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Colah R, Nadkarni A, Gorakshakar A, Sawant P, Italia K, Upadhye D, Gaikwad H, Ghosh K. Prenatal Diagnosis of HbE-β-Thalassemia: Experience of a Center in Western India. Indian J Hematol Blood Transfus 2017; 34:474-479. [PMID: 30127556 DOI: 10.1007/s12288-017-0870-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 08/30/2017] [Indexed: 12/11/2022] Open
Abstract
The clinical presentation of HbE-β-thalassemia is extremely variable, however, many cases are severe and transfusion dependent. We offered prenatal diagnosis to 108 couples, 20 of whom came prospectively. CVS was done in 93 cases (9.5-13 weeks of gestation) while amniocentesis/cordocentesis was done for 15 cases in the second trimester. Diagnosis was done by reverse dot blot hybridization, ARMS, DNA sequencing and in a few cases by HPLC analysis of fetal blood. The genetic combinations in the couples at-risk were the following: HbE trait/β-thal trait-95, HbE-thal/HbE trait-5, HbE homozygous/β-thal trait-3, HbE-thal/β-thal trait-3, HbE Lepore/β-thal trait-1, HbE trait/HbDPunjab trait-1. IVS1-5(G>C) was the commonest β-thalassemia mutation followed by codon15(G>A), codon30(G>C), codons41/42(-CTTT), the 619 bp deletion and codon8/9(+G) in the β-thalassemic parent. However, several rare mutations seen in India like -90(C>T), -88(C>T),codon15(-T), IVS1-129(A>C), IVS1-130(G>C), IVSII-1(G>A), IVSII-837(C>T) and IVSII 848(C>A) were also encountered. Twenty-one fetuses were affected (HbE-β-thal-20, β-thal major-1) and all the couples opted for termination of the pregnancies. Couples with affected children wish to undergo prenatal testing for HbE-β-thal in subsequent pregnancies. More regional centers are needed for these services, particularly in West Bengal and the North-East where HbE is very common.
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Affiliation(s)
- Roshan Colah
- 1National Institute of Immunohaematology, 13th Floor, N. M. S. Bldg, KEM Hospital Campus, Parel, Mumbai, 400012 India
| | - Anita Nadkarni
- 1National Institute of Immunohaematology, 13th Floor, N. M. S. Bldg, KEM Hospital Campus, Parel, Mumbai, 400012 India
| | - Ajit Gorakshakar
- 1National Institute of Immunohaematology, 13th Floor, N. M. S. Bldg, KEM Hospital Campus, Parel, Mumbai, 400012 India
| | - Pratibha Sawant
- 1National Institute of Immunohaematology, 13th Floor, N. M. S. Bldg, KEM Hospital Campus, Parel, Mumbai, 400012 India
| | - Khushnooma Italia
- 1National Institute of Immunohaematology, 13th Floor, N. M. S. Bldg, KEM Hospital Campus, Parel, Mumbai, 400012 India
| | - Dipti Upadhye
- 1National Institute of Immunohaematology, 13th Floor, N. M. S. Bldg, KEM Hospital Campus, Parel, Mumbai, 400012 India
| | - Harshali Gaikwad
- 1National Institute of Immunohaematology, 13th Floor, N. M. S. Bldg, KEM Hospital Campus, Parel, Mumbai, 400012 India
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Wagner SC, Lindenau JD, Castro SMD, Santin AP, Zaleski CF, Azevedo LA, Ribeiro Dos Santos ÂKC, Dos Santos SEB, Hutz MH. High Frequency of Hb E-Saskatoon (HBB: c.67G > A) in Brazilians: A New Genetic Origin? Hemoglobin 2016; 40:228-30. [PMID: 27250692 DOI: 10.1080/03630269.2016.1189433] [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] [Indexed: 10/21/2022]
Abstract
Hb E-Saskatoon [β22(B4)Glu→Lys, HBB: c.67G > A] is a rare, nonpathological β-globin variant that was first described in a Canadian woman of Scottish and Dutch ancestry and has since then been detected in several populations. The aim of the present study was to identify the origin of Hb E-Saskatoon in Brazil using β-globin haplotypes and genetic ancestry in carriers of this hemoglobin (Hb) variant. Blood samples were investigated by isoelectric focusing (IEF) and high performance liquid chromatography (HPLC) using commercial kits. Hb E-Saskatoon was confirmed by amplification of the HBB gene, followed by sequence analysis. Haplotypes of the β-globin gene were determined by polymerase chain reaction (PCR), followed by digestion with specific restriction enzymes. Individual ancestry was estimated with 48 biallelic insertion/deletions using three 16-plex PCR amplifications. The IEF pattern was similar to Hbs C (HBB: c.19G > A) and Hb E (HBB: c.79G > A) [isoelectric point (pI): 7.59-7.65], and HPLC results showed an elution in the Hb S (HBB: c.20A > T) window [retention time (RT): 4.26-4.38]. DNA sequencing of the amplified β-globin gene showed a mutation at codon 22 (GAA>AAA) corresponding to Hb E-Saskatoon. A total of 11 cases of this variant were identified. In nine unrelated individuals, Hb E-Saskatoon was in linkage disequilibrium with haplotype 2 [+ - - - -]. All subjects showed a high degree of European contribution (mean = 0.85). Hb E-Saskatoon occurred on the β-globin gene of haplotype 2 in all Brazilian carriers. These findings suggest a different genetic origin for this Hb variant from that previously described.
