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da Silva Brito R, de Lima Barros LM, Moreira LW, Normando RN, de Jesus TB, de Souza Gonçalves M, Ramasawmy R, de Oliveira SF, da Silva KER, Fraiji NA, da Hora LF, de Abreu Netto RL, de Moura Neto JP. Basic biochemical and hematological parameters of structural hemoglobin variants in the postpartum women and their respective newborn from Manaus, Amazonas, Brazil. BMC Pregnancy Childbirth 2022; 22:936. [PMID: 36522644 PMCID: PMC9756781 DOI: 10.1186/s12884-022-05143-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 10/21/2022] [Indexed: 12/23/2022] Open
Abstract
The present study aimed at estimating the prevalence of structural hemoglobinopathies in newborn and describing the hematological and biochemical characteristics between postpartum women (PW) and their respective newborns (NB) at a public maternity hospital in Manaus, Amazonas state, Brazil. In total, 825 NB and 820 PW were included in the study. Hematological and biochemical analysis and screening of structural hemoglobinopathies were performed and compared in groups of individuals (NICU or not; hemoglobin genotypes; gestational age and prenatal). The age of PW ranged from 13 to 44 years old (mean of 23.7 ± 6.6 years), with 45.9% pregnant for the first time and 54.1% multiparous. Reported receiving prenatal care 88% and regarding the type of delivery, 47.7% had delivered by cesarean section. Among the births, 19.4% were born premature and 8.3% were admission to the neonatal intensive care unit (NICU). The male NB represented 53.4% of the total. Sickle cell trait (FAS) was found in 16 (1.94%) and heterozygous for D hemoglobin (FAD) in 6 (0.73%) newborns. A statistically significant values was found between the previous history of miscarriage and increase of Mean corpuscular volume (MCV) (p < .001), Red blood cell distribution width (RDW) (p = .003), total and indirect bilirubin concentration (p < .001) and LDL cholesterol (p = .004). Hemoglobin levels below 13.5 g/dL was found in 66% black newborns, compared with 15% of Afro-Brazilian and 5% of whites. The frequency of structural hemoglobinopathies was higher in African-Brazilian newborn babies (78%) and those who with low birth weight had a higher frequency of NICU (35.7%). Interestingly, underage mothers had a higher frequency of NB with low birth weight and premature birth. Postpartum women who had children carriers of FAS and FAD had a higher frequency of urinary tract infection (65.2%) and moderate anemia (23.8%). This study estimated for the first time the prevalence of structural hemoglobinopathies in NB in Manaus, Amazonas, Brazil. Despite the small prevalence of, we highlight the importance of early diagnosis of hemoglobin variants, contributing to the improvement of the quality of life of PW and your NB, reinforce the need to implement educational and prevention programs to raise awareness among the population and in order to counsel parents regarding the probability of having a child with abnormal hemoglobins homozygous as HbSS or HbCC.
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Affiliation(s)
- Roberta da Silva Brito
- grid.512139.d0000 0004 0635 1549Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas, Manaus, Amazonas Brazil
| | | | - Lilian Wallace Moreira
- grid.512139.d0000 0004 0635 1549Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas, Manaus, Amazonas Brazil
| | - Regina Neves Normando
- grid.512139.d0000 0004 0635 1549Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas, Manaus, Amazonas Brazil
| | - Thiago Bacha de Jesus
- grid.411181.c0000 0001 2221 0517Universidade Federal do Amazonas, Faculdade de Ciências Farmacêuticas, General Rodrigo Otávio Jordão Ramos Avenue, 6200 - Coroado I, Manaus, Amazonas CEP: 69067-005 Brazil
| | - Marilda de Souza Gonçalves
- grid.418068.30000 0001 0723 0931Fundação Oswaldo Cruz - Centro de Pesquisas Gonçalo Moniz, Salvador, Bahia Brazil
| | - Rajendranath Ramasawmy
- grid.418153.a0000 0004 0486 0972Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Amazonas Brazil
| | - Stéfani Ferreira de Oliveira
- grid.411181.c0000 0001 2221 0517Universidade Federal do Amazonas, Faculdade de Ciências Farmacêuticas, General Rodrigo Otávio Jordão Ramos Avenue, 6200 - Coroado I, Manaus, Amazonas CEP: 69067-005 Brazil
| | - Keyla Emanulle Ramos da Silva
- grid.411181.c0000 0001 2221 0517Universidade Federal do Amazonas, Faculdade de Ciências Farmacêuticas, General Rodrigo Otávio Jordão Ramos Avenue, 6200 - Coroado I, Manaus, Amazonas CEP: 69067-005 Brazil
| | - Nelson Abrahim Fraiji
- grid.512139.d0000 0004 0635 1549Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas, Manaus, Amazonas Brazil
| | - Larissa Feitosa da Hora
- grid.411181.c0000 0001 2221 0517Universidade Federal do Amazonas, Faculdade de Ciências Farmacêuticas, General Rodrigo Otávio Jordão Ramos Avenue, 6200 - Coroado I, Manaus, Amazonas CEP: 69067-005 Brazil
| | - Rebeca Linhares de Abreu Netto
- grid.411181.c0000 0001 2221 0517Universidade Federal do Amazonas, Faculdade de Ciências Farmacêuticas, General Rodrigo Otávio Jordão Ramos Avenue, 6200 - Coroado I, Manaus, Amazonas CEP: 69067-005 Brazil
| | - José Pereira de Moura Neto
- grid.512139.d0000 0004 0635 1549Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas, Manaus, Amazonas Brazil ,grid.411181.c0000 0001 2221 0517Universidade Federal do Amazonas, Faculdade de Ciências Farmacêuticas, General Rodrigo Otávio Jordão Ramos Avenue, 6200 - Coroado I, Manaus, Amazonas CEP: 69067-005 Brazil
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Novel Decision Tool for More Severe α-Thalassemia Genotypes Screening with Functional Loss of Two or More α-Globin Genes: A Diagnostic Test Study. Diagnostics (Basel) 2022; 12:diagnostics12123008. [PMID: 36553015 PMCID: PMC9777031 DOI: 10.3390/diagnostics12123008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/16/2022] [Accepted: 11/22/2022] [Indexed: 12/04/2022] Open
Abstract
After the exclusion of iron deficiency and β-thalassemia, molecular research for α-thalassemia is recommended to investigate microcytic anemia. Aiming to suggest more efficiently the molecular analysis for individuals with a greater chance of having a symptomatic form of the disease, we have developed and validated a new decision tool to predict the presence of two or more deletions of α-thalassemia, increasing considerably the pre-test probability. The model was created using the variables: the percentage of HbA2, serum ferritin and mean corpuscular volume standardized by age. The model was trained in 134 patients and validated in 160 randomly selected patients from the total sample. We used Youden's index applied to the ROC curve methodology to establish the optimal odds ratio (OR) cut-off for the presence of two or more α-globin gene deletions. Using the OR cut-off of 0.4, the model's negative predictive value (NPV) was 96.8%; the cut-off point accuracy was 85.4%; and the molecular analysis pre-test probability increased from 25.9% to 65.4% after the use of the proposed model. This tool aims to assist the physician in deciding when to perform molecular studies for the diagnosis of α-thalassemia. The model is useful in places with few financial health resources.
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Exercise Capacity and Biomarkers Among Children and Adolescents With Sickle Cell Disease. Pediatr Exerc Sci 2022; 35:84-91. [PMID: 35894886 DOI: 10.1123/pes.2021-0188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 06/02/2022] [Accepted: 06/16/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Sickle cell disease is the most common genetic hemoglobinopathy globally and systemically affects body functioning, decreasing exercise capacity. OBJECTIVE To assess exercise capacity through the 6-minute walk test (6MWT) and biomarkers in children and adolescents with sickle cell disease. MATERIALS AND METHODS Cross-sectional study involving 20 children and adolescents from Brazil. Demographic and socioeconomic data were obtained. Baseline measurements included biomarkers (red blood cells, hemoglobin, hematocrit, white blood cells, platelets, reticulocytes, lactate dehydrogenase, creatine phosphokinase, C-reactive protein, interleukin 6, and fetal hemoglobin). The following data were obtained before, during, and after the 6MWT: heart rate, blood pressure, and peripheral oxygen saturation. RESULTS Eighteen children and adolescents ages 5-14 years old were analyzed, 61.1% boys, 100% black or brown, and 61.1% in primary education, with low household income. The average distance walked in 6MWT was 463.8 (137.7) m, significantly less than the predicted value (P < .001). The distance of 6MWT was associated positively with age (P = .042) and inversely with reticulocyte count (P = .42) and interleukin 6 (P = .00). Age modified the effect of interleukin 6 in younger children (P = .038). CONCLUSION Our findings suggest increased baseline levels of biomarkers of hemolysis and inflammation impact on 6MWT performance.
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Adanho CSA, Yahouédéhou SCMA, Santana SS, Vieira C, Santiago RP, de Santana JM, Pitanga TN, Aleluia MM, Maffili VV, Leite IPR, Zanette DL, Lyra IM, Goncalves MS. Association of laboratory markers and cerebral blood flow among sickle cell anemia children. Front Pediatr 2022; 10:914466. [PMID: 36090571 PMCID: PMC9458965 DOI: 10.3389/fped.2022.914466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 08/10/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Stroke is one of the highest complications of sickle-cell anemia (SCA). The Transcranial Doppler (TCD) has been adopted worldwide as a gold standard method for detecting alterations in the blood velocity in cerebral arteries. In this study, we investigated the association between laboratory parameters and increased cerebral blood flow velocity in Brazilian SCA pediatric patients. METHODS The study included 159 pediatric patients with SCA, submitted to TCD velocity screening, and the time-averaged maximum mean velocity (TAMMV) was determined in the middle cerebral artery (MCA), anterior cerebral artery (ACA), and distal intracranial internal carotid artery (ICA). We compared cerebral blood flow in patients stratified by the following: TCD1-defined as normal, with TAMMV inferior to 170 cm/s; TCD2-conditional, with TAMMV above 170 cm/s, but less than 199 cm/s; TCD3-altered, with TAMMV greater than or equal to 200 cm/s. RESULTS TAMMV was negatively correlated with age and weight (p < 0.05). Moreover, TAMMV was associated or correlated with reductions in HbF, RBC, hemoglobin, hematocrit, HDL, and haptoglobin and, increases in MCV, MCH, RDW, reticulocytes, WBC, lymphocytes, monocytes, eosinophils, total and indirect bilirubin, LDH, AST, ALT, glucose, ferritin, and AAT (p < 0.05). CONCLUSION The current study highlights the importance of the investigation of hemolytic and inflammatory biomarkers for monitoring the clinical outcome of SCA pediatric patients, to avoid acute or chronic stroke. Moreover, glucose and HDL-C appear useful for predicting higher TAMMV.
