#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Thalassemias and hemoglobin variants in children


Authors: L. Sulovská 1;  M. Divoká 2;  Z. Novák 1;  J. Hak 3;  M. Orviská 2;  D. Pospíšilová 1
Authors‘ workplace: Dětská klinika, Fakultní nemocnice a Lékařská fakulta Univerzity Palackého, Olomouc 1;  Hemato-onkologická klinika, Fakultní nemocnice a Lékařská fakulta Univerzity Palackého, Olomouc 2;  Dětská klinika, Fakultní nemocnice Hradec Králové 3
Published in: Čes-slov Pediat 2017; 72 (8): 464-470.

Věnováno panu profesorovi Hrodkovi, zakladateli moderní dětské hematologie v České republice

Overview

Hemoglobinopathies (thalassemias and structural hemoglobin variants) represent a group of inhereted microcytic anemias that are rarely diagnosed in our country. In most cases, these are individual patients or families, often with a different ethnic origin. Clinical manifestation can be heterogenic - from mild microcytic hypochromic anemia to severe, lifelong, transfusion-dependent anemia with multiorgan involvement. The aim of this work is to present a group of patients diagnosed with some forms of hemoglobinopathy together with characteristics of individual mutation.

Methods:
32 children were examed for suspected hemoglobinopathy between 2007–2017. Complete blood count, iron metabolism parameters and special hematological tests were evaluated. Mutations in HBA and HBB genes were confirmed by molecular genetic testing.

Results:
We diagnosed eight α-thalassemia carriers, one patient with hemoglobin H disease, eighteen patients with β-thalassemia minor, one patient with β-thalassemia major and four patients with hemoglobin variants (HbE, Hb Monroe, Hb Sydney and sickle cell disease).

Conclusion:
Hemoglobinopathies can be exactly diagnosed by molecular genetic testing – MLPA and Sanger sequencing. As a result of global migration, new mutations of globin genes can be imported in Czech population genofond.

Key words:
hemoglobinopathies, thalassemias, structural hemoglobin variants


Sources

1. Divoký V, Indrák K, Mojzíková R. Hemoglobinopatie: talasémie a strukturní Hb varianty. In: Pospíšilová Š, Dvořáková D, Mayer J (Eds). Molekulární hematologie. Praha: Galén, 2013: 270–283.

2. Divoký V, Luhový M, Divoká M, et al. Hemoglobin Haná or alpha 2 beta 2 63 (E7) His-Asn: a new unstable hemoglobin variant with a paradoxically different clinical manifestations in smokers and non-smokers in the same family. Vnitr Lek 1997; 43 (5): 267–272. Czech PubMed PMID: 9601847.

3. Pospíšilová D, Divoký V, Čermák J, et al. Nestabilní hemoglobinové varianty u dětí v České a Slovenské populaci. Čes-slov Pediat 2007; 62 (9): 519–526.

4. Steinberk SM, Mahoney DH, Raby BA. Genetic disorders of hemoglobin oxygen affinity. www.uptodate.com. Last update: Oct 2017.

5. Indrák K, Divoký V, Kynčlová E, et al. Hemoglobin Sydney alfa2beta2 (E11) Val-Ala a hemoglobin Olomouc alfa2beta2 86 (F2) Ala-Asp v českých rodinách. Přínos sekvenační analýzy DNA pro zpřesnění diagnostiky hemoglobinopatií. Vnitr Lék 1998; 44: 347–349.

6. Divoky V, Walczyskova S, Pospisilova D, et al. Rare forms of hereditary anaemia in the Czech and Slovak populations – β- and δβ-thalassaemia and unstable haemoglobin variants. Vnitr Lek 2005; 51: 886–893.

7. Sulovska L, Holub D, Zidova Z, et al. Characterization of iron metabolism and erythropoiesis in erythrocyte membrane defects and thalassemia traits. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2016; 160 (2): 231–237.

8. Divoká M, Partschová M, Pospíšilová D, et al. Alfa-talasémie u 45 českých rodin a 37 rodin cizinců žijících v České republice: přehled literatury a molekulárně-genetická diagnostika. Transfuze Hematol dnes 2016; 22 (3): 201–209.

9. Indrák K, Brabec V, Divoký V, et al. Structural variants in hemoglobin occurring in the Czech Republic. Vnitr Lek 1995; 41 (1): 13–20.

10. Benz EJ, Schrier SL Landaw SA. Clinical manifestation and diagnosis of the talassemias. www.uptodate.com. Last updated: Oct 2017.

11. Jones E, Pasricha SR, Allen A, et al. Hepcidin is suppressed by erythropoiesis in hemoglobin E β-thalassemia and β-thalassemia trait. Blood 2015; 125 (5): 873–880.

12. Guimarães JS, Cominal JG, Silva-Pinto AC, et al. Altered erythropoiesis and iron metabolism in carriers of thalassemia. Eur J Haematol 2015; 94 (6): 511–518.

Labels
Neonatology Paediatrics General practitioner for children and adolescents
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#