Department of Family and Community Medicine; College of Medicine and Medical Sciences; Arabian Gulf University; Manama Kingdom of Bahrain
| | - A. Radhi
- Department of Pathology; Salmaniya Medical Complex; Manama Kingdom of Bahrain
| | - J. P. Bapat
- Department of Pathology; Salmaniya Medical Complex; Manama Kingdom of Bahrain
| | - K. A. Sharif
- Department of Internal Medicine; Salmaniya Medical Complex; Manama Kingdom of Bahrain
| | - J. Al-Touq
- Department of Internal Medicine; Salmaniya Medical Complex; Manama Kingdom of Bahrain
| | - A. Al-Asheeri
- Department of Internal Medicine; Salmaniya Medical Complex; Manama Kingdom of Bahrain
| | - A. Al-Ajami
- Department of Internal Medicine; Salmaniya Medical Complex; Manama Kingdom of Bahrain
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Singh MPSS, Gupta RB, Yadav R, Sharma RK, Shanmugam R. Prevalence of α(+)-Thalassemia in the Scheduled Tribe and Scheduled Caste Populations of Damoh District in Madhya Pradesh, Central India. Hemoglobin 2016; 40:285-8. [PMID: 27189862 DOI: 10.3109/03630269.2016.1170031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This study was carried out to ascertain the allelic frequency of α(+)-thalassemia (α(+)-thal) in Scheduled caste and scheduled tribe populations of the Damoh district of Madhya Pradesh, India. Random blood samples of Scheduled tribe (267) and Scheduled caste (168), considering the family as a sampling unit, were analyzed for the presence of the -α(3.7) (rightward) (NG_000006.1: g.34164_37967del3804) and -α(4.2) (leftward) (AF221717) deletions. α(+)-Thal was significantly higher in the Scheduled tribals (77.9%) as compared to the scheduled caste population (9.0%). About 58.0% scheduled tribals carried at least one chromosome with the -α(3.7) deletion and 20.0% scheduled tribals carried the -α(4.2) deletion. Frequency for the -α(3.7) allele was 0.487 in the scheduled tribal populations in comparison to 0.021 in scheduled castes. Allelic frequency for -α(4.2) was 0.103 and 0.024, respectively, in the above communities. No Hardy-Weinberg equilibrium for α-thal gene (p < 0.05) was detected in the tribal population, indicating the presence of selection pressures in favor of α-thal mutation and adaptation.
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Affiliation(s)
- Mendi P S S Singh
- a National Institute for Research in Tribal Health (NIRTH), Indian Council of Medical Research (ICMR) , Jabalpur, Madhya Pradesh , India
| | - Rasik B Gupta
- a National Institute for Research in Tribal Health (NIRTH), Indian Council of Medical Research (ICMR) , Jabalpur, Madhya Pradesh , India
| | - Rajiv Yadav
- a National Institute for Research in Tribal Health (NIRTH), Indian Council of Medical Research (ICMR) , Jabalpur, Madhya Pradesh , India
| | - Ravendra K Sharma
- a National Institute for Research in Tribal Health (NIRTH), Indian Council of Medical Research (ICMR) , Jabalpur, Madhya Pradesh , India
| | - Rajasubramaniam Shanmugam
- a National Institute for Research in Tribal Health (NIRTH), Indian Council of Medical Research (ICMR) , Jabalpur, Madhya Pradesh , India
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Farashi S, Rad F, Shahmohammadi B, Imanian H, Azarkeivan A, Najmabadi H. First Report of a Dominantly Inherited β-Thalassemia Caused by a Novel Elongated β-Globin Chain. Hemoglobin 2016; 40:102-7. [DOI: 10.3109/03630269.2015.1135445] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Farashi S, Najmabadi H. Diagnostic pitfalls of less well recognized HbH disease. Blood Cells Mol Dis 2015; 55:387-95. [DOI: 10.1016/j.bcmd.2015.08.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 08/06/2015] [Accepted: 08/06/2015] [Indexed: 10/23/2022]
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Farashi S, Garous NF, Vakili S, Ashki M, Imanian H, Azarkeivan A, Najmabadi H. Characterization of Homozygous Hb Setif (HBA2: c.283G>T) in the Iranian Population. Hemoglobin 2015; 40:53-5. [PMID: 26574177 DOI: 10.3109/03630269.2015.1091357] [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: 11/13/2022]
Abstract
Hemoglobin (Hb) variants are abnormalities resulting from point mutations in either of the two α-globin genes (HBA2 or HBA1) or the β-globin gene (HBB). Various reports of Hb variants have been described in Iran and other countries around the world. Hb Setif (or HBA2: c.283G>T) is one of these variants with a mutation at codon 94 of of the α2-globin gene that is characterized in clinically normal heterozygous individuals. We here report clinical and hematological findings in two homozygous cases of Iranian origin for this unstable Hb variant.
