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Panyasai S, Kunyanone N, Satthakarn S. Hb Athens-Georgia (beta 40(C6) Arg > Lys, HBB:c.122G > A) with a single α-globin gene (Hb H disease) in a Thai family: molecular, hematological, and diagnostic aspects. Scandinavian Journal of Clinical and Laboratory Investigation 2020; 81:52-58. [PMID: 33287582 DOI: 10.1080/00365513.2020.1852598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Interaction of structural hemoglobin (Hb) variants with α- or β-globin defects are occasional in Southeast Asia. Herein we provide the first description of Hb Athens-Georgia (Hb A-Ga) in association with deletional Hb H disease, a novel combination previously undescribed in the population. Hematological, Hb and DNA analysis, and β-globin haplotype analyses were performed in seven participants from one ethnic Thai family. Hemoglobin analysis by capillary electrophoresis revealed an abnormal Hb fraction in the proband, his father and grandmother (I-2). DNA sequencing revealed that the G > A substitution at codon 40 of the β-globin gene was identical to the Hb A-Ga (HBB:c.122G > A). Interestingly, α-thal-1 (SEA deletion) and α-thal-2 (-α3.7 deletion) were identified in the proband resulting in Hb H disease, while α-thal-1 was identified in the father, and no α-thal was observed in I-2. Hematological analysis indicated that the proband (βA-Ga/βA, -SEA/-α3.7) had moderate anemia and was markedly hypochromic with microcytic red blood cells (RBCs). The father (βA-Ga/βA, -SEA/αα) presented mild microcytic anemia, while normal hematology was observed in the I-2 who was heterozygous for Hb Athens-Georgia (βA-Ga/βA, αα/αα). The relative level of Hb A-Ga was distinctly reduced according to the degree of α-globin defects. The developed allele-specific PCR method can successfully be used for confirmation of Hb A-Ga. The Thai Hb A-Ga allele associated with a β-haplotype [+ - - - - - +]. These findings were in accordance with the previous conclusion that this variant is a non-pathological β-Hb variant.
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Affiliation(s)
- Sitthichai Panyasai
- Department of Medical Technology, School of Allied Health Sciences, University of Phayao, Phayao, Thailand
| | - Naowarat Kunyanone
- Department of Medical Technology, Chiang Rai Prachanukroh Hospital, Chiang Rai, Thailand
| | - Surada Satthakarn
- Department of Medical Technology, School of Allied Health Sciences, University of Phayao, Phayao, Thailand
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2
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Qin D, Du L, Wang J, Yao C, Guo H, Yuan T, Liang J, Yin A. Compound heterozygosity for hemoglobin variant Hb-Broomhill and the Southeast Asian α-thalassemia deletion does not worsen outcome: a case report of two unrelated patients. J Int Med Res 2020; 48:300060520967825. [PMID: 33213249 PMCID: PMC7683915 DOI: 10.1177/0300060520967825] [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] [Indexed: 11/22/2022] Open
Abstract
We report two unrelated cases of compound heterozygosity for hemoglobin (Hb) variant Broomhill and the Southeast Asian (- - SEA/) α-thalassemia deletion, whose clinical features and laboratory findings have never been reported. Hematological analyses revealed abnormal values for both cases as α-thalassemia traits, and capillary electrophoresis suggested an abnormal peak that was incompletely separated from the Hb A peak. A suspension array system and Sanger sequencing were used to characterize the genotypes. Sanger sequencing confirmed the presence of Hb Broomhill [α114(GH2)Pro→Ala; HBA1: c.343C>G]. Eventually, both cases were accurately diagnosed as compound heterozygotes for Hb Broomhill and the (- - SEA/) α-thalassemia deletion, which is the first known report of these variants. This information will be useful when providing appropriate genetic counselling and prenatal diagnosis.