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Affiliation(s)
- Corynne Stéphanie Ahouéfa Adanho
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, Salvador, Bahia, Brazil.,Laboratório de Pesquisa em Anemia, Departamento de Análises Clínicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Sètondji Cocou Modeste Alexandre Yahouédéhou
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, Salvador, Bahia, Brazil.,Laboratório de Pesquisa em Anemia, Departamento de Análises Clínicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Sânzio Silva Santana
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, Salvador, Bahia, Brazil.,Faculdade de Biomedicina, Universidade Católica do Salvador, Salvador, Bahia, Brazil
| | - Camilo Vieira
- Ambulatório Pediátrico de Doença Cerebrovascular, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Rayra Pereira Santiago
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, Salvador, Bahia, Brazil.,Laboratório de Pesquisa em Anemia, Departamento de Análises Clínicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Jeanne Machado de Santana
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, Salvador, Bahia, Brazil
| | - Thassila Nogueira Pitanga
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, Salvador, Bahia, Brazil.,Faculdade de Biomedicina, Universidade Católica do Salvador, Salvador, Bahia, Brazil
| | | | - Vítor Valério Maffili
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, Salvador, Bahia, Brazil
| | - Ivana Paula Ribeiro Leite
- Serviço de Pediatria, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Dalila Luciola Zanette
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, Salvador, Bahia, Brazil
| | - Isa Menezes Lyra
- Serviço de Pediatria, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Bahia, Brazil.,Ambulatório, Fundação de Hematologia e Hemoterapia da Bahia, Salvador, Bahia, Brazil.,Curso de Medicina, Escola de Ciências da Saúde e Bem-Estar, Universidade Salvador, Salvador, Bahia, Brazil
| | - Marilda Souza Goncalves
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, Salvador, Bahia, Brazil.,Laboratório de Pesquisa em Anemia, Departamento de Análises Clínicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, Brazil
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Honjo RS, Castro MAA, Ferraciolli SF, Soares Junior LAV, Pastorino AC, Bertola DR, Miyake N, Matsumoto N, Kim CA. Cerebellofaciodental syndrome in an adult patient: Expanding the phenotypic and natural history characteristics. Am J Med Genet A 2021; 185:1561-1568. [PMID: 33645901 DOI: 10.1002/ajmg.a.62140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 12/17/2020] [Accepted: 02/06/2021] [Indexed: 11/06/2022]
Abstract
Cerebellofaciodental syndrome is characterized by facial dysmorphisms, intellectual disability, cerebellar hypoplasia, and dental anomalies. It is an autosomal-recessive condition described in 2015 caused by pathogenic variants in BRF1. Here, we report a Brazilian patient who faced a diagnostic challenge beginning at 11 months of age. Fortunately, whole-exome sequencing (WES) was performed, detecting the BRF1 variants NM_001519.3:c.1649delG:p.(Gly550Alafs*36) and c.421C>T:p.(Arg141Cys) in compound heterozygosity, thus finally achieving a diagnosis of cerebellofaciodental syndrome. The patient is currently 25 years old and is the oldest patient yet reported. The clinical report and a review of published cases are presented. Atlanto-occipital fusion, a reduced foramen magnum and basilar invagination leading to compression of the medulla-spinal cord transition are skeletal findings not reported in previous cases. The description of syndromes with dental findings shows that such anomalies can be an important clue to relevant differential diagnoses. The cooperation of groups from different international centers made possible the resolution of this and other cases and is one of the strategies to bring medical advances to developing countries, where many patients with rare diseases are difficult to diagnose definitively.
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Affiliation(s)
- Rachel Sayuri Honjo
- Faculdade de Medicina, Unidade de Genética, Instituto da Criança, Hospital das Clinicas HCFMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Matheus Augusto Araújo Castro
- Faculdade de Medicina, Unidade de Genética, Instituto da Criança, Hospital das Clinicas HCFMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Suely Fazio Ferraciolli
- Faculdade de Medicina, Divisão de Neurorradiologia, Instituto de Radiologia, Hospital das Clinicas HCFMUSPUniversidade de São Paulo, São Paulo, Brazil
| | | | - Antonio Carlos Pastorino
- Faculdade de Medicina, Unidade de Imunologia, Instituto da Criança, Hospital das Clinicas HCFMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Débora Romeo Bertola
- Faculdade de Medicina, Unidade de Genética, Instituto da Criança, Hospital das Clinicas HCFMUSP, Universidade de São Paulo, São Paulo, Brazil.,Centro de Pesquisa sobre o Genoma Humano e Células Tronco, Instituto de Biociências, Universidade de São Paulo, São Paulo, Brazil
| | - Noriko Miyake
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Naomichi Matsumoto
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Chong Ae Kim
- Faculdade de Medicina, Unidade de Genética, Instituto da Criança, Hospital das Clinicas HCFMUSP, Universidade de São Paulo, São Paulo, Brazil
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Santos HPD, Domingos CRB, Castro SMD. Twenty Years of Neonatal Screening for Sickle Cell Disease in Brazil: The Challenges of a Continental Country with High Genetic Heterogeneity. JOURNAL OF INBORN ERRORS OF METABOLISM AND SCREENING 2021. [DOI: 10.1590/2326-4594-jiems-2021-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
| | | | - Simone Martins de Castro
- Universidade Federal do Rio Grande do Sul, Brasil; Hospital Materno Infantil Presidente Vargas, Brasil
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Leite DCF, Cipolotti R, Gurgel RQ, Martins Filho PRS, Lopes GD. SPATIAL DISTRIBUTION OF NEWBORNS WITH SICKLE CELL TRAIT IN SERGIPE, BRAZIL. ACTA ACUST UNITED AC 2020; 38:e2018229. [PMID: 32159643 PMCID: PMC7063597 DOI: 10.1590/1984-0462/2020/38/2018229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 01/18/2019] [Indexed: 11/22/2022]
Abstract
Objective: To use the spatial distribution of the sickle cell trait (SCT) to analyze
the frequency of hemoglobin S (HbS) carriers in Sergipe. Methods: The sample consisted of all individuals born in Sergipe from October 2011 to
October 2012 who underwent neonatal screening in the public health system.
Tests were carried out in basic health units and forwarded to the University
Hospital laboratory, where they were analyzed. We used spatial
autocorrelation (Moran’s index) to assess the spatial distribution of
heterozygous individuals with hemoglobinopathies. Results: Among 32,906 newborns, 1,202 showed other types of hemoglobin besides
Hemoglobin A. We found a positive correlation between the percentage of
black and multiracial people and the incidence of SCT. Most SCT cases
occurred in the cities of Aracaju (n=273; 22.7%), Nossa Senhora do Socorro
(n=102; 8.4%), São Cristóvão (n=58; 4.8%), Itabaiana (n=39; 4.2%), Lagarto
(n=37; 4.01%), and Estância (n=46; 4.9%). Conclusions: The spatial distribution analysis identified regions in the state with a
high frequency of HbS carriers. This information is important health care
planning. This method can be applied to detect other places that need health
units to guide and care for sickle cell disease patients and their
families.
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da Guarda CC, Yahouédéhou SCMA, Santiago RP, Neres JSDS, Fernandes CFDL, Aleluia MM, Figueiredo CVB, Fiuza LM, Carvalho SP, de Oliveira RM, Fonseca CA, Ndidi US, Nascimento VML, Rocha LC, Goncalves MS. Sickle cell disease: A distinction of two most frequent genotypes (HbSS and HbSC). PLoS One 2020; 15:e0228399. [PMID: 31995624 PMCID: PMC6988974 DOI: 10.1371/journal.pone.0228399] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 01/14/2020] [Indexed: 01/08/2023] Open
Abstract
Sickle cell disease (SCD) consists of a group of hemoglobinopathies in which individuals present highly variable clinical manifestations. Sickle cell anemia (SCA) is the most severe form, while SC hemoglobinopathy (HbSC) is thought to be milder. Thus, we investigated the clinical manifestations and laboratory parameters by comparing each SCD genotype. We designed a cross-sectional study including 126 SCA individuals and 55 HbSC individuals in steady-state. Hematological, biochemical and inflammatory characterization was performed as well as investigation of previous history of clinical events. SCA patients exhibited most prominent anemia, hemolysis, leukocytosis and inflammation, whereas HbSC patients had increased lipid determinations. The main cause of hospitalization was pain crises on both genotypes. Vaso-occlusive events and pain crises were associated with hematological, inflammatory and anemia biomarkers on both groups. Cluster analysis reveals hematological, inflammatory, hemolytic, endothelial dysfunction and anemia biomarkers in HbSC disease as well as SCA. The results found herein corroborate with previous studies suggesting that SCA and HbSC, although may be similar from the genetic point of view, exhibit different clinical manifestations and laboratory alterations which are useful to monitor the clinical course of each genotype.
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Affiliation(s)
- Caroline Conceição da Guarda
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, FIOCRUZ-BA, Salvador, Bahia, Brasil
| | | | - Rayra Pereira Santiago
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, FIOCRUZ-BA, Salvador, Bahia, Brasil
| | - Joelma Santana dos Santos Neres
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, FIOCRUZ-BA, Salvador, Bahia, Brasil
| | - Camila Felix de Lima Fernandes
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, FIOCRUZ-BA, Salvador, Bahia, Brasil
| | | | - Camylla Vilas Boas Figueiredo
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, FIOCRUZ-BA, Salvador, Bahia, Brasil
| | - Luciana Magalhães Fiuza
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, FIOCRUZ-BA, Salvador, Bahia, Brasil
| | - Suellen Pinheiro Carvalho
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, FIOCRUZ-BA, Salvador, Bahia, Brasil
| | - Rodrigo Mota de Oliveira
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, FIOCRUZ-BA, Salvador, Bahia, Brasil
| | - Cleverson Alves Fonseca
- Laboratório de Pesquisa em Anemias, Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, Brasil
| | - Uche Samuel Ndidi
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, FIOCRUZ-BA, Salvador, Bahia, Brasil
| | | | - Larissa Carneiro Rocha
- Fundação de Hematologia e Hemoterapia do Estado da Bahia, HEMOBA, Salvador, Bahia, Brasil
| | - Marilda Souza Goncalves
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, FIOCRUZ-BA, Salvador, Bahia, Brasil
- * E-mail:
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9
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Yahouédéhou SCMA, da Guarda CC, Figueiredo CVB, Santiago RP, Carvalho SP, Fiuza LM, Ndidi US, Oliveira RM, Carvalho MOS, Nascimento VML, Rocha LC, Lyra IM, Adorno EV, Goncalves MS. Hydroxyurea alters hematological, biochemical and inflammatory biomarkers in Brazilian children with SCA: Investigating associations with βS haplotype and α-thalassemia. PLoS One 2019; 14:e0218040. [PMID: 31306416 PMCID: PMC6629070 DOI: 10.1371/journal.pone.0218040] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Accepted: 05/24/2019] [Indexed: 12/13/2022] Open
Abstract
This study investigated the effects of hydroxyurea (HU) on hematological, biochemical and inflammatory parameters in children with sickle cell anemia (SCA) in association with βS haplotype and α-thalassemia. We included 22 children with SCA who were followed for an average of 14.5 months. Laboratory parameters were assessed by electronic methods, and molecular analysis was investigated by PCR-RFLP and allele-specific PCR. Results showed significant increases in hemoglobin, HbF, hematocrit, MCV, MCH, glucose, HDL-C and albumin levels, as well as significant decreases in MCHC and AST levels, WBC, neutrophils, eosinophils, lymphocytes and reticulocytes, in children during HU therapy. HbF levels were positively correlated with hemoglobin, hematocrit, MCV and total protein, yet negatively correlated with MCHC, RDW, AAT and AST during HU therapy (p<0.05). Children who carried the Central African Republic haplotype, in response to HU therapy, presented significant increases in hemoglobin, hematocrit, triglycerides and uric acid levels, as well as significant decreases in MCHC, AST and direct bilirubin levels, WBC, neutrophils, eosinophils, lymphocytes and reticulocytes. Those with the Benin haplotype presented increases in HbF and albumin levels, and a reduction in platelet counts (p<0.05). Children with α-thalassemia presented decreased ALT during HU use, while those without this deletion presented increases in hemoglobin, hematocrit, MCV, MCH, HDL-C and albumin, as well as decreases in MCHC, neutrophils, lymphocytes, reticulocytes and AST (p<0.05). Hence, regardless of its use in association with βS haplotypes or α-thalassemia, HU seems to be linked to alterations in hemolytic, inflammatory, hepatic, lipid and glycemic profiles.