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Affiliation(s)
- Samaneh Farashi
- a Genetics Research Centre, University of Social Welfare & Rehabilitation Sciences , Tehran , Iran.,b Kariminejad-Najmabadi Pathology & Genetics Centre , Tehran , Iran
| | - Negin F Garous
- b Kariminejad-Najmabadi Pathology & Genetics Centre , Tehran , Iran
| | - Shadi Vakili
- b Kariminejad-Najmabadi Pathology & Genetics Centre , Tehran , Iran
| | - Mehri Ashki
- b Kariminejad-Najmabadi Pathology & Genetics Centre , Tehran , Iran
| | - Hashem Imanian
- b Kariminejad-Najmabadi Pathology & Genetics Centre , Tehran , Iran
| | - Azita Azarkeivan
- b Kariminejad-Najmabadi Pathology & Genetics Centre , Tehran , Iran.,c Iranian Blood Transfusion Organization, High Institute for Transfusion Research Centre , Tehran , Iran
| | - Hossein Najmabadi
- a Genetics Research Centre, University of Social Welfare & Rehabilitation Sciences , Tehran , Iran.,b Kariminejad-Najmabadi Pathology & Genetics Centre , Tehran , Iran
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Farashi S, Bayat N, Vakili S, Faramarzi Garous N, Ashki M, Imanian H, Najmabadi H, Azarkeivan A. Point mutations which should not be overlooked in Hb H disease. Expert Rev Hematol 2015; 9:107-13. [DOI: 10.1586/17474086.2016.1107470] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Serum Total Bilirubin, not Cholelithiasis, is Influenced by UGT1A1 Polymorphism, Alpha Thalassemia and β(s) Haplotype: First Report on Comparison between Arab-Indian and African β(s) Genes. Mediterr J Hematol Infect Dis 2015; 7:e2015060. [PMID: 26543529 PMCID: PMC4621171 DOI: 10.4084/mjhid.2015.060] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 10/10/2015] [Indexed: 12/30/2022] Open
Abstract
Background We explored the potential relationship between steady state serum bilirubin levels and the incidence of cholelithiasis in the context of UGT1A1 gene A(TA)nTAA promoter polymorphism in Omani sickle cell anemia (SCA) patients, homozygotes for African (Benin and Bantu) and Arab-Indian βS haplotypes, but sharing the same microgeographical environment and comparable life style factors. Methods 136 SCA patients were retrospectively studied in whom imaging data including abdominal CT scan, MRI or Ultrasonography were routinely available. Available data on the mean steady state hematological/biochemical parameters (n=136), βs haplotypes(n=136), α globin gene status (n=105) and UGT1A1 genotypes (n=133) were reviewed from the respective medical records. Results The mean serum total bilirubin level was significantly higher in the homozygous UGT1A1(AT)7 group as compared to UGT1A1(AT)6 group. Thus, not cholelithiasis but total serum bilirubin was influenced by UGT1A1 polymorphism in this SCA cohort. Conclusion As observed in other population groups, the UGT1A1 (AT)7 homozygosity was significantly associated with raised serum total bilirubin level, but the prevalence of gallstones in the Omani SCA patients was not associated with α thalassaemia, UGT1A1 polymorphism, or βs haplotypes.
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Farashi S, Vakili S, Garous NF, Ashki M, Imanian H, Azarkeivan A, Najmabadi H. Mutations on theα2-Globin Gene That May Triggerα+-Thalassemia. Hemoglobin 2015; 39:398-402. [DOI: 10.3109/03630269.2015.1075890] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Ünal Ş, Gümrük F. The Hematological and Molecular Spectrum of α-Thalassemias in Turkey: The Hacettepe Experience. Turk J Haematol 2015; 32:136-43. [PMID: 26316481 PMCID: PMC4451481 DOI: 10.4274/tjh.2014.0200] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE The spectrum of α-thalassemias correlates well with the number of affected α-globin genes. Additionally, combinations of the several non-deletional types of mutations with a large trans deletion comprising the 2 α-globin genes have an impact on the clinical severity. The objective of this study was to analyze the hematological and molecular data of 35 patients with Hb H disease from a single center in order to identify the genotypes of Hb H disease and genotype-phenotype correlations. MATERIALS AND METHODS Herein, we report the hematological and mutational spectrum of patients with Hb H disease (n=35). Additionally, genotypes of α-gene mutations of 78 individuals, who were referred to our institution for α-gene screening, were analyzed. RESULTS Supporting the previous data from Turkey, -α3.7 was the most common mutation among patients with Hb H disease (62.8%) and in the other 78 subjects (39.7%). Of the patients with Hb H disease, the most common genotypes were -α3.7/--20.5, -α3.7/--26.5, and -α3.7/--17.5 in 10 (28.6%), 6 (17.1%), and 6 (17.1%) patients, respectively. Another small deletion, -4.2 alpha, and several non-deletional types of α-gene mutations, namely α (-5nt): IVS-I donor site (GAG.GTG.AGG->GAG.G-----); α (PA-2): AATAAA>AATGGA, and α (cd59): GGC->GAC, were found to be associated with Hb H disease when present at trans loci of one of the large deletions given above. The combinations consisting of 1 non-deletional and 1 of the large deletional types of mutations (αTα/--) at trans loci were found to result in a more severe phenotype compared to the genotypes composed of 1 small trans deletion of a large deletion (-α/--). The combination of α (Cd59) and -- in trans was associated with severe phenotype and the disease was associated with an increase in Hb Bart's level with null Hb H. In spite of the presence of 2 intact α-globin genes, homozygosity for PA-2 mutation resulted in severe Hb H disease. CONCLUSION This study indicated that Hb H disease is not rare in Turkey and its genotype is quite heterogeneous.
