A case of concomitant Gilbert's syndrome and hereditary spherocytosis / 대한간학회지

We describe moderate hyperbilirubinemia in a 28-year-old man who suffered from gallstones and splenomegaly, with combined disorders of hereditary spherocytosis (HS) and Gilbert's syndrome (GS). Since it is difficult to diagnose HS in the absence of signs of anemia, we evaluated both the genetic mutation in the UGT1A1 gene and abnormalities in the erythrocyte membrane protein; the former was heterozygous for a UGT1A1 allele with three mutations and the latter was partially deficient in ankyrin expression. This is the first report of the concomitance of HS and GS with three heterozygous mutations [T-3279G, A (TA)7TAA, and G211A] in the UGT1A1 gene.

Andálisis de los polimorfismos G199A, NcoI del gen ANK1 y Memphis I del gen SLC4A1 en individuos sanos y pacientes mexicanos con esferocitosis hereditaria / Polymorphism analysis of G199A, Ncol in ANK1 and Memphis I in SLC4A1 genes in Mexican healthy individuals and subjects affected with hereditary spherocytosis

Antecedentes. En México la esferocitosis hereditaria (EH) es la causa principal de anemia hemolítica hereditaria y se debe a mutaciones en uno o más genes implicados en la membrana eritrocitaria, lo que dificulta la identificación del gen primario. Objetivo. Con el fin de valorar la utilización de los polimorfismos G199A y NcoI del gen ANK1, y Memphis I del gen SLC4A1 como marcadores genéticos para identificar esta enfermedad, estimamos sus frecuencias alélicas y genotípicas en 45 muestras de ADN de pacientes con EH y 28 de individuos sanos, las cuales fueron similares en uno y otro grupos para los polimorfismos G199A y Memphis I, con baja frecuencia de heterocigotos, lo que limita su utilidad como marcador genético. Resultados. El polimorfismo NcoI no mostró diferencias alélicas y genotípicas en los grupos de estudio, pero sí mayor frecuencia de heterocigotos (0.49 y 0.43 en enfermos y sanos respectivamente), característica que le confiere ventajas para ser utilizado como marcador genético en familias con EH. Conclusiones. Finalmente, debido a que existen otros genes implicados en la patología molecular de la EH, consideramos que es necesario analizar otros polimorfismos de genes que codifican para las proteínas involucradas en las deficiencias que conducen a esferocitosis hereditaria en la población mexicana.

BACKGROUND: In Mexico, Hereditary Spherocytosis (HS) is the main cause of hereditary hemolytic anemia, due to mutations of one or more genes involved in the erythrocyte membrane, making it difficult to identify the primary gene. OBJECTIVE: With the purpose of estimating the use of the polymorphisms G199A and NcoI of ANK1 gene, and Memphis I of SLC4A1 gene, as genetic markers to screen this disease, we searched the allelic and genotypic frequencies in 45 DNA samples of HS patients and 28 from healthy individuals. RESULTS: Allelic and genotypic frequencies were similar in both studied groups for the G199A and Memphis I polymorphisms, with low frequency of heterozygosis showing its limited use as a genetic marker. The allelic and genotypic frequencies of the NcoI polymorphism were also similar in both groups, however a higher heterozygote frequency was observed (0.49 and 0.43 in patients and healthy individuals), a feature that may turn it into a useful genetic marker. CONCLUSIONS: Since there are other genes implicated in the molecular pathology of the HS, we consider it necessary to continue analyzing other polymorphisms of the genes involved in Hereditary Spherocytosis among the Mexican population.