Hematological and Molecular Characterization of a Novel Hb A2 Variant with Homozygous α-Thalassemia-2 in a Southern Thai Individual

Hemoglobin. 2017 May;41(3):213-215. doi: 10.1080/03630269.2017.1345760. Epub 2017 Aug 10.

Abstract

We report here the hematological and molecular features of a novel δ-globin chain variant found in a Southern Thai woman. Her complete blood count was as follows: red blood cell (RBC) count 5.90 × 1012/L, hemoglobin concentration (Hb) 12.6 g/dL, packed cell volume (PCV) 0.41 L/L, mean corpuscular volume (MCV) 69.5 fL, mean corpuscular Hb (MCH) 21.4 pg, mean corpuscular Hb concentration (MCHC) 30.7 g/dL and RBC distribution width (RDW) 13.1%. The blood smear demonstrated microcytic hypochromic RBCs suggestive of thalassemia trait. Hemoglobin analysis identified Hb A2 + Hb A2-Kiriwong (2.4%) and Hb F (0.1%) on high performance liquid chromatography (HPLC). To characterize the α-thalassemia (α-thal) genotype, common α-thal-1 and α-thal-2 alleles were characterized by multiplex gap-polymerase chain reaction (gap-PCR). The results revealed homozygous α-thal-2 (-α3.7/-α3.7) in this case. DNA sequencing showed the presence of a novel δ-globin gene mutation [δ77(EF1)His→Arg; HBD: c.233A>G] that we named Hb A2-Kiriwong for the village from where the proband lived. In summary, the presence of microcytic hypochromic RBCs in this case was likely the result of the homozygous -α3.7 (rightward) deletion and was not affected by this Hb A2 variant.

Keywords: Hb A2 variant; Southern Thai population; novel δ-globin gene mutation.

Publication types

  • Case Reports

MeSH terms

  • Chromatography, High Pressure Liquid
  • DNA Mutational Analysis
  • Hemoglobin A2 / chemistry
  • Hemoglobin A2 / genetics*
  • Homozygote*
  • Humans
  • Mutation*
  • Phenotype*
  • Thailand
  • alpha-Thalassemia / blood*
  • alpha-Thalassemia / diagnosis
  • alpha-Thalassemia / genetics*
  • delta-Globins / genetics*

Substances

  • delta-Globins
  • Hemoglobin A2