Li Xiaohong, Liao Lin, Deng Xuelian, Huang Jian, Deng Zengfu, Wei Hongying, Mo Wuning, Lin Faquan
Department of Clinical Laboratory, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region 530021, P.R. China.
Department of Clinical Laboratory, First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine, Nanning, Guangxi Zhuang Autonomous Region 530021, P.R. China.
Exp Ther Med. 2018 Feb;15(2):1298-1303. doi: 10.3892/etm.2017.5579. Epub 2017 Nov 28.
A family of four from the Guangxi Zhuang Autonomous Region of China, including a child with α-thalassaemia and hereditary spherocytosis (HS), underwent laboratory identification, and genetic analysis. After harvesting peripheral blood samples from the child patient and his family members, GAP-polymerase chain reaction (PCR) and reverse dot-blot tests were used to identify thalassaemia genotypes. After amplifying exons and the adjacent introns of solute carrier family 4 member 1 (Diego blood group) (SLC4A1), ankyrin 1, spectrin α erythrocytic 1, spectrin β erythrocytic and erythrocyte membrane protein band 4.2 by PCR, DNA sequencing was utilised to detect gene mutations of HS. The thalassaemia gene of the child patient was -α/αα and identical to the genotype of his mother. DNA testing of HS identified two mutation sites on the gene: Exon 3 c.113A>C (Asp 38 Ala) and intron 7 c.609+86G>A. The father and older sister of the patient also had the same mutations. Due to the mutual interference with disorders of haemoglobin synthesis and erythrocyte membrane defects of laboratory results, it is difficult to diagnose HS when it coexists with thalassaemia. When clinical manifestations and laboratory results cannot be explained by a single haemolytic anaemia, the possibility of combining with another haemolytic anaemia should be considered. Thus, it is necessary to perform pedigree investigation and genetic analyses for a final diagnosis.
来自中国广西壮族自治区的一个四口之家,包括一名患有α地中海贫血和遗传性球形红细胞增多症(HS)的儿童,接受了实验室鉴定和基因分析。在采集患儿及其家庭成员的外周血样本后,采用缺口聚合酶链反应(PCR)和反向点杂交试验鉴定地中海贫血基因型。通过PCR扩增溶质载体家族4成员1(迭戈血型)(SLC4A1)、锚蛋白1、血影蛋白α红细胞1、血影蛋白β红细胞和红细胞膜蛋白带4.2的外显子及相邻内含子后,利用DNA测序检测HS的基因突变。患儿的地中海贫血基因是-α/αα,与他母亲的基因型相同。HS的DNA检测在该基因上鉴定出两个突变位点:外显子3 c.113A>C(Asp 38 Ala)和内含子7 c.609+86G>A。患儿的父亲和姐姐也有相同的突变。由于血红蛋白合成障碍和红细胞膜缺陷对实验室结果相互干扰,HS与地中海贫血共存时难以诊断。当临床表现和实验室结果不能用单一的溶血性贫血解释时,应考虑合并另一种溶血性贫血的可能性。因此,有必要进行家系调查和基因分析以做出最终诊断。