Division of Hematology/Oncology, Department of Pediatrics, Children's Hospital at Montefiore, Albert Einstein College of Medicine, New York, NY.
Neoreviews. 2024 Nov 1;25(11):e720-e728. doi: 10.1542/neo.25-11-e720.
Hemoglobinopathies in neonates constitute a group of disorders influenced by genetic mutations in the human globin genes. They are often broadly categorized into quantitative defects or qualitative defects, though they are not mutually exclusive. In quantitative defects, the mutation causes insufficient production of a normal globin chain, which can range from no production to mild deficiency. These are typically referred to as thalassemias. In qualitative defects, the structure of the hemoglobin is altered. The most common structural hemoglobinopathy is sickle cell disease. During fetal development, distinct globin chains are synthesized, which undergo a progressive switch to adult globin chains perinatally. This affects the timing of the clinical presentation of these disorders and thus, our ability to diagnose them. In this review, we focus on the epidemiology, genetic causes, clinical presentation, and general overview and management of common hemoglobin disorders that may be encountered in the neonatal period.
新生儿血红蛋白病是一组受人类珠蛋白基因突变影响的疾病。它们通常被广泛分为数量缺陷或质量缺陷,尽管它们不是相互排斥的。在数量缺陷中,突变导致正常珠蛋白链的产生不足,其范围从无产生到轻度缺乏。这些通常被称为地中海贫血。在质量缺陷中,血红蛋白的结构发生改变。最常见的结构性血红蛋白病是镰状细胞病。在胎儿发育过程中,合成了不同的珠蛋白链,这些珠蛋白链在围产期逐渐向成人珠蛋白链转换。这会影响这些疾病的临床表现时间,从而影响我们的诊断能力。在这篇综述中,我们重点介绍了在新生儿期可能遇到的常见血红蛋白疾病的流行病学、遗传原因、临床表现以及概述和管理。