Hb Bart's Hydrops Fetalis Syndrome and Hb H Disease Caused by Deletional Chiang Rai (- -) α-Thalassemia in Two Unrelated Thai Families.

α-Thalassemia (α-thal) Chiang Rai (- -; NC_000016.10: g.144215_188843del) was identified as a novel 44.6 kb deletional type of α-thalassemia (α-thal), removing all α-like globin genes. However, little is known about the deleterious effects of this genetic disorder, particularly when it is combined with other types of thalassemia. We performed molecular analysis of the - - deletion using gap-polymerase chain reaction (gap-PCR) in two independent families residing in Phayao and Chiang Mai, Thailand, with an unknown causative mutation for Hb Bart's hydrops fetalis syndrome and Hb H disease. Five out of seven individuals were diagnosed to be heterozygous for the - - deletion. Of these, two also carried Hb H disease with compound heterozygosities for - - and -α (rightward) deletions. However, hematological parameters of the - - carriers displayed microcytic hypochromic anemia that is comparable to other α-thal traits. Although the prevalence of - - has never been elucidated in a specific population, our study demonstrated that genotyping for - - might be considered as an additional investigation for unexplained Hb Bart's hydrops fetal syndrome and Hb H disease.