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新变体血红蛋白不稳定性特征的重要性:Hb Dompierre [β29(B11)Gly→Arg, : c.88G>C] 案例。

The Importance of Characterizing the Hemoglobin Instability of New Variants: The Case of Hb Dompierre [β29(B11)Gly→Arg, : c.88G>C].

机构信息

Department of Biological Hematology, CHU Montpellier, Montpellier, France.

Department of Clinical Hematology, CHU Clermont-Ferrand, Clermont-Ferrand, France.

出版信息

Hemoglobin. 2020 Jan;44(1):13-16. doi: 10.1080/03630269.2020.1721021. Epub 2020 Feb 3.

DOI:10.1080/03630269.2020.1721021
PMID:32008383
Abstract

Hb Dompierre [β29(B11)Gly→Arg, : c.88G>C] is a rare β-globin gene variant that was previously described in the heterozygous state in a 24-year-old female patient. It is defined in the HbVar database as being clinically and biologically asymptomatic. A few years after the first description, we had an opportunity of reassessing the index case because she presented with splenomegaly and clinical and biological manifestations of hemolysis. After ruling out the most common causes of hemolysis, further analyses on the variant hemoglobin (Hb) using brilliant cresyl blue staining, indicated that it showed mild instability, which may explain the clinical and biological manifestations. A structural bioinformatic analysis on the Hb variant suggested that the amino acid replacement may be deleterious to the integrity of the Hb. This report confirms the importance of completely characterizing all new Hb variants in order to guide the patients' clinical management and follow-up, as well as to provide the probands and their family members with appropriate genetic counseling.

摘要

Hb Dompierre [β29(B11)Gly→Arg, : c.88G>C] 是一种罕见的β-珠蛋白基因突变,此前在一位 24 岁女性的杂合子状态下被描述过。它在 HbVar 数据库中被定义为临床和生物学上无症状。在首次描述后的几年,我们有机会重新评估该索引病例,因为她出现了脾肿大和溶血性的临床及生物学表现。在排除了最常见的溶血原因后,使用灿烂甲酚蓝染色对变异血红蛋白 (Hb) 进行进一步分析,表明其表现出轻度不稳定性,这可能解释了临床和生物学表现。对 Hb 变异体的结构生物信息学分析表明,氨基酸替换可能对 Hb 的完整性有害。本报告证实了完全描述所有新的 Hb 变异体的重要性,以便指导患者的临床管理和随访,并为先证者及其家属提供适当的遗传咨询。

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