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Affiliation(s)
- Şule Ünal
- Hacettepe University Faculty of Medicine, Division of Pediatric Hematology, Ankara, Turkey Phone: +90 532 526 37 49 E-mail:
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Adekile AD, Azab AF, Al-Sharida SI, Al-Nafisi BA, Akbulut N, Marouf RA, Mustafa NY. Clinical and Molecular Characteristics of Non-Transfusion-Dependent Thalassemia in Kuwait. Hemoglobin 2015; 39:320-6. [DOI: 10.3109/03630269.2015.1053489] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Wisedpanichkij R, Jindadamrongwech S, Butthep P. Identification of Hb Constant Spring (HBA2: c.427T > C) by an Automated High Performance Liquid Chromatography Method. Hemoglobin 2015; 39:190-5. [PMID: 26016900 DOI: 10.3109/03630269.2015.1027828] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Laboratory investigation of hemoglobinopathies includes complete blood count (CBC), hemoglobin (Hb) typing by high performance liquid chromatography (HPLC) and DNA analysis. DNA analysis is the most reliable method but requires a manually laborious procedure and is time consuming. A more practical method of detecting abnormal Hbs is the HPLC technique, because it is more rapid and easier to interpret. Hb Constant Spring (Hb CS; HBA2: c.427T > C) is an abnormal variant that is labile and difficult to detect using conventional methods. To evaluate the efficiency of Hb CS determination by HPLC, blood samples from 578 subjects were analyzed using an automated cell analyzer for hematological parameters, automated HPLC for Hb identification, and polymerase chain reaction (PCR) for α-thalassemia (α-thal) and Hb CS confirmation. These included 169 normal, 119 heterozygous α-thal-2, 30 homozygous α-thal-2, 177 heterozygous α-thal-1, 59 heterozygous Hb CS, seven homozygous Hb CS and 17 compound heterozygous α-thal-2 and Hb CS subjects. The results showed that sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of Hb CS by HPLC were 93.78, 99.80, 98.73 and 99.00%, respectively. The mean of misdiagnosis value of the three groups of Hb CS subjects (total 83) was 6.02% (n = 5), with percentages for heterozygous Hb CS, homozygous Hb CS, and compound heterozygous α-thal-2 and Hb CS being 6.8, 0.0 and 5.9%, respectively. The HPLC method yielded good results, although it may also lead to misdiagnosis of Hb CS due to the relatively small amount and lability.
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Affiliation(s)
- Raewadee Wisedpanichkij
- Hematology Laboratory, Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University , Bangkok , Thailand
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Farashi S, Faramarzi Garous N, Ashki M, Vakili S, Zeinali F, Imanian H, Azarkeivan A, Najmabadi H. Hb Dartmouth (HBA2: c.200T>C): An α2-Globin Gene Associated with Hb H Disease in One Homozygous Patient. Hemoglobin 2015; 39:152-5. [DOI: 10.3109/03630269.2015.1027915] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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30
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Farashi S, Faramarzi Garous N, Zeinali F, Vakili S, Ashki M, Imanian H, Najmabadi H, Azarkeivan A, Tamaddoni A. A 21 Nucleotide Duplication on theα1- andα2-Globin Genes Involves a Variety of Hypochromic Microcytic Anemias, From Mild to Hb H Disease. Hemoglobin 2015; 39:196-200. [DOI: 10.3109/03630269.2015.1030757] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Prevalence of alpha thalassemia in microcytic anemia: a tertiary care experience from north India. Mediterr J Hematol Infect Dis 2015; 7:e2015004. [PMID: 25574363 PMCID: PMC4283920 DOI: 10.4084/mjhid.2015.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Accepted: 11/24/2014] [Indexed: 11/24/2022] Open
Abstract
Introduction Cases with microcytosis not responding adequately to iron supplementation are diagnostic dilemma and have been reported to harbor alpha (α) thalassemia mutations. The aim of this study was to determine the common α globin gene deletions in cases with microcytic anemia. Methods Fifty four patients selected (22 females and 32 males) had microcytic anemia (MCV < 80 fl, Hb <12gm/dl) with raised TRBC (> 5M/mm3) but normal Hb HPLC. They had either low or normal Transferrin Saturation (TS). Gap-PCR for four common α-gene deletions (-α3.7, -α4.2, - -αSA and --αSEA) was done. Results Out of the total fifty-four cases nineteen (35.2%) cases were found to have α gene mutations; Three homozygous and sixteen heterozygous cases including -α3.7 deletions and a single case of -- α SA ; but no -α4.2 and –SEA mutations were found. Conclusion α gene mutations can confound iron deficiency anemia, but no RBC indices, or a discriminant function can identify it is presence Molecular studies have to be resorted to. Gap PCR for common α thalassemia mutation including –α SA should be done even in the face of low iron stores in subjects who respond incompletely to iron supplementation.
