Fucharoen Supan, Pengjam Yutthana, Surapot Satja, Fucharoen Goonnapa, Sanchaisuriya Kanokwan
Department of Clinical Chemistry, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand.
Am J Hematol. 2002 Oct;71(2):109-13. doi: 10.1002/ajh.10202.
The hereditary persistence of fetal hemoglobin (HPFH)-6 is sporadically found in Thailand whereas the deletion-inversion type (G)gamma((A)gamma delta beta)(0)-thalassemia is described among Indians. We report a hitherto un-described case in which these two defects co-segregate. He was a 3-year-old Thai boy who had a feature of thalassemia intermedia phenotype with the following hematologic data; Hb 8.8 g/dL, Hct 29.2%, MCV 66.9 fL, MCH 20 pg, and MCHC 30.1 g/dL. Hemoglobin analysis revealed 100% Hb F with only (G)gamma-globin chain. Globin gene analyses demonstrated that he carried the HPFH-6 deletion in trans to the Indian deletion-inversion (G)gamma((A)gamma delta beta)(0)-thalassemia. Hematologic data of the patient was compared to those of the HPFH-6 heterozygote found in his father, to (G)gamma((A)gamma delta beta)(0)-thalassemia heterozygotes detected in his mother and sister, and to that of an unrelated Thai patient who was a compound heterozygote for the deletion-inversion (G)gamma((A)gamma delta beta)(0)-thalassemia and HbE.
胎儿血红蛋白遗传性持续存在(HPFH)-6在泰国偶有发现,而缺失-倒位型(G)γ((A)γδβ)(0)-地中海贫血在印度人中被描述。我们报告了一个迄今未被描述的病例,其中这两种缺陷共同分离。他是一名3岁的泰国男孩,具有中间型地中海贫血的表型特征,其血液学数据如下:血红蛋白8.8 g/dL,血细胞比容29.2%,平均红细胞体积66.9 fL,平均红细胞血红蛋白含量20 pg,平均红细胞血红蛋白浓度30.1 g/dL。血红蛋白分析显示100%为Hb F,仅含(G)γ-珠蛋白链。珠蛋白基因分析表明,他携带的HPFH-6缺失与印度缺失-倒位型(G)γ((A)γδβ)(0)-地中海贫血呈反式。将该患者的血液学数据与在其父亲中发现的HPFH-6杂合子、在其母亲和妹妹中检测到的(G)γ((A)γδβ)(0)-地中海贫血杂合子以及一名无关的泰国患者(该患者是缺失-倒位型(G)γ((A)γδβ)(0)-地中海贫血和HbE的复合杂合子)的数据进行了比较。