Comparison of HbA2, E, F and Red Cell Parameters in Homozygous HbE With and Without α0-Thalassemia Trait

Analysis of Common Alpha-Globin Gene Abnormalities and Their Effects as Genetic Modifiers in Thai Children With β-Globin Gene Abnormalities

Beta-thalassemia exhibits a broad phenotypic range influenced by the severity of HBB mutation and various genetic modifiers. One of the most essential modifiers is the coinheritance of α-globin gene mutation. Nevertheless, the understanding of these α-globin variations' impact on beta-thalassemia is lacking among pediatric patients. This study investigated the impact of common α-globin gene mutations on clinical phenotype and hematological parameters in 122 Thai children with either β-thalassemia diseases or carriers recruited from Phramongkutklao Hospital, a major thalassemia center. Clinical characteristics, transfusion history, and hematological parameters were recorded, with molecular testing for common α-globin deletions and Hb CS mutations. The cohort included 8 homozygous β-thalassemia, 55 β-thalassemia/Hb E, 18 homozygous Hb E, 26 heterozygous Hb E, and 15 heterozygous β-thalassemia children. Coinheritance of α-globin mutations was less frequent in β-thalassemia diseases (6 of 63) than in β-thalassemia traits (25 of 59) (p < 0.001), indicating a potential modifier effect that reduces severity. Among β-thalassemia/Hb E patients, single α-globin deletions or Hb CS mutations were linked with lower Hb E, MCV, and MCH. Similarly, in both β-thalassemia and Hb E traits with α-globin gene mutation had significantly lower MCV, MCH and Hb E levels (only in the Hb E trait) and elevated RDW. Moreover, lower hematocrit and hemoglobin in these carriers were noted in cases coinherited with deletional Hb H disease initially undiagnosed by Hb typing. In conclusion, the diagnostic value of hematological parameters and Hb typing in identifying common α-globin mutations in pediatric β-thalassemia patients were highlighted. Hematological parameters are vital indicators that may prompt genetic screening to confirm α-globin abnormalities, supporting improved diagnosis and management of complex αβ-thalassemia syndromes.

A demographic prevalence of β Thalassemia carrier and other hemoglobinopathies in adolescent of Tharu population

BACKGROUND AND AIMS

Hemoglobinopathies and thalassemias are the commonest single gene disorders in India. In Terai region of India, Hemoglobinopathies and thalassemias are the most common in the Tharu community. Therefore, in this study, we aim to evaluate the Hb variant analysis of hemoglobinopathies and thalassemias in a Tharu population in Lakhimpur Kheri Districts of Uttar Pradesh, India.

MATERIALS AND METHODS

Total 493 individuals were recruited in this study. The demographic details and blood samples were collected from different location at Kheri district during mega health camp. Hb variant analysis was performed by high performance liquid chromatography (HPLC) system beta thalassemia short program in BIO-RAD VARIANT.

RESULTS

Out of 493, 108 (21.9%) individual suffers with abnormal haemoglobinopathies. In which β-thalassemia trait is the commonest haemoglobinopathy (12.98%), followed by HbE trait (7.50%), and compound heterozygous HbS/β-Thalassemia trait (1.42%) in overall population. The HbF was significantly greater in HbS heterozygous (1.45 ± 1.41), whereas mean HbA2 was significantly greater in β-Thalassemia trait (5.17 ± 1.36).

CONCLUSION

The high incidence of hemoglobinopathies and thalassemias were observed in Tharu community in Lakhimpur Kheri districts of Uttar Pradesh, Indian.

A Formula to Identify Potential Cases of β-Thalassemia/HbE Disease Among Patients With Absent HbA, HbE >75% and HbF Between 5 and 15

OBJECTIVE

To establish a simple formula to be used for discrimination between β-thalassemia/hemoglobin E (β-thal/HbE) and homozygous hemoglobin (Hb)E in specimens with absent hemoglobin (Hb)A, HbE of greater than 75%, and HbF between 5% and 15%.

METHODS

We analyzed laboratory results from February 2015 through February 2018. Molecular analysis for diagnosis of β-thal mutation and HbE was performed in specimens that contained HbE of greater than 75% and HbF from 5% to 15%, as measured by high-performance liquid chromatography (HPLC). HbA2 and HbF levels were also measured by capillary electrophoresis. Then, the formula (6 × HbA2 + HbF)/MCV was developed.

RESULTS

The score of 0.9 or higher was found in all 19 β-thal/HbE specimens (100%) and only 8 of 65 homozygous HbE specimens (12.3%). Also, the formula yielded 90.5% efficiency in identifying β-thal/HbE disease, and the efficiency was found to be higher compared with when the HbA2 value of greater than 6% was used by itself (85.4%).

CONCLUSION

The formula (6 × HbA2 + HbF)/MCV, with a cutoff point at 0.9, could identify the potential cases of β-thal/HbE disease among patients with absent HbA, HbE of greater than 75%, and HbF between 5% and 15%.