Rashid Arsala, Tabassum Shehroze, Naeem Aroma, Naveed Asif, Iqbal Haris, Tabassum Shehram, Rafiq Humera
King Edward Medical University, Pakistan.
University of Health Sciences, Pakistan.
Ann Med Surg (Lond). 2022 Nov 17;84:104918. doi: 10.1016/j.amsu.2022.104918. eCollection 2022 Dec.
Thalassemia is a genetically complex disorder that evolves from a mutation in the beta chain of hemoglobin. Much work has been done on the common mutations, but some rare mutations have been found that impact and diversify the disease spectrum.
Our case report is on a young adult who presented with anemia, gall stones, and off-and-on transfusion dependency. A detailed workup revealed that the patient was suffering from thalassemia intermedia. The interesting finding was that the patient, product of non-consanguineous marriage was homozygous for beta thalassemia mutation on genetic analysis. A detailed genetic analysis of the parents revealed them as carriers for the same mutation. It was found that patient was homozygous for a rare and novel mutation -88(C > A)[HBB:c.-138C > A] on whole gene sequencing.
The area of genomics in thalassemia is rapidly growing, and our case report aims to update the current knowledge of thalassemia's genomic information in Pakistan. The mutation found in our patient was -88(C > A)[HBB:c.-138C > A], and the data provided by the National Library of Medicine for this mutation as Allele ID: 380597 and variant type of single nucleotide variant shows that only ten such cases exist in the world with this rare mutation. Our case would be the 11th case in the world and 1st in Pakistan according to the literature, reporting above mentioned mutation.
Further translational study is required to accurately utilize genomic data as an instrument of precision treatment in thalassemia patients, especially in underdeveloped countries like Pakistan.
地中海贫血是一种由血红蛋白β链突变引发的基因复杂疾病。关于常见突变已开展了大量研究,但也发现了一些影响疾病谱并使其多样化的罕见突变。
我们的病例报告涉及一名年轻成年人,其表现为贫血、胆结石以及间歇性输血依赖。详细检查显示该患者患有中间型地中海贫血。有趣的是,基因分析表明,这名非近亲结婚的患者β地中海贫血突变呈纯合状态。对其父母的详细基因分析显示他们是同一突变的携带者。全基因测序发现该患者为一种罕见的新型突变-88(C>A)[HBB:c.-138C>A]的纯合子。
地中海贫血的基因组学领域发展迅速,我们的病例报告旨在更新巴基斯坦地中海贫血基因组信息的现有知识。我们患者中发现的突变是-88(C>A)[HBB:c.-138C>A],美国国立医学图书馆提供的该突变数据,等位基因ID为380597,单核苷酸变异类型表明世界上仅有十例此类罕见突变病例。根据文献,我们的病例将是世界上第11例、巴基斯坦第1例报告上述突变的病例。
需要进一步开展转化研究,以便准确利用基因组数据作为地中海贫血患者精准治疗的工具,尤其是在像巴基斯坦这样的欠发达国家。