Clinical Chemistry Laboratory, University Hospital of Nice, Nice, France
Medical School, University of Côte d'Azur, Nice, France.
J Clin Pathol. 2019 Jul;72(7):501-505. doi: 10.1136/jclinpath-2018-205616. Epub 2019 Apr 2.
Normal haemoglobin is a tetramer molecule, consisting of two α and β haemoglobin chains. Haemoglobinopathies occur when abnormalities in these proteins are present. More than 1000 naturally occurring human haemoglobin variants with single amino acid substitution throughout the molecule have been identified and can be discovered through their clinical and biological manifestations. Here, we report the case of a 60-year-old woman for whom no oximetry results were obtained during blood gas analysis (BGA) and the values of oxygen saturation obtained from pulse oximetry (73%) and co-oximetry (90%) differed. Haemoglobin analysis demonstrated the presence of a variant in the alpha chain. Clinical history of the patient and her family revealed they carry a haemoglobin variant (Titusville type), thus representing the first French family case reported. Those results raised the question whether the presence of this variant could be the cause of the errors encountered during BGA.
正常血红蛋白是由两个α和β血红蛋白链组成的四聚体分子。当这些蛋白质存在异常时,就会发生血红蛋白病。在整个分子中,已经发现了超过 1000 种天然存在的人类血红蛋白变体,它们具有单个氨基酸取代,可以通过其临床和生物学表现来发现。在这里,我们报告了一例 60 岁女性的病例,在血气分析(BGA)期间无法获得血氧饱和度结果,并且从脉搏血氧饱和度(73%)和比色法(90%)获得的氧饱和度值不同。血红蛋白分析显示α链中存在变体。患者及其家人的临床病史表明他们携带血红蛋白变体(Titusville 型),因此代表了第一个法国家族病例。这些结果提出了这样一个问题,即这种变体的存在是否可能是 BGA 期间出现错误的原因。