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Hafezi-Nejad N, Khosravi M, Bayat N, Kariminejad A, Hadavi V, Oberkanins C, Azarkeivan A, Najmabadi H. Characterizing a Cohort of α-Thalassemia Couples Collected During Screening for Hemoglobinopathies: 14 Years of an Iranian Experience. Hemoglobin 2014; 38:153-7. [DOI: 10.3109/03630269.2014.909365] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Pandey SK, Pandey S, Ranjan R, Shah V, Mishra RM, Sharma M, Saxena R. Phenotypic effect of α-globin gene numbers on Indian sickle β-thalassemia patients. J Clin Lab Anal 2014; 28:110-3. [PMID: 24395608 DOI: 10.1002/jcla.21652] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2011] [Accepted: 06/03/2013] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Sickle cell β-thalassemia is a compound heterozygous state of β-thalassemia and sickle cell anemia. Patient with these conditions showed mild-to-severe clinical phenotype. OBJECTIVES The objective of this study was to evaluate the effects of α-globin gene numbers on the phenotype of sickle cell β-thalassemia patients. MATERIALS AND METHODS Seventy-five sickle cell β-thalassemia patients were characterized. Clinical, hematological, and molecular characterization was performed in all subjects. Amplified refectory mutation system-polymerase chain reaction was applied for β-thalassemia mutation study while α-genotyping was conducted by Gap-PCR. RESULTS Highest frequency of IVS1-5 (33 out of 75 patients) β-thalassemia genotype was recorded. Twenty-eight patients were reported with α-globin chain deletion while four had α-triplications (Anti α-3.7kb). Sickle β-thalassemia patients with α-chain deletions ameliorate hematological and clinical variables. CONCLUSIONS This study indicates that the coexistence of α-globin chain deletions showed mild phenotype instead of absence of α-chain deletions while the patients with triplication of α-genes express severe phenotype.
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Affiliation(s)
- Sanjay Kumar Pandey
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
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Nishank SS, Ranjit M, Chhotray GP. First report of a nonsense mutation at codon 15(TGG→TAG) in exon 1 of theβglobin gene in aβthalassemia trait in State of Orissa, India. Hematology 2013; 13:65-7. [DOI: 10.1179/102453308x315852] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Affiliation(s)
| | - Manoranjan Ranjit
- Regional Medical Research Centre (ICMR), Chandrasekharpur, Bhubaneswar-751023, India
| | - Guru Prasad Chhotray
- Regional Medical Research Centre (ICMR), Chandrasekharpur, Bhubaneswar-751023, India
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Panigrahi I, Dixit A, Arora S, Kabra M, Mahapatra M, Choudhry VP, Saxena R. Do alpha deletions influence hydroxyurea response in thalassemia intermedia? Hematology 2013; 10:61-3. [PMID: 16019448 DOI: 10.1080/10245330400020439] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Thalassemia intermedia patients show variable phenotypes. Hydroxyurea (HU) may benefit some of the thalassemia intermedia cases (1), however, the parameters influencing the response to HU have not been reported. In this study, the molecular parameters, alpha-globin and beta-globin genotype and the Xmn I polymorphism, were correlated with the HU response. Twenty patients with thalassemia intermedia were given HU (10-20 mg/kg) and responses were evaluated over a one year period. Twelve patients (60%) showed a good response to therapy with a significant increase in Hb and HbF levels and with elimination of the transfusion requirement in four patients. Four out of the twelve (33%) patients were positive for -alpha(3.7) deletions whereas none of the 8 non-responders were positive for alpha deletions. One each of the responders and non-responders were positive for alpha alpha alpha(anti-3.7) triplication. Three (25%) responsive and one non-responsive patients were homozygous for the IVS1-1 (G-->T) mutation. Three of the responsive patients with alpha deletions were also homozygous positive for Xmn I polymorphism. Thus, in addition to acting in synergy with the XmnI polymorphism, alpha deletions may be an independent factor predicting good response to HU in thalassemia intermedia, although this needs to be confirmation in larger studies.