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Affiliation(s)
- Sètondji Cocou Modeste Alexandre Yahouédéhou
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, Salvador, Bahia, Brasil
- Laboratório de Pesquisa em Anemia, Departamento de Análises Clínicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, Brasil
| | - Caroline Conceição da Guarda
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, Salvador, Bahia, Brasil
- Laboratório de Pesquisa em Anemia, Departamento de Análises Clínicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, Brasil
| | - Camylla Vilas Boas Figueiredo
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, Salvador, Bahia, Brasil
- Laboratório de Pesquisa em Anemia, Departamento de Análises Clínicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, Brasil
| | - Rayra Pereira Santiago
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, Salvador, Bahia, Brasil
- Laboratório de Pesquisa em Anemia, Departamento de Análises Clínicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, Brasil
| | - Suellen Pinheiro Carvalho
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, Salvador, Bahia, Brasil
- Laboratório de Pesquisa em Anemia, Departamento de Análises Clínicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, Brasil
| | - Luciana Magalhães Fiuza
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, Salvador, Bahia, Brasil
- Laboratório de Pesquisa em Anemia, Departamento de Análises Clínicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, Brasil
| | | | - Rodrigo Mota Oliveira
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, Salvador, Bahia, Brasil
- Laboratório de Pesquisa em Anemia, Departamento de Análises Clínicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, Brasil
| | | | | | | | - Isa Menezes Lyra
- Fundação de Hematologia e Hemoterapia da Bahia, Salvador, Bahia, Brasil
| | - Elisângela Vitória Adorno
- Laboratório de Pesquisa em Anemia, Departamento de Análises Clínicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, Brasil
| | - Marilda Souza Goncalves
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, Salvador, Bahia, Brasil
- Laboratório de Pesquisa em Anemia, Departamento de Análises Clínicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, Brasil
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10
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Souza RC, Miranda Neto PAD, Santos JRN, Monteiro SG, Gonçalves MC, Silva FB, Holanda RA, Santos JRA. Sickle Cell Anaemia Prevalence Among Newborns in the Brazilian Amazon-Savanna Transition Region. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1638. [PMID: 31083436 PMCID: PMC6540180 DOI: 10.3390/ijerph16091638] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 05/07/2019] [Accepted: 05/08/2019] [Indexed: 11/16/2022]
Abstract
Sickle cell anaemia is one of the most common hemoglobinopathies worldwide and an important public health problem in Brazil. This study evaluated the prevalence of sickle cell anaemia and its traits in newborns from the Amazon-Savanna Transition Region in the state of Maranhão, Brazil. A cross-sectional study was carried out, based on data from neonatal screening tests performed in 2013-2015 in Maranhão. The Hardy-Weinberg theorem was applied to analyse the frequency of expected homozygotes based on HbSS phenotype. A spatial-temporal distribution analysis was performed to delimit the regions with the greatest number of newborn cases with sickle cell anaemia. Of 283,003 newborns, 162 were found to have sickle cell anaemia, while 10,794 had a sickle cell trait, with a prevalence of 0.05% and 3.8%, respectively. The prevalence of expected homozygotes was higher in the North Region and in the state capital of Maranhão. This study may contribute to existing social and public health actions or the creation of new strategies for sickle cell disease in endemic areas in Brazil to improve the quality of life.
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Affiliation(s)
- Rayane Cristina Souza
- Biomédica and Mestranda em Meio Ambiente da Universidade CEUMA, São Luís, MA, CEP: 65075-120, Brazil.
| | | | | | - Sílvio Gomes Monteiro
- Mestrado em Meio Ambiente da Universidade CEUMA, São Luís, MA, CEP: 65075-120, Brazil.
| | | | - Fabrício Brito Silva
- Mestrado em Meio Ambiente da Universidade CEUMA, São Luís, MA, CEP: 65075-120, Brazil.
| | | | - Julliana Ribeiro Alves Santos
- Mestrado em Meio Ambiente e Mestrado em Biologia Microbiana da Universidade CEUMA, São Luís, MA, CEP: 65075-120, Brazil.
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11
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Alladagbin DJ, Fernandes PN, Tavares MB, Brito JT, Oliveira GGS, Silva LK, Khouri NA, Oliveira MB, Amorim T, Matos CM, Ribeiro GS, Lopes AA, Gonçalves MS, dos-Santos WLC. The sickle cell trait and end stage renal disease in Salvador, Brazil. PLoS One 2018; 13:e0209036. [PMID: 30557319 PMCID: PMC6296547 DOI: 10.1371/journal.pone.0209036] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 11/27/2018] [Indexed: 12/12/2022] Open
Abstract
Background Carriers of the sickle cell trait (HbAS) usually remain asymptomatic. However, under conditions of low tissue oxygenation, red blood cell sickling and vascular obstruction may develop. Chronic kidney disease (CKD) can arise from conditions promoting low-oxygen in kidney tissue, which may be aggravated by the presence of the sickle cell trait. In addition, CKD can arise from other genetic traits. Aim To compare the frequency of HbAS among hemodialysis patients and the general newborn population of Salvador (Bahia-Brazil), as well as to investigate the frequencies of apolipoprotein L1 risk variants in patients undergoing hemodialysis. Methods A cross-sectional study included 306 patients with ESRD (End Stage Renal Disease) on hemodialysis for no more than three years. Hemoglobin profiles were characterized by high-performance liquid chromatography. To estimate the sickle cell trait frequency in the general population of Salvador, we analyzed data collected by a local neonatal screening program between 2011 and 2016. To exclude the potential contributing effect of the apolipoprotein L1 (APOL1) gene variants, we performed genotyping by PCR and DNA sequencing of 45 patients. Results The frequency of HbAS was significantly higher in hemodialysis patients (9.8%) than in the general population (4.6%): Odds Ratio = 2.32 (95% CI = 1.59–3.38). No differences in demographic, clinical or laboratory data were found among patients with or without the sickle cell trait. The frequency of patients with none, one or two APOL1 risk haplotypes (G1 and G2) for CKD were 80%, 18% and 2%, respectively. Conclusions The frequency of the sickle cell trait is higher in patients with ESRD on hemodialysis compared to the general population. APOL1 haplotypes do not seem to be the determinant of ESRD in these patients.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Tatiana Amorim
- Serviço de Referência em Triagem Neonatal—SRTN, Salvador, Brazil
| | | | - Guilherme S. Ribeiro
- Instituto Gonçalo Moniz-FIOCRUZ-Bahia, Salvador, Brazil
- Universidade da Bahia, Salvador, Brazil
| | | | - Marilda S. Gonçalves
- Instituto Gonçalo Moniz-FIOCRUZ-Bahia, Salvador, Brazil
- Universidade da Bahia, Salvador, Brazil
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12
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Daltro G, Franco BA, Faleiro TB, Rosário DAV, Daltro PB, Fortuna V. Osteonecrosis in sickle cell disease patients from Bahia, Brazil: a cross-sectional study. INTERNATIONAL ORTHOPAEDICS 2018; 42:1527-1534. [PMID: 29582115 DOI: 10.1007/s00264-018-3905-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 03/13/2018] [Indexed: 12/19/2022]
Abstract
PURPOSE The aim of this study was to describe the clinical features of osteonecrosis (ON) in sickle cell disease (SCD) patients in Bahia, a Northeast state with the highest prevalence of the disease in Brazil. METHODS Between 2006 and 2017, 283 cases of osteonecrosis in SCD patients were enrolled to analyse the age at diagnosis, genotype, gender, pain, distribution of the lesions and disease staging. MRI and radiograph were obtained at the participation. RESULTS Of the 283 SCD cases, 120 (42.4%) were haemoglobin SS genotype while 163 (57.6%) were SC genotype. Two hundred and forty-six cases were bilateral and 37 were unilateral, with an average age at diagnosis of 33.7 (range 10-67) years. The most frequent identified ON site not only was the hip (74.6%), but also affected shoulder, knee and ankle. Most cases presented at early stage I (172, 60.8%) disease. No significant differences on the features of osteonecrosis were identified between haemoglobin SS and haemoglobin SC cases. CONCLUSIONS Given the relatively high prevalence of bilateral osteonecrosis at early stages, painful symptoms and rather late age at diagnosis, SCD patients should have radiological examination of their joints more often in order to prevent severe functional disability and increase patient's life quality.
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Affiliation(s)
- Gildasio Daltro
- Prof. Edgar Santos Hospital Complex, Federal University of Bahia, R. Doutor Augusto Viana, s/n, Canela, Salvador, BA, 40110-060, Brazil
| | - Bruno Adelmo Franco
- Prof. Edgar Santos Hospital Complex, Federal University of Bahia, R. Doutor Augusto Viana, s/n, Canela, Salvador, BA, 40110-060, Brazil
| | - Thiago Batista Faleiro
- Prof. Edgar Santos Hospital Complex, Federal University of Bahia, R. Doutor Augusto Viana, s/n, Canela, Salvador, BA, 40110-060, Brazil
| | - Davi Araujo Veiga Rosário
- Prof. Edgar Santos Hospital Complex, Federal University of Bahia, R. Doutor Augusto Viana, s/n, Canela, Salvador, BA, 40110-060, Brazil
| | - Paula Braga Daltro
- Health Science Institute, Federal University of Bahia, Av. Reitor Miguel Calmon, s/n, Vale do Canela, Salvador, BA, 40110-100, Brazil
| | - Vitor Fortuna
- Health Science Institute, Federal University of Bahia, Av. Reitor Miguel Calmon, s/n, Vale do Canela, Salvador, BA, 40110-100, Brazil.
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13
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Mota NO, Kimura EM, Ferreira RD, Pedroso GA, Albuquerque DM, Ribeiro DM, Santos MNN, Bittar CM, Costa FF, Sonati MDF. Rare α0-thalassemia deletions detected by MLPA in five unrelated Brazilian patients. Genet Mol Biol 2017; 40:768-773. [PMID: 28981562 PMCID: PMC5738609 DOI: 10.1590/1678-4685-gmb-2016-0330] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 07/23/2017] [Indexed: 11/21/2022] Open
Abstract
Alpha-thalassemias are among the most common genetic diseases in the world. They are characterized by hypochromic and microcytic anemia and great clinical variability, ranging from a practically asymptomatic phenotype to severe anemia, which can lead to intrauterine or early neonatal death. Deletions affecting the α-globin genes, located on chromosome 16p13.3, are the main causes of α-thalassemia. Multiplex ligation-dependent probe amplification (MLPA) can be used to detect rearrangements that cause α-thalassemia, particularly large deletions involving the whole α cluster and/or deletions in the HS-40 region. Here, MLPA was used to investigate the molecular basis of α-thalassemia in five unrelated patients, three of whom had Hb H disease. In addition to the -α3.7 deletion identified in the patients with Hb H disease, four different α0 deletions removing 15 to 225 kb DNA segments were found: two of them remove both the α genes, one affects only the regulatory element (HS-40) region, and another one extends over the entire α cluster and the HS-40 region. These results illustrate the diversity of α-thalassemia deletions in the Brazilian population and highlight the importance of molecular investigation in cases that present with microcytosis and hypochromia without iron deficiency and normal or reduced Hb A2 levels..