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Affiliation(s)
- Danqing Qin
- Medical Genetic Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China.,Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China.,Thalassemia Diagnosis Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
| | - Li Du
- Medical Genetic Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China.,Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China.,Thalassemia Diagnosis Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
| | - Jicheng Wang
- Medical Genetic Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China.,Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China.,Thalassemia Diagnosis Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
| | - Cuize Yao
- Medical Genetic Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China.,Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China.,Thalassemia Diagnosis Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
| | - Hao Guo
- Medical Genetic Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China.,Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China.,Thalassemia Diagnosis Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
| | - Tenglong Yuan
- Medical Genetic Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China.,Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China.,Thalassemia Diagnosis Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
| | - Jie Liang
- Medical Genetic Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China.,Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China.,Thalassemia Diagnosis Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
| | - Aihua Yin
- Medical Genetic Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China.,Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China.,Thalassemia Diagnosis Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
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Yuan Y, Zhou X, Ren Q, Ji L. Hb broomhill [α1 or α2 114(GH2) pro > ala; HBA1 or HBA2:c.343C > G]: a rare Hb variant found in a diabetic chinese individual. Scandinavian Journal of Clinical and Laboratory Investigation 2020; 80:606-609. [PMID: 32783538 DOI: 10.1080/00365513.2020.1804609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
We report a clinically silent hemoglobin (Hb) variant, Hb Broomhill [α1 or α2 114(GH2) Pro > Ala;HBA1 or HBA2:c.343C > G] in a diabetic Chinese man. The Hb fractions of the subject were analyzed using various chromatographic and electrophoretic techniques. The glycated hemoglobin (HbA1c) levels measured using cation-exchange high-performance liquid chromatography (CE-HPLC) and the boronate affinity method showed nearly identical results. Analysis of the chromatogram of the CE-HPLC revealed an abnormal shoulder peak that appeared towards the end of the elution profile. Though the capillary electrophoresis method did not interpret the results, a manual examination revealed an abnormal shoulder on the HbA0 peak. Similarly, the electropherogram of the capillary zone electrophoresis also had an abnormal shoulder on the HbA peak. A missense mutation specific to the Hb Broomhill variant was found using Sanger sequencing.
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Affiliation(s)
- Yanping Yuan
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China
| | - Xianghai Zhou
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China
| | - Qian Ren
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China
| | - Linong Ji
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China
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4
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Yuan Y, Zhou X, Gao L, Ren Q, Ji L. Silent hemoglobin variant during capillary electrophoresis: A case report. J Diabetes Investig 2020; 11:1014-1017. [PMID: 32020779 PMCID: PMC7378421 DOI: 10.1111/jdi.13222] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 12/23/2019] [Accepted: 01/29/2020] [Indexed: 11/28/2022] Open
Abstract
Hemoglobin (Hb) North Manchester [β51(D2) Pro→His; HBB:c.155 C>A] is a rare Hb β-globin gene variant that affects glycated Hb measurement values, such as ion-exchange high-performance liquid chromatography, in patients with diabetes. This variant was first detected in the UK in 1998. Here, we describe the first case involving Hb North Manchester detected incidentally in a patient with type 2 diabetes in Northern China. The Hb variant was discovered by ion-exchange high-performance liquid chromatography, yet capillary electrophoresis of both glycated Hb program and Hb program failed to detect it. Subsequently, Sanger sequencing was carried out to help identify the Hb variant.
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Affiliation(s)
- Yanping Yuan
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China
| | - Xianghai Zhou
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China
| | - Leili Gao
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China
| | - Qian Ren
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China
| | - Linong Ji
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China
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Nybo J, Hansen AT, Petersen JB, Brock A. Hemoglobin variants found in relation to HbA1c testing: high occurrence of Hb Athens-Georgia in the Northern Jutland, Denmark. ACTA ACUST UNITED AC 2018; 57:e108-e110. [DOI: 10.1515/cclm-2018-0902] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 09/10/2018] [Indexed: 11/15/2022]
Affiliation(s)
- Jan Nybo
- Department of Clinical Biochemistry , Aalborg University Hospital , Aalborg , Denmark
| | - Anette Tarp Hansen
- Department of Clinical Biochemistry , Aalborg University Hospital , Aalborg , Denmark
| | | | - Axel Brock
- Department of Clinical Biochemistry , Aalborg University Hospital , Aalborg , Denmark
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Pondman KM, Brinkman JW, van der Straaten HM, Stroobants AK, Harteveld CL. Hb Nouakchott [α114(GH2)Pro→Leu; HBA1: c.344C>T], A Second and Third Case Described in Two Unrelated Dutch Families. Hemoglobin 2018; 42:51-53. [DOI: 10.1080/03630269.2018.1429280] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Kirsten M. Pondman
- Department of Clinical Chemistry, St. Jansdal Hospital, Harderwijk, The Netherlands
| | - Jacoline W. Brinkman
- Department of Clinical Chemistry, St. Jansdal Hospital, Harderwijk, The Netherlands
| | | | - An K. Stroobants
- Department of Clinical Chemistry, Amsterdam Medical Center (AMC), Amsterdam, The Netherlands
| | - Cornelis L. Harteveld
- Hemoglobinopathies Laboratory, Department of Clinical Genetics (LDGA), Leiden University Medical Center (LUMC), Leiden, The Netherlands
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