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Affiliation(s)
- I Panigrahi
- Department of Hematology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
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36
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Seeratanachot T, Sanguansermsri T, Shimbhu D. Detection of Hb H Disease Genotypes Common in Northern Thailand by Quantitative Real-Time Polymerase Chain Reaction and High Resolution Melting Analyses. Hemoglobin 2013; 37:574-83. [DOI: 10.3109/03630269.2013.828228] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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37
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Harteveld CL. State of the art and new developments in molecular diagnostics for hemoglobinopathies in multiethnic societies. Int J Lab Hematol 2013; 36:1-12. [PMID: 23721114 DOI: 10.1111/ijlh.12108] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Accepted: 04/17/2013] [Indexed: 12/01/2022]
Abstract
For detecting carriers of thalassemia traits, the basic part of diagnostics consists of measurement of the hematological indices followed by mostly automatic separation and measurement of the Hb fractions, while direct Hb separation either on high pressure liquid chromatography or capillary electrophoresis is sufficient to putatively identify carriers of the common Hb variants like HbS, C, E, D, and O-Arab. A putative positive result is reported together with an advice for parents, partner, or family analysis. For couples, presumed at-risk confirmation at the DNA level is essential. In general, this part of diagnostics is done in specialized centers provided with sufficient experience and the technical tools needed to combine hematological and biochemical interpretation with identification of the mutations at the molecular level. State-of-the-art tools are usually available in centers that also provide prenatal diagnosis and should consist of gap-PCR for the common deletions, direct DNA sequencing for all kind of point-mutations and the capacity to uncover novel or rare mutations or disease mechanisms. New developments are MLPA for large and eventually unknown deletion defects and microarray technology for fine mapping and primer design for breakpoint analysis. Gap-PCR primers designed in the region flanking the deletion breakpoints can subsequently be used to facilitate carrier detection of uncommon deletions in family members or isolated populations in laboratories where no microarray technology or MLPA is available.
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Affiliation(s)
- C L Harteveld
- Department of Human and Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
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38
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Al Moamen NJ, Mahdi F, Salman E, Ahmed T, Abbas R, Al Arrayed S, Sanad H, Ahmed AA. Silent β-Thalassemia Mutations at −101 (C>T) and −71 (C>T) and Their Coinheritance with the Sickle Cell Mutation in Bahrain. Hemoglobin 2013; 37:369-77. [DOI: 10.3109/03630269.2013.785434] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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39
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Asadov CD, Abdulalimov ER, Mammadova TA, Qafarova SN, Guliyeva YJ, Tuli A, Cürük MA. Identification of two rare β-globin gene mutations in a patient with β-thalassemia intermedia from Azerbaijan. Hemoglobin 2013; 37:291-6. [PMID: 23510507 DOI: 10.3109/03630269.2013.774283] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
β-Thalassemias are an inherited group of disorders of hemoglobin (Hb) and comprise the most common monogenic disorders in Azerbaijan. They are extremely heterogeneous at the molecular level. Here we report the first identification of a patient who is a compound heterozygote for two rare β-thalassemia (β-thal) mutations, IVS-I-130 (G>C) and codon 37 (TGG>TGA).
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Affiliation(s)
- Chingiz D Asadov
- Department of Hereditary Pathology of Erythrone, Institute of Haematology and Transfusiology, AZ1007 Baku, Azerbaijan.
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Rosnah B, Rosline H, Zaidah AW, Noor Haslina MN, Marini R, Shafini MY, Nurul Ain FA. Detection of common deletional alpha-thalassemia spectrum by molecular technique in kelantan, northeastern malaysia. ISRN HEMATOLOGY 2012; 2012:462969. [PMID: 22888447 PMCID: PMC3408647 DOI: 10.5402/2012/462969] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Accepted: 06/07/2012] [Indexed: 11/25/2022]
Abstract
Thalassemia is a hereditary blood disorder that results from genetic defects causing deficient synthesis of hemoglobin polypeptide chains. Although thalassemia mostly affects developing countries, there is limited knowledge of its accurate frequency and distribution in these regions. Knowing the prevalence of thalassemia and the frequency of responsible mutations is therefore an important step in the prevention and control program as well as treatment strategies. This study was performed to determine the prevalence and to study the spectrum of gene deletions that are responsible in α-thalassemia in Kelantan, located in northeastern Malaysia. A total 400 first-time blood donors from multiple areas of donation centre were chosen randomly. The presence of three types of α-thalassemia gene deletion in southeast Asian population which were -SEAdeletion, -α3.7 rightward deletion, and -α4.2 leftward deletion was detected by using multiplex PCR method. 37 (9.25%) of blood donors were confirmed to have α-thalassemia deletion types. 34 (8%) were heterozygous for α3.7 deletion, 1 (0.25%) was heterozygous for α4.2 deletion, and 2 (0.5%) were heterozygous for SEA type deletion. Alpha-thalassemia-2 with 3.7 deletion was the most common determinant detected in Kelantan Malay compared to other ethnic groups. It has been noted that alpha-thalassemia-2 with 3.7 deletion is the most common type of α-thalassemia throughout the world.