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Affiliation(s)
- Natália O Mota
- Laboratório de Hemoglobinopatias, Departamento de Patologia Clínica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | - Elza M Kimura
- Laboratório de Hemoglobinopatias, Departamento de Patologia Clínica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | - Roberta D Ferreira
- Laboratório de Hemoglobinopatias, Departamento de Patologia Clínica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | - Gisele A Pedroso
- Laboratório de Hemoglobinopatias, Departamento de Patologia Clínica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | | | - Daniela M Ribeiro
- Laboratório de Hemoglobinopatias, Departamento de Patologia Clínica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | - Magnun N N Santos
- Laboratório de Hemoglobinopatias, Departamento de Patologia Clínica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | | | - Fernando F Costa
- Hemocentro, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | - Maria de Fatima Sonati
- Laboratório de Hemoglobinopatias, Departamento de Patologia Clínica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
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14
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Aleluia MM, Fonseca TCC, Souza RQ, Neves FI, da Guarda CC, Santiago RP, Cunha BLA, Figueiredo CVB, Santana SS, da Paz SS, Ferreira JRD, Cerqueira BAV, Gonçalves MDS. Comparative study of sickle cell anemia and hemoglobin SC disease: clinical characterization, laboratory biomarkers and genetic profiles. BMC HEMATOLOGY 2017; 17:15. [PMID: 28932402 PMCID: PMC5602866 DOI: 10.1186/s12878-017-0087-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 09/05/2017] [Indexed: 12/12/2022]
Abstract
Background In this study, we evaluate the association of different clinical profiles, laboratory and genetic biomarkers in patients with sickle cell anemia (SCA) and hemoglobin SC disease (HbSC) in attempt to characterize the sickle cell disease (SCD) genotypes. Methods We conducted a cross-sectional study from 2013 to 2014 in 200 SCD individuals (141 with SCA; 59 with HbSC) and analyzed demographic data to characterize the study population. In addition, we determined the association of hematological, biochemical and genetic markers including the βS-globin gene haplotypes and the 3.7 Kb deletion of α-thalassemia (−α3.7Kb-thal), as well as the occurrence of clinical events in both SCD genotypes. Results Laboratory parameters showed a hemolytic profile associated with endothelial dysfunction in SCA individuals; however, the HbSC genotype was more associated with increased blood viscosity and inflammatory conditions. The BEN haplotype was the most frequently observed and was associated with elevated fetal hemoglobin (HbF) and low S hemoglobin (HbS). The -α3.7Kb-thal prevalence was 0.09 (9%), and it was associated with elevated hemoglobin and hematocrit concentrations. Clinical events were more frequent in SCA patients. Conclusions Our data emphasize the differences between SCA and HbSC patients based on laboratory parameters and the clinical and genetic profile of both genotypes.
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Affiliation(s)
- Milena Magalhães Aleluia
- Laboratório de Hematologia e Genética Computacional, Instituto Gonçalo Moniz - IGM, Fundação Oswaldo Cruz (Fiocruz), Rua Waldemar Falcão, 121, Candeal, Salvador, Bahia CEP, 40296-710 Brazil.,Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - Teresa Cristina Cardoso Fonseca
- Centro de Referência a Doença Falciforme, Itabuna, Bahia, Brazil.,Universidade Estadual de Santa Cruz (UESC), Ilhéus, Bahia, Brazil
| | - Regiana Quinto Souza
- Centro de Referência a Doença Falciforme, Itabuna, Bahia, Brazil.,Universidade Estadual de Santa Cruz (UESC), Ilhéus, Bahia, Brazil
| | | | - Caroline Conceição da Guarda
- Laboratório de Hematologia e Genética Computacional, Instituto Gonçalo Moniz - IGM, Fundação Oswaldo Cruz (Fiocruz), Rua Waldemar Falcão, 121, Candeal, Salvador, Bahia CEP, 40296-710 Brazil.,Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - Rayra Pereira Santiago
- Laboratório de Hematologia e Genética Computacional, Instituto Gonçalo Moniz - IGM, Fundação Oswaldo Cruz (Fiocruz), Rua Waldemar Falcão, 121, Candeal, Salvador, Bahia CEP, 40296-710 Brazil.,Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | | | - Camylla Villas Boas Figueiredo
- Laboratório de Hematologia e Genética Computacional, Instituto Gonçalo Moniz - IGM, Fundação Oswaldo Cruz (Fiocruz), Rua Waldemar Falcão, 121, Candeal, Salvador, Bahia CEP, 40296-710 Brazil.,Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - Sânzio Silva Santana
- Laboratório de Hematologia e Genética Computacional, Instituto Gonçalo Moniz - IGM, Fundação Oswaldo Cruz (Fiocruz), Rua Waldemar Falcão, 121, Candeal, Salvador, Bahia CEP, 40296-710 Brazil.,Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - Silvana Sousa da Paz
- Laboratório de Hematologia e Genética Computacional, Instituto Gonçalo Moniz - IGM, Fundação Oswaldo Cruz (Fiocruz), Rua Waldemar Falcão, 121, Candeal, Salvador, Bahia CEP, 40296-710 Brazil
| | - Júnia Raquel Dutra Ferreira
- Laboratório de Hematologia e Genética Computacional, Instituto Gonçalo Moniz - IGM, Fundação Oswaldo Cruz (Fiocruz), Rua Waldemar Falcão, 121, Candeal, Salvador, Bahia CEP, 40296-710 Brazil.,Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | | | - Marilda de Souza Gonçalves
- Laboratório de Hematologia e Genética Computacional, Instituto Gonçalo Moniz - IGM, Fundação Oswaldo Cruz (Fiocruz), Rua Waldemar Falcão, 121, Candeal, Salvador, Bahia CEP, 40296-710 Brazil.,Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
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15
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Santiago RP, Oliveira RM, Soares LF, Figueiredo CVB, Silva DO, Hurtado-Guerrero AF, Fiuza LM, Guarda CC, Adorno EV, Barbosa CG, Gonçalves MS. Hemoglobin Variant Profiles among Brazilian Quilombola Communities. Hemoglobin 2017; 41:83-88. [PMID: 28589738 DOI: 10.1080/03630269.2017.1321014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Brazilian Quilombolas are communities composed of African-derived populations that have their territories guaranteed by the Brazilian Constitution. The present study investigated the hemoglobin (Hb) variants among these population groups. This study was conducted in a total of 2843 individuals of Brazilian Quilombola communities of the Bahia, Pará, and Piauí states. All the participants had their Hb profiles evaluated. The Hb S (HBB: c.20A>T) variant was described in all the studied localities. However, the individuals in Bahia State had the highest frequency of the Hb C (HBB: c.19G>A) variant; individuals from Piauí State had a higher frequency of the Hb D-Punjab (HBB: c.364G>C) variant compared to the other states, and individuals from Pará State only carried the Hb S variant. The present study revealed a specific distribution of Hb variants that could represent different waves of African influence in these Brazilian populations.
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Affiliation(s)
- Rayra P Santiago
- a Laboratório de Hematologia, Genética e Biologia Computacional , Instituto Gonçalo Moniz, Fundação Oswaldo Cruz , Bahia , Brasil.,b Departamento de Análises Clínicas e Toxicológicas , Universidade Federal da Bahia , Bahia , Brasil
| | - Rodrigo M Oliveira
- a Laboratório de Hematologia, Genética e Biologia Computacional , Instituto Gonçalo Moniz, Fundação Oswaldo Cruz , Bahia , Brasil.,b Departamento de Análises Clínicas e Toxicológicas , Universidade Federal da Bahia , Bahia , Brasil
| | - Leonardo F Soares
- c Departamento de Bioquímica e Farmacologia , Universidade Estadual da Paraíba , Campina Grande , Brasil
| | - Camylla V B Figueiredo
- a Laboratório de Hematologia, Genética e Biologia Computacional , Instituto Gonçalo Moniz, Fundação Oswaldo Cruz , Bahia , Brasil.,b Departamento de Análises Clínicas e Toxicológicas , Universidade Federal da Bahia , Bahia , Brasil
| | - Denise Oliveira Silva
- d Laboratório de Situação de Saúde e Gestão do Cuidado às Populações em Situação de Vulnerabilidade, Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz , Manaus , Brasil
| | - Ana F Hurtado-Guerrero
- d Laboratório de Situação de Saúde e Gestão do Cuidado às Populações em Situação de Vulnerabilidade, Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz , Manaus , Brasil
| | - Luciana M Fiuza
- a Laboratório de Hematologia, Genética e Biologia Computacional , Instituto Gonçalo Moniz, Fundação Oswaldo Cruz , Bahia , Brasil.,b Departamento de Análises Clínicas e Toxicológicas , Universidade Federal da Bahia , Bahia , Brasil
| | - Caroline C Guarda
- a Laboratório de Hematologia, Genética e Biologia Computacional , Instituto Gonçalo Moniz, Fundação Oswaldo Cruz , Bahia , Brasil.,b Departamento de Análises Clínicas e Toxicológicas , Universidade Federal da Bahia , Bahia , Brasil
| | - Elisângela V Adorno
- b Departamento de Análises Clínicas e Toxicológicas , Universidade Federal da Bahia , Bahia , Brasil
| | - Cynara G Barbosa
- b Departamento de Análises Clínicas e Toxicológicas , Universidade Federal da Bahia , Bahia , Brasil
| | - Marilda S Gonçalves
- a Laboratório de Hematologia, Genética e Biologia Computacional , Instituto Gonçalo Moniz, Fundação Oswaldo Cruz , Bahia , Brasil.,b Departamento de Análises Clínicas e Toxicológicas , Universidade Federal da Bahia , Bahia , Brasil
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16
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Aleluia MM, da Guarda CC, Santiago RP, Fonseca TCC, Neves FI, de Souza RQ, Farias LA, Pimenta FA, Fiuza LM, Pitanga TN, Ferreira JRD, Adorno EV, Cerqueira BAV, Gonçalves MDS. Association of classical markers and establishment of the dyslipidemic sub-phenotype of sickle cell anemia. Lipids Health Dis 2017; 16:74. [PMID: 28399852 PMCID: PMC5387254 DOI: 10.1186/s12944-017-0454-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 03/13/2017] [Indexed: 02/08/2023] Open
Abstract
Background Sickle cell anemia (SCA) patients exhibit sub-phenotypes associated to hemolysis and vaso-occlusion. The disease has a chronic inflammatory nature that has been also associated to alterations in the lipid profile. This study aims to analyze hematological and biochemical parameters to provide knowledge about the SCA sub-phenotypes previously described and suggest a dyslipidemic sub-phenotype. Methods A cross-sectional study was conducted from 2013 to 2014, and 99 SCA patients in steady state were enrolled. We assessed correlations and associations with hematological and biochemical data and investigated the co-inheritance of -α3.7Kb-thalassemia (-α3.7Kb-thal). Correlation analyses were performed using Spearman and Pearson coefficient. The median of quantitative variables between two groups was compared using t-test and Mann-Whitney. P-values <0.05 were considered statistically significant. Results We found significant association of high lactate dehydrogenase levels with decreased red blood cell count and hematocrit as well as high levels of total and indirect bilirubin. SCA patients with low nitric oxide metabolites had high total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol and reduced very low-density cholesterol, triglycerides, direct bilirubin level and reticulocyte counts. In SCA patients with high-density lipoprotein cholesterol greater than 40 mg/dL, we observed increased red blood cell count, hemoglobin, hematocrit, and fetal hemoglobin and decreased nitric oxide metabolites levels. The presence of -α3.7Kb-thal was associated with high red blood cell count and low mean corpuscular volume, mean corpuscular hemoglobin, platelet count and total and indirect bilirubin levels. Conclusions Our results provide additional information about the association between biomarkers and co-inheritance of -α3.7Kb-thal in SCA, and suggest the role of dyslipidemia and nitric oxide metabolites in the characterization of this sub-phenotype.
