Coinheritance of HbO Arab/ß0-thalassemia with Severe Manifestation in Newborn.

OBJECTIVE: In this study, we report a Tunisian newborn boy referred for neonatal hemolytic anemia with yellowish skin and enlarged spleen due to coinheritance of hemoglobin O (HbO) Arab and ß-thalassemia. STUDY DESIGN: Hematological parameters were collected using an automated blood cell counter. The amounts of Hb fractions were measured by capillary electrophoresis of Hb. Amplification and sequencing of the HBB gene were performed by Sanger's method. RESULTS: Family study and genetic analysis revealed that the proband was a carrier of two hemoglobinopathies: HbO Arab and ß0-thalassemia. CONCLUSION: The coexistence of these two pathologies complicated the general state of the newborn boy and led to a severe anemia at birth. KEY POINTS: · Severe neonatal anemia can be caused by hemoglobinopathy.. · Coinheritance of HbO Arab/ß0-thalassemia complicated the general state of the newborn.. · Diagnosing hemoglobinopathy at an early age improves patient care..

A new δ chain variant, Hb A2-Tunis [δ46(CD5)Gly → Glu; HBD: c.140G>A], observed in a Tunisian family in association with a compound heterozygosity for Hb C [ß6(A3)Glu → Lys; HBB: c.19G>A] ß(0)-thalassemia [IVS-I-1 (ß143, G>A); HBB: c.92+1G>A].

We describe a new δ-globin variant, Hb A2-Tunis [δ46(CD5)Gly → Glu; HBD: c.140G>A]. This hemoglobin (Hb) variant displayed a faster electrophoretic mobility than normal Hb A2 and was expressed at 3.2%. The molecular defect was characterized by DNA sequencing analysis. Hb A2-Tunis was found in a carrier of a ß(0)-thalassemia (ß(0)-thal) [IVS I-1 (ß143, G>A); HBB: c.92 + 1G>A] and Hb C [ß6(A3)Glu → Lys; HBB: c.19G>A], presenting with a normal Hb A2 level. Phenotype and genotype investigations revealed that the patient has a total Hb A2 level of 7.1% that was expected for a ß-thalassemia (ß-thal) minor carrier.