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Affiliation(s)
- B Rosnah
- Hematology Department, Hospital Universiti Sains Malaysia, Kelantan 16150 Kubang Kerian, Malaysia
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Pandey S, Ranjan R, Mishra RM, Pandey S, Saxena R. Interaction of - α 3.7, ß Thalassemia Mutation IVS 1-5 and HbD Punjab in a Family: A Case Report. Indian J Clin Biochem 2012; 27:314-7. [PMID: 26405395 DOI: 10.1007/s12291-012-0189-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2011] [Accepted: 01/15/2012] [Indexed: 10/28/2022]
Abstract
Hemoglobin D exist in four form; HbD trait, HbD-thalassemia, HbD sickle cell and HbD homozygous. HbD trait and HbD homozygous generally asymptomatic condition but when HbD co-inherit with thalassemia and sickle cell anemia, produces clinically significant conditions like chronic hemolytic anemia. Here we present a case of HbD Punjab with α 3.7 kb deletion and IVS-1-5 β-thalassemia across a family. Diagnosis of HbD patient was performed by high performance liquid chromatography and complete blood count was measured by automated cell analyzer. Molecular study for common alpha deletions done by Gap-PCR while beta thalassemia mutation identified by ARMS-PCR. Case was clinically significant due to the inheritance of HbD/β(+)thalassemia genotype. Thus observed case behaved like thalassemia intermedia due to co-existence of α 3.7 deletions with IVS 1-5 β-thalassemia mutation in HbD Punjab patient.
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Affiliation(s)
- S Pandey
- Department of Haematology, All India Institute of Medical Sciences, I.R.C.H. Building (1st floor), Ansari Nagar, New Delhi, 110 029 India
| | - Ravi Ranjan
- Department of Haematology, All India Institute of Medical Sciences, I.R.C.H. Building (1st floor), Ansari Nagar, New Delhi, 110 029 India
| | - R M Mishra
- Department of Environmental Biology, APS University, Rewa, India
| | - Sw Pandey
- Department of Haematology, All India Institute of Medical Sciences, I.R.C.H. Building (1st floor), Ansari Nagar, New Delhi, 110 029 India
| | - R Saxena
- Department of Haematology, All India Institute of Medical Sciences, I.R.C.H. Building (1st floor), Ansari Nagar, New Delhi, 110 029 India
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42
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Pandey S, Mishra RM, Suhail A, Rahul S, Ravi K, Pandey S, Seth T, Saxena R. Association of Low Serum Iron with Alpha Globin Gene Deletions and High Level of HbF with Xmn-1 Polymorphism in Sickle Cell Traits. Indian J Clin Biochem 2012; 27:270-3. [PMID: 26405386 PMCID: PMC4577506 DOI: 10.1007/s12291-011-0170-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2011] [Accepted: 09/24/2011] [Indexed: 11/30/2022]
Abstract
Usually sickle cell traits are asymptomatic but co-existence of various factrors may alter the clinical as well as biochemical levels. In India sickle cell traits are neglected condition. Here we are presenting the alpha deletion in association with low serum iron and increased HbF level with Xmn-1 carriers in sickle cell traits. Sickle traits with alpha deletions had significantly low level of serum iron (P-value <0.05) with low level of reticulocytes and red cell indices while Xmn-1 polymorphism associated with increased HbF level. Study concludes low serum iron associated with alpha deletions and high level of HbF associated with Xmn-1 polymorphism in sickle cell traits.
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Affiliation(s)
- S. Pandey
- />Department of Hematology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110 029 India
| | - R. M. Mishra
- />Department of Environmental Biology, APS University Rewa, Rewa, India
| | - A. Suhail
- />Department of Hematology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110 029 India
| | - S. Rahul
- />Department of Hematology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110 029 India
| | - K. Ravi
- />Department of Hematology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110 029 India
| | - Sw. Pandey
- />Department of Hematology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110 029 India
| | - T. Seth
- />Department of Hematology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110 029 India
| | - R. Saxena
- />Department of Hematology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110 029 India
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Pandey S, Pandey S, Ranjan R, Mishra R, Sharma M, Saxena R. Phenotypic heterogeneity of asian Indian inversion deletions gγ(aγδβ)0 breakpoint a and breakpoint B. Indian J Clin Biochem 2012; 28:98-101. [PMID: 24381431 DOI: 10.1007/s12291-012-0232-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Accepted: 05/27/2012] [Indexed: 11/28/2022]
Abstract
Asian Indian inversion deletion Gγ (Aγδβ)0-thalassemia is a rare entities characterized by high HbF. Due to interaction with various genetic factors, patients with Gγ (Aγδβ)0-thalassemia showed clinical variability. Here we are presenting the phenotypic expression of Gγ(Aγδβ)0 thalassemia under influence of various co-inherited factors. Patient with α-globin gene deletion had mild phenotype than the patient with β-globin mutations. Patient with alpha gene deletion were presenting clinical character like thalassemia intermedia while Gγ (Aγδβ)0-thalassemia patients with co- presence of beta thalssemia mutation clinically behaved like thalassemia major.