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Affiliation(s)
- Milena Magalhães Aleluia
- Laboratório de Hematologia e Genética Computacional, Instituto Gonçalo Moniz - IGM, Rua Waldemar Falcão, 121, Candeal - Salvador/BA, CEP: 40296-710, Bahia, Brazil.,Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - Caroline Conceição da Guarda
- Laboratório de Hematologia e Genética Computacional, Instituto Gonçalo Moniz - IGM, Rua Waldemar Falcão, 121, Candeal - Salvador/BA, CEP: 40296-710, Bahia, Brazil.,Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - Rayra Pereira Santiago
- Laboratório de Hematologia e Genética Computacional, Instituto Gonçalo Moniz - IGM, Rua Waldemar Falcão, 121, Candeal - Salvador/BA, CEP: 40296-710, Bahia, Brazil.,Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - Teresa Cristina Cardoso Fonseca
- Centro de Referência a Doença Falciforme de Itabuna, Itabuna, Bahia, Brazil.,Universidade Estadual de Santa Cruz (UESC), Ilhéus, Bahia, Brazil
| | | | - Regiana Quinto de Souza
- Centro de Referência a Doença Falciforme de Itabuna, Itabuna, Bahia, Brazil.,Universidade Estadual de Santa Cruz (UESC), Ilhéus, Bahia, Brazil
| | | | | | - Luciana Magalhães Fiuza
- Laboratório de Hematologia e Genética Computacional, Instituto Gonçalo Moniz - IGM, Rua Waldemar Falcão, 121, Candeal - Salvador/BA, CEP: 40296-710, Bahia, Brazil.,Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - Thassila Nogueira Pitanga
- Laboratório de Hematologia e Genética Computacional, Instituto Gonçalo Moniz - IGM, Rua Waldemar Falcão, 121, Candeal - Salvador/BA, CEP: 40296-710, Bahia, Brazil
| | - Júnia Raquel Dutra Ferreira
- Laboratório de Hematologia e Genética Computacional, Instituto Gonçalo Moniz - IGM, Rua Waldemar Falcão, 121, Candeal - Salvador/BA, CEP: 40296-710, Bahia, Brazil.,Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | | | | | - Marilda de Souza Gonçalves
- Laboratório de Hematologia e Genética Computacional, Instituto Gonçalo Moniz - IGM, Rua Waldemar Falcão, 121, Candeal - Salvador/BA, CEP: 40296-710, Bahia, Brazil. .,Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.
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17
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Martins MMF, Teixeira MCP. Análise dos gastos das internações hospitalares por anemia falciforme no estado da Bahia. ACTA ACUST UNITED AC 2017. [DOI: 10.1590/1414-462x201700010209] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Resumo Introdução A anemia falciforme é uma doença com alterações genéticas que afeta principalmente a população negra. No curso da doença, surgem diversas complicações clínicas, levando à necessidade de repetidas internações hospitalares. Objetivo Descrever os gastos das internações hospitalares por complicações da anemia falciforme no estado da Bahia, no período de 2008 a 2014. Métodos Estudo descritivo, a partir de dados secundários. A população do estudo foi composta por pacientes internados com diagnóstico de anemia falciforme. Para coleta e análise dos dados, utilizou-se a divisão por Macrorregião de Saúde do estado da Bahia. Resultados Foram analisadas 8.103 internações do SIH-SUS. Predomínio do sexo masculino e faixa etária de 5-14 anos. A Macrorregião de Saúde Leste obteve o maior número de ocorrências de internações por anemia falciforme (33,4%) com maior gasto total; a Macrorregião Sul apresentou maior coeficiente de hospitalização; e a Macrorregião Extremo Sul apresentou a maior taxa de letalidade. As Macrorregiões Leste e Sul são as que abrigam os maiores volumes de gastos, 40,5% e 18,9%, respectivamente. Conclusão O estudo permite conhecer o perfil de internações hospitalares por anemia falciforme e ter uma ideia dos custos hospitalares através das internações pela referida doença no período em estudo.
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Cantú-Reyna C, Zepeda LM, Montemayor R, Benavides S, González HJ, Vázquez-Cantú M, Cruz-Camino H. Incidence of Inborn Errors of Metabolism by Expanded Newborn Screening in a Mexican Hospital. JOURNAL OF INBORN ERRORS OF METABOLISM AND SCREENING 2016. [DOI: 10.1177/2326409816669027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Affiliation(s)
- Consuelo Cantú-Reyna
- Genomi-k SAPI de CV, Monterrey, Nuevo León, México
- Escuela de Medicina Tecnológico de Monterrey, Monterrey, Nuevo León, México
| | - Luis Manuel Zepeda
- Genomi-k SAPI de CV, Monterrey, Nuevo León, México
- Escuela de Medicina Tecnológico de Monterrey, Monterrey, Nuevo León, México
| | - René Montemayor
- Hospital de Ginecología y Obstetricia SA de CV Monterrey, Nuevo León, México
| | - Santiago Benavides
- Hospital de Ginecología y Obstetricia SA de CV Monterrey, Nuevo León, México
| | | | - Mercedes Vázquez-Cantú
- Genomi-k SAPI de CV, Monterrey, Nuevo León, México
- Department of Biosystems Science and Engineering ETH Zurich, Basel, Switzerland
| | - Héctor Cruz-Camino
- Genomi-k SAPI de CV, Monterrey, Nuevo León, México
- Escuela de Biotecnología y Ciencias de la Salud, Instituto Tecnológico de Monterrey, Monterrey, México
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Braga JAP, Veríssimo MPDA, Saad STO, Cançado RD, Loggetto SR. Guidelines on neonatal screening and painful vaso-occlusive crisis in sickle cell disease: Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular: Project guidelines: Associação Médica Brasileira - 2016. Rev Bras Hematol Hemoter 2016; 38:147-57. [PMID: 27208574 PMCID: PMC4877615 DOI: 10.1016/j.bjhh.2016.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 04/04/2016] [Indexed: 11/11/2022] Open
Affiliation(s)
| | | | | | - Rodolfo Delfini Cançado
- Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), São Paulo, SP, Brazil; Hospital Samaritano, São Paulo, SP, Brazil
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Carlos AM, Souza RAV, Souza BMBD, Pereira GDA, Tostes Júnior S, Martins PRJ, Moraes-Souza H. Hemoglobinopathies in newborns in the southern region of the Triângulo Mineiro, Brazil. Cross-sectional study. SAO PAULO MED J 2015; 133:439-44. [PMID: 26648434 PMCID: PMC10871810 DOI: 10.1590/1516-3180.2015.00042302] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 02/23/2015] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND OBJECTIVE Hemoglobinopathies are among the commonest and most widespread genetic disorders worldwide. Their prevalence varies according to ethnic composition and/or geographical region. The aim of this study was to investigate the presence of hemoglobinopathies and their association with ethnicity among 1,004 newborns, to confirm the guideline of the Brazilian National Neonatal Screening Program. DESIGN AND SETTING Cross-sectional study conducted in a public referral hospital in the Triângulo Mineiro region, Minas Gerais, Brazil. METHODS Qualitative assessment of hemoglobin was performed through electrophoresis on cellulose acetate: at alkaline pH to identify the hemoglobin (Hb) profile and at acid pH to differentiate Hb S from Hb D and Hb C from Hb E and others that migrate to similar positions at alkaline pH. Neutral pH was used to detect Hb Bart's identified in alpha thalassemia (α-thal). The elution method after electrophoresis was used to quantitatively assess hemoglobins. RESULTS There was predominance of α-thal, with 105 cases (10.46%), followed by Hb S with 61 cases (6.08%, comprising 46 Hb AS, 2 Hb SS and 13 Hb S/α-thal), 9 cases (0.9%) of Hb AC and 6 cases (0.6%) suggestive of beta thalassemia (β-thal). The frequency of hemoglobinopathies was significantly higher among Afro-descendants. CONCLUSIONS These findings corroborated of the National Neonatal Screening Program for diagnosing sickle cell disease and Hb C, Hb D, Hb E and β-thal hemoglobinopathies.
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Affiliation(s)
| | | | | | - Gilberto de Araujo Pereira
- Biostatistics Section, Department of Nursing, Universidade Federal do Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Sebastião Tostes Júnior
- Forensic Medicine Section, Department of Social Medicine, Universidade Federal do Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Paulo Roberto Juliano Martins
- Hematology and Hemotherapy Section, Department of Medicine, Universidade Federal do Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Helio Moraes-Souza
- Hematology and Hemotherapy Section, Department of Medicine, Universidade Federal do Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
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Figueiredo MS. The importance of hemoglobin A2 determination. Rev Bras Hematol Hemoter 2015; 37:287-9. [PMID: 26408359 PMCID: PMC4685102 DOI: 10.1016/j.bjhh.2015.06.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 07/07/2015] [Indexed: 01/03/2023] Open
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de Souza RAV, Carlos AM, de Souza BMB, Rodrigues CV, Pereira GDA, Moraes-Souza H. Α-Thalassemia: Genotypic Profile Associated with Ethnicity and Hematological Differentiation of Iron Deficiency Anemia in the Region of Uberaba, Minas Gerais, Brazil. Hemoglobin 2015; 39:264-9. [PMID: 26182338 DOI: 10.3109/03630269.2015.1037890] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
α-Thalassemia (α-thal) is a hereditary hemoglobinopathy characterized by microcytic anemia due to impaired production of α chains of human globin. Brazilian studies show that the most common genotype is an -α(3.7) deletion with the loss of one or two α genes. As the production of α chains is not as accentuated in these cases, the correct diagnosis can only be achieved through molecular analysis that is not usually routinely performed by laboratories. We investigated the occurrence of α-thal babies born between September 2011 to January 2013 at the hospital of the Universidade Federal do Triângulo Mineiro (UFTM), Uberaba, Brazil, and blood donors of the Uberaba Regional Blood Center, Hemominas Foundation, Uberaba, Brazil, correlating it with ethnicity and differences between hematological parameters of donors, α-thal and iron deficiency patients. α-Thalassemia was investigated for the most common deleted alleles (-α(3.7), -α(4.2), - -(SEA), - -(FIL), - -(THAI), -(α)(20.5) and - -(MED)). The incidence in newborns was 13.16% with a predominance of heterozygosity for the -α(3.7) genotype (12.35%), followed by the -α(3.7)/-α(3.7) (0.46%) and αα/-α(4.2) genotypes (0.35%). In blood donors, the prevalence of α-thal was 14.89%, with all cases being heterozygous for the -α(3.7) deletion. There was an association of the α-thal genotype with African ancestors for both groups, thereby confirming published data and showing the strong influence of Blacks on the composition of the population of Brazil's southeastern region. Minor changes were found between hematological parameters of blood donors with iron deficiency and α-thal that did not contribute to the differential diagnosis between the two types of anemia.
