Delta-beta thalassemia

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Delta-beta thalassemia
Delta Beta Thalassemia.jpg
Delta-beta thalassemia
Specialty Hematology   OOjs UI icon edit-ltr-progressive.svg
CausesProduces only gamma-globin and forms HbF(deletes entire delta and beta gene sequence) [1]
Diagnostic method High-performance liquid chromatography
TreatmentBlood transfusions [2]

Delta-beta thalassemia is a rare form of thalassemia in which there is a reduced production of hemoglobin subunit delta and hemoglobin subunit beta and raised levels of hemoglobin subunit gamma. It is an autosomal recessive disorder. [1] [3]

Contents

Signs and symptoms

An individual with delta-beta thalassemia is usually asymptomatic, however microcytosis can occur where the red blood cells are abnormally small. [1] [4]

Mechanism

Structure of hemoglobin the proteins a and b subunits are in red and blue, 1GZX Haemoglobin.png
Structure of hemoglobin the proteins α and β subunits are in red and blue,

Delta-beta thalassemia is autosomal recessive disorder, [1] which means both parents are affected and two copies of the gene must be present. [5] A carrier gets a normal gene to produce hemoglobin A, from one parent and the other parent supplies a gene which makes no hemoglobin A. [6] Delta-beta thalassemia is considered rare. [2]

Delta-beta-thalassemia is caused by deletions of the entire delta and beta genes sequences and only gamma-globin and HbF are formed. Rarely, non-deletional forms have been reported. [7] [8]

When two delta0 mutations are inherited, no hemoglobin A2 (alpha2, delta2) are formed. This is innocuous because only 2-3% of normal adult hemoglobin is hemoglobin A2. The individual will have normal hematological parameters (erythrocyte count, total hemoglobin, mean corpuscular volume).[ medical citation needed ] The delta-beta thalassemia demonstrates one mutation is at the +69 position. [9]

Relation to beta thalassemia

Delta-beta thalassemia can mask the diagnosis of beta thalassemia trait. In beta thalassemia, an increase in hemoglobin A2 results, but the co-existence of a delta-beta thalassemia mutation will decrease the value of the hemoglobin A2 into the normal range, thereby obscuring the diagnosis of beta thalassemia trait [10]

Diagnosis

Following the detection of hypochromic microcytic red blood cells, delta-beta thalassemia is confirmed by high-performance liquid chromatography. [11]

Treatment

When needed, treatment for anemia, such as blood transfusions are used. [2]

Stem cell transplant is another option, but the donor and the individual who will receive the bone marrow transplant must be compatible, the risks involved should be evaluated. [2] [12] [13]

See also

Related Research Articles

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Thalassemias are inherited blood disorders that result in abnormal hemoglobin. Symptoms depend on the type of thalassemia and can vary from none to severe. Often there is mild to severe anemia as thalassemia can affect the production of red blood cells and also affect how long the red blood cells live. Symptoms of anemia include feeling tired and having pale skin. Other symptoms of thalassemia include bone problems, an enlarged spleen, yellowish skin, pulmonary hypertension, and dark urine. Slow growth may occur in children. Symptoms and presentations of thalassemia can change over time. Older terms included Cooley's anemia and Mediterranean anemia for beta-thalassemia. These have been superseded by the terms Transfusion-Dependent Thalassemia (TDT) and non-Transfusion-Dependent Thalassemia (NTDT). Patients with TDT require regular transfusions, typically every two to five weeks. TDTs include Beta-thalassemia major, nondeletional HbH disease, survived Hb Bart's disease, and severe HbE/beta-thalassemia.

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<span class="mw-page-title-main">Hemoglobin subunit alpha</span> Human hemoglobin protein

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<span class="mw-page-title-main">HBD</span> Mammalian protein found in Homo sapiens

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<span class="mw-page-title-main">HBG1</span>

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<span class="mw-page-title-main">Hemoglobin E</span> Medical condition

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<span class="mw-page-title-main">Hemoglobin Lepore syndrome</span> Medical condition

Hemoglobin Lepore syndrome is typically an asymptomatic hemoglobinopathy, which is caused by an autosomal recessive genetic mutation. The Hb Lepore variant, consisting of two normal alpha globin chains (HBA) and two delta-beta globin fusion chains which occurs due to a "crossover" between the delta (HBD) and beta globin (HBB) gene loci during meiosis and was first identified in the Lepore family, an Italian-American family, in 1958. There are three varieties of Hb Lepore, Washington, Baltimore and Hollandia. All three varieties show similar electrophoretic and chromatographic properties and hematological findings bear close resemblance to those of the beta-thalassemia trait; a blood disorder that reduces the production of the iron-containing protein hemoglobin which carries oxygen to cells and which may cause anemia.

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References

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  11. Ahmad SQ, Zafar SI, Malik HS, Ahmed S (November 2017). "Delta-Beta Thalassaemia in a Pathan Family". Journal of the College of Physicians and Surgeons (Pakistan). 27 (11): 722–724. PMID   29132487.
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  13. "Risks". nhs.uk. Retrieved 2018-04-28.

Further reading