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Affiliation(s)
- Sanjay Pandey
- Department of Haematology, All India Institute of Medical Sciences, New Pvt. Ward (2nd Floor), Ansari Nagar, New Delhi, 110 029 India
| | - Sweta Pandey
- Department of Haematology, All India Institute of Medical Sciences, New Pvt. Ward (2nd Floor), Ansari Nagar, New Delhi, 110 029 India
| | - Ravi Ranjan
- Department of Haematology, All India Institute of Medical Sciences, New Pvt. Ward (2nd Floor), Ansari Nagar, New Delhi, 110 029 India
| | | | - Monica Sharma
- Department of Haematology, All India Institute of Medical Sciences, New Pvt. Ward (2nd Floor), Ansari Nagar, New Delhi, 110 029 India
| | - Renu Saxena
- Department of Haematology, All India Institute of Medical Sciences, New Pvt. Ward (2nd Floor), Ansari Nagar, New Delhi, 110 029 India
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Pandey S, Mishra RM, Pandey S, Shah V, Saxena R. Molecular characterization of hemoglobin D Punjab traits and clinical-hematological profile of the patients. SAO PAULO MED J 2012; 130:248-51. [PMID: 22965366 PMCID: PMC10619953 DOI: 10.1590/s1516-31802012000400008] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2011] [Revised: 07/11/2011] [Accepted: 01/18/2012] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND OBJECTIVE Hemoglobin (Hb) D hemoglobinopathies are widespread diseases in northwestern India and usually present with mild hemolytic anemia and mild to moderate splenomegaly. The heterozygous form of Hb D is clinically silent, but coinheritance of Hb D with Hb S or beta-thalassemia produces clinically significant conditions like thalassemia intermedia of moderate severity. Under heterozygous conditions with coinheritance of alpha and beta-thalassemia, patients show a degree of clinical variability. Thus, our aim was to molecularly characterize the Hb D trait among individuals who were clinically symptomatic because of co-inheritance of alpha deletions or any beta-globin gene mutations. DESIGN AND SETTING This was a cross-sectional study conducted in an autonomous tertiary-care hospital. METHODS Complete blood count and red cell indices were measured using an automated cell analyzer. Quantitative assessment of hemoglobin Hb F, Hb A, Hb A2 and Hb D was performed by means of high performance liquid chromatography (HPLC). DNA extraction was done using the phenol-chloroform method. Molecular analyses on common alpha deletions and common beta mutations were done using the Gap polymerase chain reaction and Amplification Refractory Mutation System, respectively. RESULTS We evaluated 30 patients and found clinical variation in the behavior of Hb D traits. In six patients, the Hb D traits were clinically symptomatic and behaved like those of thalassemia intermedia. Molecular characterization showed that three out of these six were IVS-1-5 positive. CONCLUSIONS HPLC may not be the gold standard for diagnosing symptomatic Hb D Punjab traits. Hence, standard confirmation should include molecular studies.
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Affiliation(s)
- Sanjay Pandey
- MSc. Senior Research Fellow, Department of Hematology, All India Institute of Medical Sciences, New Delhi, India.
| | - Rahasya Mani Mishra
- PhD. Professor, Department of Environmental Biology, Awadhesh Pratap Singh University, Rewa, Madhya Pradesh, India
| | - Sweta Pandey
- MSc. Student, Department of Hematology, All India Institute of Medical Sciences, New Delhi, India.
| | - Vineet Shah
- MSc. Senior Research Fellow, Department of Cardiac Biochemistry, All India Institute of Medical Sciences, New Delhi, India.
| | - Renu Saxena
- MD. Professor, Department of Hematology, All India Institute of Medical Sciences, New Delhi, India.
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Thalassemia-like phenotype in a novel complex hemoglobinopathy with α, β, δ globin chain abnormalities. J Pediatr Hematol Oncol 2011; 33:589-91. [PMID: 22042275 DOI: 10.1097/mph.0b013e318228255c] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The occurrence of multiple abnormalities of α, β, δ, and γ globin genes may lead to unusual and complex phenotypes when they arise simultaneously in the same individual. Here, we report the findings of an African American boy who coinherited 3 heterozygous globin gene abnormalities: the unstable β-globin chain variant; hemoglobin (Hb) Showa-Yakushiji [β110(G12) Leu→Pro], the δ-globin chain variant; HbB2 [δ16(A13) Gly→Arg] and α-thalassemia (α-thal); (α-/αα). Hb Showa-Yakushiji had been previously described in Japanese, Indian, and European populations. We report its first occurrence in a child of African ancestry who presented with anemia not responsive to iron and an incomplete β-thalassemia minor phenotype. Although the clinical and laboratory features of Hb Showa-Yakushiji mimic those of a β-thalassemia, the coinheritance of the δ-globin chain variant Hb B2 suppressed the relative increase in Hb A2 usually observed in heterozygotes for the Hb Showa-Yakushiji mutation. Protein-based methods detected only a trace amount of HbB2 and failed to reveal presence of Hb Showa-Yakushiji and α-thal. The latter were only identified through DNA analyses. The diagnostic difficulties, molecular characteristics, and genotype/phenotype correlations of this novel complex hemoglobinopathy syndrome are reviewed.