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Affiliation(s)
- Renata A Volpe de Souza
- Department of Clinical Medicine, Universidade Federal do Triângulo Mineiro (UFTM) , Uberaba, Minas Gerais , Brazil
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da Fonseca SF, Amorim T, Purificação A, Gonçalves M, Boa-Sorte N. Hemoglobin A2 values in sickle cell disease patients quantified by high performance liquid chromatography and the influence of alpha thalassemia. Rev Bras Hematol Hemoter 2015; 37:296-301. [PMID: 26408362 PMCID: PMC4685046 DOI: 10.1016/j.bjhh.2015.05.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2013] [Accepted: 05/11/2015] [Indexed: 11/15/2022] Open
Abstract
Background In sickle cell disease, the quantification of Hb A2 is important for the differential diagnosis between sickle cell anemia (Hb SS) and Hb S/β0-thalassemia. Objective To determine Hb A2 levels as quantified by high performance liquid chromatography in patients with sickle cell anemia (Hb SS) and with the SC hemoglobinopathy, with or without concomitant alpha thalassemia. Methods This is a retrospective study of 242 children aged between two and six years with diagnoses of Hb SS or Hb SC. The hemoglobin was evaluated using high performance liquid chromatography and alpha thalassemia [3.7 kb deletion (−α3.7)] was detected by polymerase chain reaction. Patients were classified as homozygous (−α3.7/−α3.7), heterozygous (−α3.7/α), or homozygous wild-type. Analysis of variance was used to compare the mean Hb A2 values between the alpha thalassemia groups. Results The mean (± standard deviation) Hb A2 concentrations in the Hb SS group (n = 135) was 3.68 ± 0.65%. The mean values for individuals with Hb SS and heterozygous (n = 28) or homozygous for alpha thalassemia (n = 3) were 3.98 ± 0.64% and 4.73 ± 0.25%, respectively. The mean Hb A2 of all the Hb SC patients (n = 107) was 4.01 ± 0.507 with 4.29 ± 0.41% and 4.91 ± 0.22% in individuals heterozygous (n = 23) and homozygous for alpha thalassemia (n = 7), respectively. All patients homozygous for alpha thalassemia had Hb A2 levels above 3.5%. However, Hb A2 values above 5.2% were seen in patients with Hb SS and Hb SC, independently of alpha thalassemia. Conclusion Hb A2 levels are elevated in patients with Hb S or Hb C, and are directly influenced by the alpha thalassemia genotypes.
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Affiliation(s)
| | - Tatiana Amorim
- Associação de Pais e Amigos dos Excepcionais (APAE), Salvador, BA, Brazil
| | | | | | - Ney Boa-Sorte
- Associação de Pais e Amigos dos Excepcionais (APAE), Salvador, BA, Brazil
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Daltro GC, Fortuna V, de Souza ES, Salles MM, Carreira AC, Meyer R, Freire SM, Borojevic R. Efficacy of autologous stem cell-based therapy for osteonecrosis of the femoral head in sickle cell disease: a five-year follow-up study. Stem Cell Res Ther 2015; 6:110. [PMID: 26021713 PMCID: PMC4465459 DOI: 10.1186/s13287-015-0105-2] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 04/08/2015] [Accepted: 05/21/2015] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Stem cell therapy with bone marrow-derived mononuclear cells (BMMCs) is an option for improving joint function in osteonecrosis of the femoral head (ONFH). Bone marrow-derived mesenchymal stromal cell (MSC) numbers and their osteogenic differentiation are decreased in patients with ONFH. However, whether this decrease also extends to the early stages of ONFH in sickle cell disease (SCD) is still unclear. METHODS We conducted a phase I/II, non-controlled study to determine efficacy and safety of BMMC implantation using a minimally invasive technique in SCD patients with ONFH. Eighty-nine patients were recruited and followed up for 60 months after surgery. Clinical and radiographic findings were assessed, and data were completed by in vitro analysis. RESULTS At the final follow-up (60 months) there was a significant improvement in clinical joint symptoms and pain relief as measured by the Harris Hip Score (P = 0.0005). In addition, after the BMMC implantation procedure, radiographic assessment showed disease stabilization and only 3.7 % of the treated patients did not achieve a satisfactory clinical result. The amount of fibroblast colony-forming units was 28.2 ± 13.9 per 1 million BMMCs after concentration. Flow cytometry analysis showed a significantly higher number of hematopoietic stem/endothelial progenitor cell markers in concentrated BMMCs when compared with bone marrow aspirate, indicating an enrichment of these cell types. Isolated MSCs from SCD patients with pre-collapse ONFH maintained the replicative capacity without significant loss of their specific biomolecular characteristics, multi-differentiation potential, and osteogenic differentiation activities. Cytokines and growth factors (interleukin-8, transforming growth factor-beta, stromal cell-derived factor-1alpha and vascular endothelial growth factor) that mediate endogenous bone regeneration were also produced by expanded MSCs from SCD patients. CONCLUSION The autologous BMMC implantation with a minimally invasive technique resulted in significant pain relief and halted the progression of early stages of ONFH in SCD patients. MSCs from SCD patients display biological properties that may add to the efficiency of surgical treatment in ONFH. In summary, our results indicate that infusion of BMMCs enriched with stem/progenitor cells is a safe and effective treatment for the early stages of ONFH in SCD patients. TRIAL REGISTRATION ClinicalTrials.gov NCT02448121; registered 15 May 2015.
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Affiliation(s)
| | - Vitor Fortuna
- Health Science Institute, Federal University of Bahia, Reitor Miguel Calmon Avenue, Salvador, BA, 40110-100, Brazil.
| | - Eliane Silva de Souza
- Health Science Institute, Federal University of Bahia, Reitor Miguel Calmon Avenue, Salvador, BA, 40110-100, Brazil.
| | - Marcela Miranda Salles
- Health Science Institute, Federal University of Bahia, Reitor Miguel Calmon Avenue, Salvador, BA, 40110-100, Brazil.
| | - Ana Claudia Carreira
- Cell and Molecular Therapy Center NUCEL-NETCEM, School of Medicine, Internal Medicine Department, and Chemistry Institute, Biochemistry Department, University of São Paulo, São Paulo, SP, 05508-900, Brazil.
| | - Roberto Meyer
- Health Science Institute, Federal University of Bahia, Reitor Miguel Calmon Avenue, Salvador, BA, 40110-100, Brazil.
| | - Songeli Menezes Freire
- Health Science Institute, Federal University of Bahia, Reitor Miguel Calmon Avenue, Salvador, BA, 40110-100, Brazil.
| | - Radovan Borojevic
- Petrópolis School of Medicine/Arthur de Sá Earp Faculties, Petrópolis, RJ, 25680-120, Brazil. .,National Institute of Metrology, Quality and Technology (Inmetro), Xerém, Rio de Janeiro, RJ, 25250-020, Brazil.
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Guimarães JS, Cominal JG, Silva-Pinto AC, Olbina G, Ginzburg YZ, Nandi V, Westerman M, Rivella S, de Souza AM. Altered erythropoiesis and iron metabolism in carriers of thalassemia. Eur J Haematol 2014; 94:511-8. [PMID: 25307880 DOI: 10.1111/ejh.12464] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2014] [Indexed: 12/13/2022]
Abstract
The thalassemia syndromes (α- and β-thalassemia) are the most common and frequent disorders associated with ineffective erythropoiesis. Imbalance of α- or β-globin chain production results in impaired red blood cell synthesis, anemia, and more erythroid progenitors in the blood stream. While patients affected by these disorders show definitive altered parameters related to erythropoiesis, the relationship between the degree of anemia, altered erythropoiesis, and dysfunctional iron metabolism has not been investigated in both α-thalassemia carriers (ATC) and β-thalassemia carriers (BTC). Here, we demonstrate that ATC have a significantly reduced hepcidin and increased soluble transferrin receptor levels but relatively normal hematological findings. In contrast, BTC have several hematological parameters significantly different from controls, including increased soluble transferrin receptor and erythropoietin levels. These changes in both groups suggest an altered balance between erythropoiesis and iron metabolism. The index sTfR/log ferritin and (hepcidin/ferritin)/sTfR are, respectively, increased and reduced relative to controls, proportional to the severity of each thalassemia group. In conclusion, we showed in this study, for the first time in the literature, that thalassemia carriers have altered iron metabolism and erythropoiesis.
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Affiliation(s)
- Jacqueline S Guimarães
- Laboratório de Hematologia Clínica, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil.,The Strauss Thalassemia Laboratory, Pediatric Hematology-Oncology, Weill Medical College of Cornell University, New York, NY, USA
| | - Juçara G Cominal
- Laboratório de Hematologia Clínica, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Ana Cristina Silva-Pinto
- Centro Regional de Hemoterapia de Ribeirão Preto, Departamento de Medicina Interna, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | | | | | | | | | - Stefano Rivella
- The Strauss Thalassemia Laboratory, Pediatric Hematology-Oncology, Weill Medical College of Cornell University, New York, NY, USA
| | - Ana Maria de Souza
- Laboratório de Hematologia Clínica, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
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Abstract
Sickle cell disease (SCD), caused by a mutation in the β-globin gene HBB, is widely distributed in malaria endemic regions. Cardiopulmonary complications are major causes of morbidity and mortality. Hemoglobin SS (Hb SS) represents a large proportion of SCD in the Americas, United Kingdom, and certain regions of Africa while higher proportions of hemoglobin SC are observed in Burkina Faso and hemoglobin Sβ-thalassemia in Greece and India. Coinheritance of α-thalassemia and persistence of hemoglobin F production are observed in highest frequency in certain regions of India and the Middle East. As confirmed in the PUSH and Walk-PHaSST studies, Hb SS, absence of co-inheriting alpha-thalassemia, and low hemoglobin F levels tend to be associated with more hemolysis, lower hemoglobin oxygen saturations, greater proportions of elevated tricuspid regurgitant jet velocity and brain natriuretic peptide, and increased left ventricular mass index. Identification of additional genetic modifiers will improve prediction of cardiopulmonary complications in SCD.
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Luz JD, Ávila A, Icasuriaga S, Gongóra M, Castillo L, Serrón A, Kimura EM, Costa FF, Sans M, Sonati MDF. Frequency and spectrum of hemoglobinopathy mutations in a Uruguayan pediatric population. Genet Mol Biol 2013; 36:316-22. [PMID: 24130436 PMCID: PMC3795163 DOI: 10.1590/s1415-47572013005000027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Accepted: 04/12/2013] [Indexed: 11/22/2022] Open
Abstract
Hemoglobinopathies are the most common recessive diseases worldwide but their prevalence in Uruguay has not been investigated. In this study, 397 unrelated outpatient children from the Pereira Rosell Hospital Center (CHPR), as well as 31 selected patients with microcytic anemia and 28 β-thalassemia carriers were analyzed for hemoglobinopathies by using biochemical and molecular biology methods. Parametric and non-parametric methods were used to compare the hematological indices between groups of genotypes. Of the 397 patients in the first group, approximately 1% (0.76% HbS and 0.25% β-thalassemia) had a mutation in the HBB gene and 3.3% had β-thalassemia. These mutations had a heterogeneous distribution that varied according to individual ancestry. HbS was found exclusively in individuals with declared African ancestry and had a carrier frequency of 2.2%. The frequency of α-thalassemia carriers in outpatients of European and African ancestry was 1.2% and 6.5%, respectively. In contrast, the frequency of α-thalassemia carriers in patients with microcytic anemia was 25.8%, significantly higher (p < 0.01) than that observed in the sample as a whole and in Afro-descendants and Euro-descendants. Significant differences were observed in the hematological parameters between individuals with thalassemia genotypes and those with a normal genotype. These results indicate that hemoglobinopathies are a relevant health problem in Uruguay.