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Affiliation(s)
- Sandrine C Wagner
- a Universidade Federal de Ciencias da Saude , Porto Alegre , Brazil.,b Departamento de Genética , Instituto de Biociências, Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
| | - Juliana D Lindenau
- b Departamento de Genética , Instituto de Biociências, Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
| | - Simone M de Castro
- c Faculdade de Farmácia , Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil and
| | - Ana Paula Santin
- c Faculdade de Farmácia , Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil and
| | - Carina F Zaleski
- c Faculdade de Farmácia , Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil and
| | - Laura A Azevedo
- c Faculdade de Farmácia , Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil and
| | | | - Sidney E B Dos Santos
- d Laboratório de Genética Humana e Médica , Universidade Federal do Pará , Belém , Brazil
| | - Mara H Hutz
- b Departamento de Genética , Instituto de Biociências, Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
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Ropero P, Fernandez C, de la Fuente-Gonzalo F, González Fernández FA. [Alpha genes triplication-associated E-Saskatoon hemoglobinopathy]. Med Clin (Barc) 2014; 143:374-5. [PMID: 24485590 DOI: 10.1016/j.medcli.2013.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Revised: 12/10/2013] [Accepted: 12/12/2013] [Indexed: 11/18/2022]
Affiliation(s)
- Paloma Ropero
- Servicio de Hematología, Hospital Clínico San Carlos, Madrid, España.
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Couto GK, Lorenzini PF, Pilger DA, Azevedo LA, Weber C, Macedo JL, Diedrich V, de Castro SM. Association of hemoglobin E-Saskatoon with hemoglobin S: report of the first case found in Brazil. Acta Haematol 2013; 131:84-7. [PMID: 24081202 DOI: 10.1159/000353471] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 06/02/2013] [Indexed: 02/02/2023]
Affiliation(s)
- G K Couto
- School of Pharmacy, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Italia K, Sheth J, Sawant P, Nadkarni A, Ghosh K, Colah R. Prenatal diagnosis of HbE-Lepore and Hb Lepore-β-thalassemia: the importance of accurate genotyping of the couple at risk. Prenat Diagn 2012; 32:703-7. [DOI: 10.1002/pd.3884] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Revised: 02/28/2012] [Accepted: 03/06/2012] [Indexed: 11/07/2022]
Affiliation(s)
| | - Jayesh Sheth
- Foundation for Research in Genetics and Endocrinology (FRIGE); Institute of Human Genetics; Ahmedabad; India
| | | | | | | | - Roshan Colah
- National Institute of Immunohematology; Mumbai; India
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Theodoridou S, Vyzantiadis TA, Theodoridis T, Tantanasis T, Karababa P, Loutradi A, Manitsa A. Hemoglobin E-Saskatoon and pregnancy: report of two cases. J Obstet Gynaecol Res 2006; 32:346-8. [PMID: 16764628 DOI: 10.1111/j.1447-0756.2006.00408.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Hemoglobin E-Saskatoon (beta22-Glu-Lys) is found worldwide but is extremely rarely. Two cases of pregnant women who carried the abnormal hemoglobin and the various problems that arise from it are reported. A discussion of the combinations with other abnormal hemoglobin is also presented.
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Affiliation(s)
- Stamatia Theodoridou
- Hemoglobinopathy Prevention Unit, Hippokration Hospital of Thessaloniki, Thessaloniki, Greece.
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