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Pandey S, Pandey S, Mishra RM, Sharma M, Saxena R. Genotypic influence of α-deletions on the phenotype of Indian sickle cell anemia patients. THE KOREAN JOURNAL OF HEMATOLOGY 2011; 46:192-5. [PMID: 22065975 PMCID: PMC3208203 DOI: 10.5045/kjh.2011.46.3.192] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2011] [Revised: 09/03/2011] [Accepted: 09/06/2011] [Indexed: 11/17/2022]
Abstract
BACKGROUND Some reports have shown that co-inheritance of α-thalassemia and sickle cell disease improves hematological parameters and results in a relatively mild clinical picture for patients; however, the exact molecular basis and clinical significance of the interaction between α-thalassemia and sickle cell disease in India has not yet been described. There is little agreement on the clinical effects of α-thalassemia on the phenotype of sickle cell disease. METHODS Complete blood count and red cell indices were measured by an automated cell analyzer. Quantitative assessment of hemoglobin variants HbF, HbA, HbA(2), and HbS was performed by high performance liquid chromatography (HPLC). DNA extraction was performed using the phenol-chloroform method, and molecular study for common α-deletions was done by gap-PCR. RESULTS Out of 60 sickle cell anemia patients, the α-thalassemia genotype was found in 18 patients. Three patients had the triplicated α-genotype (Anti α-3.7 kb), and the remaining patients did not have α-deletions. This study indicates that patients with co-existing α-thalassemia and sickle cell disease had a mild phenotype, significantly improved hematological parameters, and fewer blood transfusions than the patients with sickle cell anemia without co-existing α-deletions. CONCLUSION Co-existence of α-thalassemia and sickle cell anemia has significant effects on the phenotype of Indian sickle cell patients.
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Affiliation(s)
- Sanjay Pandey
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Sweta Pandey
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Rahasya Mani Mishra
- Department of Environmental Biology, Awadhesh Pratap Singh University, Rewa, India
| | - Monica Sharma
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Renu Saxena
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
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Ebrahimkhani S, Azarkeivan A, Bayat N, Houry-Parvin M, Jalil-Nejad S, Zand S, Golkar Z, Hadavi V, Imanian H, Oberkanins C, Najmabadi H. Genotype-Phenotype Correlation In Iranian Patients With Hb H Disease. Hemoglobin 2011; 35:40-6. [DOI: 10.3109/03630269.2010.546314] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Bhat VS, Dewan KK, Krishnaswamy PR. The Diagnosis of α-Thalassaemia: A Case of Hemoglobin H -α Deletion. Indian J Clin Biochem 2010; 25:435-40. [PMID: 21966120 PMCID: PMC2994557 DOI: 10.1007/s12291-010-0053-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2009] [Accepted: 01/18/2010] [Indexed: 10/19/2022]
Abstract
We report a case of hemolytic anemia that was subsequently identified to be a case of α-thalassaemia harboring the common rightward 3.7 kb deletion/HbH. The diagnosis was based on sequential analyses using BioRad D10 HPLC, Alkaline gel electrophoresis, GPO α THAL-IC strips and the identification of the specific genetic lesion using an α Globin reverse dot blot hybridization assay. Supravital stain of RBCs helped in identifying classical HbH inclusions. In a background of a variable clinical presentation, lack of definitive hematological markers, and general under-diagnosis of α-thalassaemias we have used this case to highlight the features and sequence of techniques involved in identifying and characterizing an α-globin chain mutation, starting from a diffuse clinical history and presentation up to the identification of a specific genetic lesion involved.
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Affiliation(s)
- Vijay S. Bhat
- Department of Biochemistry, Manipal Hospital Diagnostic Services, Manipal Hospital, Old Airport Road, Bangalore, 560017 India
| | - Kalyan Kumar Dewan
- Cauvery Medical Center, 43/2 Sahakarnagar, Bellary Road, NH-7, Bangalore, 560 092 India
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50
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High prevalence of alpha- and beta-thalassemia in the Kadazandusuns in East Malaysia: challenges in providing effective health care for an indigenous group. J Biomed Biotechnol 2010; 2010. [PMID: 20871816 PMCID: PMC2943116 DOI: 10.1155/2010/706872] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2010] [Revised: 06/30/2010] [Accepted: 07/20/2010] [Indexed: 11/18/2022] Open
Abstract
Thalassemia can lead to severe transfusion-dependent anemia, and it is the most common genetic disorder in Malaysia. This paper aims to determine the prevalence of thalassemia in the Kadazandusuns, the largest indigenous group in Sabah, East Malaysia. α- and β-thalassemia were confirmed in 33.6% and 12.8%, of the individuals studied respectively. The high prevalence of α- and β-thalassemia in the Kadazandusuns indicates that thalassemia screening, genetic counseling, and prenatal diagnosis should be included as part of their healthcare system. This preliminary paper serves as a baseline for further investigations into the health and genetic defects of the major indigenous population in Sabah, East Malaysia.
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