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Affiliation(s)
- Julio Da Luz
- Departamento de Genética, Facultad de Medicina, Universidad de la República, Montevideo,
Uruguay
| | - Amalia Ávila
- Departamento de Genética, Facultad de Medicina, Universidad de la República, Montevideo,
Uruguay
| | - Sandra Icasuriaga
- Departamento de Laboratorio Clínico, Centro Hospitalario Pereira Rosell, Montevideo,
Uruguay
| | - María Gongóra
- Servicio de Hemato-Oncología Pediátrica, Centro Hospitalario Pereira Rosell, Montevideo,
Uruguay
| | - Luis Castillo
- Servicio de Hemato-Oncología Pediátrica, Centro Hospitalario Pereira Rosell, Montevideo,
Uruguay
| | - Alejandra Serrón
- Departamento de Genética, Facultad de Medicina, Universidad de la República, Montevideo,
Uruguay
| | - Elza Miyuki Kimura
- Departamento de Patologia Clínica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP,
Brazil
| | - Fernando Ferreira Costa
- Hemocentro, Faculdade de Ciências Médicas, Universidad Estadual de Campinas, Campinas, SP,
Brazil
| | - Mónica Sans
- Departmento de Antropología Biológica, Facultad de Humanidades y Ciencias de la Educación, Universidad de la República, Montevideo,
Uruguay
| | - Maria de Fátima Sonati
- Departamento de Patologia Clínica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP,
Brazil
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Prevalence and management of anemia in hemodialysis patients in a Brazilian population of predominantly African descent. Int J Artif Organs 2013; 36:640-9. [PMID: 23918268 DOI: 10.5301/ijao.5000204] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2013] [Indexed: 11/20/2022]
Abstract
BACKGROUND/OBJECTIVE Findings from the international DOPPS indicated a rise in hemoglobin levels for patients on maintenance hemodialysis (MHD) for more than 180 days across many countries with more than 60% with hemoglobin ≥11 g/dl. However, the situation of anemia control for a large contingent of the hemodialysis population remains unknown. Studies in the United States indicate that hemoglobin level is lower for African Americans on MHD, but studies in other populations of African descent are lacking. We investigated the prevalence of, and associated factors for, hemoglobin <11 g/dl in MHD patients from the Brazilian city with the largest proportion of African descendants outside Africa. METHODS Cross-sectional study of 1,263 MHD patients enrolled in the Prospective Study of the Prognosis of Chronic Hemodialysis Patients (PROHEMO) in Salvador, Brazil 2005-2009. RESULTS 88.0% black or mixed race; age 49.0 ± 14.7 years; 96.6% receiving erythropoietin, median = 6,000 units/week. In patients on MHD for more than 180 days, 67.4% had hemoglobin <11 g/dl. Factors associated with hemoglobin<11 g/dl were MHD by catheter (odds ratio (OR) = 3.03, 95% confidence interval (CI) = 1.43-6.42), hospitalization in prior 3 months (OR = 2.14, 95% CI = 1.20-3.83), transferrin saturation <20% (OR = 1.49, 95% CI = 1.05-2.12) and higher malnutrition-inflammation score (OR = 1.58 per each log-transformed unit, 95% CI = 1.14-2.19). CONCLUSIONS The results suggest that iron deficiency, insufficient erythropoietin dose, catheter use, malnutrition-inflammation, and problems associated with hospitalization are explanations for the high prevalence of hemoglobin below the guideline target in MHD patients from a large African descent Brazilian population. These results have implications for understanding the lower hemoglobin concentration in MHD populations of African descent.
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Domínguez Y, Zurita C, Calvopiña D, Villacís J, Mora M. Prevalence of common hemoglobin variants in an afro-descendent Ecuadorian population. BMC Res Notes 2013; 6:132. [PMID: 23557107 PMCID: PMC3626573 DOI: 10.1186/1756-0500-6-132] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Accepted: 03/20/2013] [Indexed: 11/10/2022] Open
Abstract
Background Hemoglobinopathies are among the most studied and frequent pathologies. These genetic disorders are considered a very important health care threat in many tropical countries. Ecuador is a tropical Latin-American country with an important presence of afro-descendants (7.2%). Afro-descendants are among the ethnic groups with higher frequency of hemoglobinopathies reported. Ambuqui is a region within the Imbabura province with an important presence of afro-descendants (>50%). The present study analyzed the frequency of the most common hemoglobin variants in an asymptomatic afro-descendent population using capillary electrophoresis. Findings From 114 individuals, 25 (22%) reported a hemoglobin variant. All individuals that presented hemoglobin variants were heterozygotes (asymptomatic). Hemoglobin S (sickle cell trait) was the most frequent variant found (14%), followed by hemoglobin E (4.4%), Fetal (2.6%) and C (1%). Conclusion Prevalence of hemoglobin S was consistent with populations from other countries, but it was lower than other Ecuadorian afro-descendent populations. Frequency of hemoglobin C was lower than other afro-descendent populations. This data suggests the possibility of gene flow from Native American individuals to the Ambuqui population there by lowering the frequency of their hemoglobin variants compared with other afro-descendant populations. Evaluating the frequency of hemoglobinopathies in Ecuadorian populations is essential. Despite the high frequency of these disorders, very few health care facilities implement hemoglobinopathies tests as a routine practice.
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Affiliation(s)
- Yamila Domínguez
- Escuela Politécnica de Ejército, Av. Gral. Rumiñahui s/n, Sangolquí, Ecuador
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Fonseca SF, Moura Neto JP, Goncalves MS. Prevalence and molecular characterization of β-thalassemia in the state of Bahia, Brazil: first identification of mutation HBB: c.135delC in Brazil. Hemoglobin 2013; 37:285-90. [PMID: 23425035 DOI: 10.3109/03630269.2013.771271] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
β-Thalassemia (β-thal) is a hereditary disease with at least 200 known causative molecular defects, with a limited number of distinct mutations predominating in any given population. The Brazilian population is one of the most heterogeneous in the world. Although occurrences of β-thal in this country have been recognized for a long time and previous studies have shown important regional differences related to the mutational profile, no extensive analysis of mutations of the HBB gene has been carried out in Brazil. We examined 1011 teenagers from Bahia, a state located in the northeast of Brazil. Hematological data were obtained using automated cell counting, hemoglobin (Hb) profiles were studied by high performance liquid chromatography (HPLC), and DNA was analyzed by automated sequencing. None of the four Mediterranean mutations that are most frequently found in South and Southeast Brazil (HBB: c.118C>T; HBB: c.93-21G>A; HBB: c.92+1G>A; HBB: c.92+6T>C), was found to be responsible for thalassemia in the cases that we studied. One heterozygote for a frameshift mutation at codon 44 (-C) was identified. This is the first study to determine the prevalence and profile of β-thal in Bahia State. For the first time in Brazil, we report the occurrence of the HBB: c.135delC mutation in the β-globin gene.
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Affiliation(s)
- Silvana F Fonseca
- Departamento de Pediatric, Universidade de Brasilia UnB, Brasilia, Brazil.
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Lervolino LG, Baldin PEA, Picado SM, Calil KB, Viel AA, Campos LAF. Prevalence of sickle cell disease and sickle cell trait in national neonatal screening studies. Rev Bras Hematol Hemoter 2013; 33:49-54. [PMID: 23284244 PMCID: PMC3521436 DOI: 10.5581/1516-8484.20110015] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2009] [Accepted: 01/20/2011] [Indexed: 11/27/2022] Open
Abstract
Sickle cell anemia is the best known hereditary blood disorder; there are serious complications associated with the condition. Diagnosis and early intervention reduce morbidity and mortality. These benefits have resulted in the widespread use of newborn screening education programs. In Brazil, the National Neonatal Screening Program established by decree 822/01 included sickle cell disease in the list of diseases tested in the so called "heel prick test". Since then, national studies of the results of this program have been periodically published. To review the literature in order to assess the prevalence of sickle cell trait and sickle cell anemia from data of national neonatal screening studies on hemoglobin S (Hb S). A bibliographic review was carried out using the key words: sickle cell anemia & hemoglobinopathies & neonatal screening & Brazil in the Bireme and SciELO databases. Original Brazilian studies presenting data on prevalence of the sickle cell trait (Hb AS) and sickle cell anemia (Hb SS) based on neonatal screening for Hb S were analysed. Twelve original national studies were identified with prevalences varying from 1.1% to 9.8% for the sickle cell trait and from 0.8 to 60 per 100,000 live births for sickle cell disease in different Brazilian regions. Conclusion: Neonatal screening for Hb S is a very useful method to assess the prevalence of sickle cell trait (Hb AS) and sickle cell anemia (Hb SS) in Brazil. There is a heterogeneous distribution of this disease with the highest prevalence in the northeastern region and the lowest prevalence in the south.
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Soares LF, Rocha OAMDS, de Oliveira EH, Vieira JFPDN. Neonatal screening in the state of Piauí: an urgent need - a study on the prevalence of sickle cell disease in newborns. Rev Bras Hematol Hemoter 2012; 34:392-3. [PMID: 23125548 PMCID: PMC3486830 DOI: 10.5581/1516-8484.20120096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Accepted: 07/18/2012] [Indexed: 11/27/2022] Open
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de Medeiros Alcoforado GH, Bezerra CM, Araújo Moura Lemos TM, de Oliveira DM, Kimura EM, Ferreira Costa F, de Fátima Sonati M, de Medeiros TMD. Prevalence of α-thalassemia 3.7 kb deletion in the adult population of Rio Grande do Norte, Brazil. Genet Mol Biol 2012; 35:594-8. [PMID: 23055797 PMCID: PMC3459408 DOI: 10.1590/s1415-47572012005000049] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2011] [Accepted: 04/03/2012] [Indexed: 12/03/2022] Open
Abstract
α-Thalassemia, arising from a defect in α-globin chain synthesis, is often caused by deletions involving one or both of the α-genes on the same allele. With the aim of investigating the prevalence of α-thalassemia 3.7 kb deletion in the adult population of Rio Grande do Norte, 713 unrelated individuals, between 18 and 59 years-of-age, were analyzed. Red blood cell indices were electronically determined, and A2 and F hemoglobins evaluated by HPLC. PCR was applied to the molecular investigation of α-thalassemia 3.7 kb deletion. Eighty (11.2%) of the 713 individuals investigated presented α-thalassemia, of which 79 (11.1%) were heterozygous (-α3.7/αα) deletions and 1 (0.1%) homozygous (-α3.7/-α3.7). Ethnically, heterozygous deletions were higher (24.8%) in Afro-Brazilians. Comparison of hematological parameters between individuals with normal genotype and those with heterozygous α+-thalassemia showed a statistically significant difference in the number of erythrocytes (p < 0.001), MCV (p < 0.001), MCH (p < 0.001) and Hb A2 (p = 0.007). This study is one of the first dedicated to investigating α-thalassemia 3.7 kb deletion in the population of the State Rio Grande do Norte state. Results obtained demonstrate the importance of investigating this condition in order to elucidate the causes of microcytosis and hypochromia.
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Neves FS, de Almeida DA, Oliveira-Santos C, dos Santos JN, Toralles MBP, da Silva MCBO, Campos MIG, Crusoé-Rebello I. Radiographic changes of the jaws in HbSS and HbSC genotypes of sickle cell disease. SPECIAL CARE IN DENTISTRY 2011; 31:129-33. [DOI: 10.1111/j.1754-4505.2011.00195.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Wagner SC, de Castro SM, Gonzalez TP, Santin AP, Zaleski CF, Azevedo LA, Dreau H, Henderson S, Old J, Hutz MH. Neonatal screening for hemoglobinopathies: results of a public health system in South Brazil. Genet Test Mol Biomarkers 2010; 14:565-9. [PMID: 20722469 DOI: 10.1089/gtmb.2010.0008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
AIM The aim of this study was to estimate the prevalence of hemoglobinopathies in South Brazil. METHODS Samples of dried blood spots collected by heel prick in neonates were evaluated by isoeletric focusing and/or high-performance liquid chromatography techniques. All variants were characterized at the molecular level. RESULTS A total of 437,787 samples were evaluated. Among these, 6391 showed an abnormal hemoglobin pattern. These included 48 cases (0.01%) of sickle cell disorders (33 hemoglobin SS [Hb SS], 7 Hb SC, 7 Hb S/beta thalassemia, 1 Hb SD), 1 neonate who was homozygous for beta thalassemia, 6272 (1.4%) newborns who were heterozygous for Hb S, C, or D, and 71 (0.02%) neonates who were carriers for rare hemoglobin variants. Most of these rare variants were identified for the first time in Brazil. CONCLUSIONS Comparing these results with those obtained in other Brazilian regions, we observe a highly heterogeneous distribution. This knowledge is useful in healthcare planning and allocation of resources, as well as identifying at-risk couples, which will assist with disease prevention.
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Affiliation(s)
- Sandrine C Wagner
- Departamento de Genética, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Wagner SC, de Castro SM, Gonzalez TP, Santin AP, Filippon L, Zaleski CF, Azevedo LA, Amorin B, Callegari-Jacques SM, Hutz MH. Prevalence of common α-thalassemia determinants in south Brazil: Importance for the diagnosis of microcytic anemia. Genet Mol Biol 2010; 33:641-5. [PMID: 21637571 PMCID: PMC3036136 DOI: 10.1590/s1415-47572010005000086] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2010] [Accepted: 06/21/2010] [Indexed: 11/21/2022] Open
Abstract
Alpha thalassemia has not been systematically investigated in Brazil. In this study, 493 unrelated individuals from the southernmost Brazilian state of Rio Grande do Sul were screened for deletional forms of α-thalassemia. One hundred and one individuals had microcytic anemia (MCV < 80 fL) and a normal hemoglobin pattern (Hb A 2 < 3.5% and Hb F < 1%). The subjects were screened for - α3.7 , - α4.2 , - α20.5 , — SEA and — MED deletions but only the - α3.7 allele was detected. The - α3.7 allele frequency in Brazilians of European and African ancestry was 0.02 and 0.12, respectively, whereas in individuals with microcytosis the frequency was 0.20. The prevalence of α-thalassemia was significantly higher in individuals with microcytosis than in healthy individuals (p = 0.001), regardless of their ethnic origin. There were also significant differences in the hematological parameters of individuals with - α3.7 / αα, - α3.7 /- α3.7 and β-thalassemia trait compared to healthy subjects. These data suggest that α-thalassemia is an important cause of microcytosis and mild anemia in Brazilians.
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Affiliation(s)
- Sandrine C Wagner
- Departamento de Genética, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS Brazil
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Giménez OG, Torrealba MC, Urquiola MB, Ortiz GG, Fonseca SM, Merzón R, de Donato M, Castillo O, Arends de Pérez A. [Diagnosis of hemoglobinopathies in newborns in Venezuela hospitals]. An Pediatr (Barc) 2009; 71:314-8. [PMID: 19775947 DOI: 10.1016/j.anpedi.2009.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2009] [Revised: 07/10/2009] [Accepted: 07/13/2009] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Hemoglobinopathies are the most common hereditary disorders in humans representing a public health problem in Venezuela. In this study the prevalence of hemoglobinopathies was evaluated in newborns from different areas of Venezuela, in cooperation with the neonatal screening system of the Study Unit of Inborn Errors of Metabolism (IDEA). MATERIALS AND METHODS The heel blood samples of 101,301 newborns were analysed by high performance liquid chromatography (HPLC-CE) technique using Variant* Bio Rad System with the Sickle Cell Short program for the filter paper samples in and the Beta Tal Short program for the family studies. RESULTS We found a high prevalence of newborns heterozygous for hemoglobin S and C (Hb S and Hb C). It was observed that 1.96% (1989) of the newborns were carriers, with Hb FAS (67.92) being the most frequent phenotype, followed by Hb FAC (23.18%), Hb FAD (7.49%), Hb FSC (0.96%),) and Hb FSD (0.20%). All the neonatal positives cases were confirmed at 3 months of age. CONCLUSIONS The frequencies of the variants found in this study confirms that the hemoglobin disorders are a public health problem in Venezuela, emphasizing the importance of instituting a national program of screening for hemoglobinopathies throughout the country, comprising not only an early treatment, but also an educational program and genetic counseling for the family group.
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Watanabe AM, Pianovski MAD, Zanis Neto J, Lichtvan LCL, Chautard-Freire-Maia EA, Domingos MT, Wittig EO. [Prevalence of hemoglobin S in the State of Paraná, Brazil, based on neonatal screening]. CAD SAUDE PUBLICA 2008; 24:993-1000. [PMID: 18461228 DOI: 10.1590/s0102-311x2008000500006] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2007] [Accepted: 10/08/2007] [Indexed: 11/21/2022] Open
Abstract
The Brazilian Ministry of Health created the National Neonatal Screening Program under ruling no. 822/2001, including neonatal screening for hemoglobinopathies. In the State of Paraná, neonatal screening is conducted by the Ecumenical Foundation for the Protection of the Handicapped. The prevalence rates were determined for homozygous and heterozygous hemoglobin S and Sbeta-thalassemia. Blood samples drawn on filter paper were examined by isoelectric focusing (IEF) and high-performance liquid chromatography (HPLC). From January 2002 to December 2004, 548,810 newborns were screened, with the detection of 21 with FS, two FSA/FS, and four FSA. After confirmatory tests at six months of age, 12 were defined as sickle-cell anemia, or a prevalence of 2.2:100,000 newborns; Sbeta-thalassemia was confirmed in 15 (2.7:100,000 newborns); and 8,321 newborns were diagnosed as heterozygous HbS (1,500:100,000 newborns). HbS prevalence in Paraná (in southern Brazil) is lower than in the Central-West, North, and Northeast of the country. Ethnic origin of the population, fetal deaths, and non-random procreation may contribute to the relatively low number of homozygous individuals in the State. Sbeta-thalassemia interaction suggests the presence of Euro-Mediterranean peoples in this population's miscegenation.
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Affiliation(s)
- Alexandra M Watanabe
- Fundação Ecumênica de Proteção ao Excepcional, Avenida Prefeito Lothário Meissner 836, Curitiba, Brazil.
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Daltro GC, Fortuna VA, Araújo MASD, Lessa PIF, Batista Sobrinho UDA, Borojevic R. Tratamento da Osteonecrose da Cabeça Femoral com celulas progenitoras autólogas em anemia falciforme. ACTA ORTOPEDICA BRASILEIRA 2008. [DOI: 10.1590/s1413-78522008000100004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: Avaliação da segurança e eficácia do uso de células progenitoras autólogas da medula óssea (CMMO) no tratamento da Osteonecrose da Cabeça Femoral (OCF) de pacientes portadores de anemia falciforme. MÉTODOS: Foram estudados 8 pacientes portadores de anemia falciforme, com OCF nos estágios I e II (classificação de Ficat e Arlet). As CMMO retiradas da crista ilíaca posterior foram concentradas e reinfundidas na área central da osteonecrose. Os principais parâmetros avaliados foram segurança, sintomas clínicos e progressão da doença, através da avaliação clínica (Harris Hip Score) e radiológica. RESULTADOS: A maior parte dos pacientes (7 em 8) referiu melhora dos sintomas após o tratamento. Não houve complicações durante o procedimento anestésico e cirúrgico. A medida do escore (Harris Hip Score) no pré-operatório foi 78,5 +/- 6,2 pontos, com aumento significativo destes valores no pós-operatório (98,3 +/- 2,5 pontos) (p< 0,001). As avaliações radiográficas e os parâmetros celulares foram favoráveis. CONCLUSÃO: O implante autólogo de CMMO parece ser seguro e eficaz no tratamento dos estágios iniciais da OCF em pacientes falciformes. Embora os resultados iniciais sejam promissores, sua interpretação é limitada pelo número de pacientes avaliados e o período curto de duração do seguimento pós-operatório. Necessita-se estender o grupo em estudo e os parâmetros celulares avaliados.
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Sommer CK, Goldbeck AS, Wagner SC, Castro SM. [Neonatal screening for hemoglobinopathies: a one-year experience in the public health system in Rio Grande do Sul State, Brazil]. CAD SAUDE PUBLICA 2006; 22:1709-14. [PMID: 16832542 DOI: 10.1590/s0102-311x2006000800019] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Hemoglobinopathies are the most common inherited disorders in humans; the most frequent are hemoglobins S and C (Hb S and Hb C). Studies in Brazil show the high prevalence of Hb S and Hb C heterozygotes, indicating the need for diagnosis to allow medical care and suitable genetic counseling. This study evaluates the prevalence of hemoglobin patterns in different areas of Rio Grande do Sul State, Brazil, using neonatal data from the public health system. Blood samples from 117,320 newborns, obtained by heel stick, and 2,389 blood samples from parents of newborns, obtained by venopuncture, were submitted to IEF and HPLC. Among the newborns, 1,629 (1.4%) showed abnormal hemoglobin patterns: 1,342 FAS; 225 FAC; 45 FAD; 2 FSC; 1 FS and 26 variant hemoglobin heterozygotes. We conclude that the methods used are able to identify a broad variety of hemoglobin patterns with high specificity and sensitivity. The information is of paramount importance for transmitting knowledge in the public health field, besides facilitating planning and resource allocation.
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Affiliation(s)
- Camila K Sommer
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
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Almeida ADM, Godinho TM, Teles MS, Rehem APP, Jalil HM, Fukuda TG, Araújo ÊP, Matos EC, Muritiba Júnior DC, Dias CPF, Pimentel HM, Fontes MIMM, Acosta AX. Avaliação do Programa de Triagem Neonatal na Bahia no ano de 2003. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2006. [DOI: 10.1590/s1519-38292006000100010] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJETIVOS: descrever e avaliar o perfil do Programa de Triagem Neonatal baiano em 2003. MÉTODOS: estudo descritivo baseado no banco de dados do Serviço de Referência de Triagem Neonatal baiano com todos os recém-nascidos que realizaram a triagem na rede de coleta do Estado em 2003. RESULTADOS: observou-se implantação do programa em 94,5% dos municípios. A média mensal de testados foi de 13.991 (72,51% dos recém-nascidos registrados). Na coleta, 63,9% das crianças estavam com idade entre oito dias e um mês, 14,5% com até sete dias e 21,6% com mais de um mês. A incidência observada foi de 1:22.000 para fenilcetonúria, 1:4.000 para o hipotireoidismo congênito e 1:650 para as hemoglobinopatias. CONCLUSÕES: o Programa de Triagem Neonatal baiano mostrou, em 2003, dificuldades quanto a cobertura preconizada em 100%; a faixa etária ideal para realização da coleta; ao tempo entre a coleta e a chegada das amostras ao Serviço de Referência em Triagem Neonatal; ao tempo de entrega dos resultados à família; e ao tempo de reconvocação dos casos positivos. Assim, são necessárias algumas melhorias para agilizar esses processos.
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Luz JAD, Sans M, Kimura EM, Albuquerque DM, Sonati MDF, Costa FF. alpha-thalassemia, HbS, and beta-globin gene cluster haplotypes in two Afro-Uruguayan sub-populations from northern and southern Uruguay. Genet Mol Biol 2006. [DOI: 10.1590/s1415-47572006000400002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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