Hemoglobinopathy

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Hemoglobinopathy Main page

Overview

Classification

Epidemiology and Demographics

Diagnostic approach

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sogand Goudarzi, MD [2]


Overview

Hemoglobinopathy is a kind of genetic defect that results in abnormal structure of one of the globin chains of the hemoglobin molecule. Most common hemoglobinopathies include sickle-cell disease.The renge of clinical manifestations of the hemoglobinopathies are from mild hypochromic anemia to moderate hematological disease to severe.


Classification

Hemoglobinopathy be classified according to genetic and structure of hemoglobin into two main groups:

  • Thalassemia syndromes
    • α-thalassemia
    • β-thalassemia
  • Structural hemoglobin variants
    • HbS
    • HbE
    • HbC
    • Hb Bart’s
    • Hb J(Johnstown)
    • HbM
    • HbX
    • HbD

The renge of clinical manifestations of the hemoglobinopathies are from mild hypochromic anemia to moderate hematological disease to severe

Differentiating between Hemoglobinopathies

 
 
 
 
 
 
 
Hemoglobinopathy
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Quantititive disorders of globin chain synthesis
 
 
 
 
 
 
 
qualitativ disorders of globin structyre
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Diagnosis of abnormal hemoglobin
 
 
 
 
Diagnosis of β-thalassemia
 
 
 
 
Diagnosis of α-thalassemia
Gene type Red blood cell (RBC) count g/dl Hemoglobin pattern Differentiating Symptoms
Hemoglobin g/dl MCH /pg
Alpha Thalassemia -+/++ Normal Normal Normal None
-+/-+

--/++

Normal or low <26 Normal Mild anemia
--/-+ 8 to 10 <22 HbH 10 to 20% Chronic hemolytic anemia
Hb Bart’s hydrops fetalis

--/--

<6 <20 Hb Bart’s 80 to 90%,

Hb Portland 10 to 20%,

HbH <1%

Life-threatening fetal anemia
Beta Thalessemia &β/++
&β/-+
&β/--
Sickle cell Disease
HBC

Epidemiology and Demographics

Incidence

  • The incidence/prevalence of [disease name] is approximately [number range] per 100,000 individuals worldwide.
  • In [year], the incidence/prevalence of [disease name] was estimated to be [number range] cases per 100,000 individuals worldwide.[1]

Prevalence

  • In 2008, the prevalence of hemoglobinopathy was estimated to be 7% of the worldwide population being carrier.[1]
  • The most prevalance of hemoglobinopathy gene carriers in the world's are in South-East Asia(up to 70%) and Arab nations(up to 60).[1]
  • In Russia is seen rare[1]
  • Recent years is increased in Germany.[2]

Race

α-thalassemias

It occure cur mainly in Africa, Arab nations, and, more frequently and South-East Asia.

β-thalassemias

It occure cur mainly in Mediterranean countries, South-East Europe, Arab nations and Asia.

Diagnosis

Hemoglobin testing(hemoglobin electrophoresi or chromatography) , red blood cell count, hemoglobin pattern, cardinal symptoms[3]

 
 
 
Hemoglobinopathy
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
History & clinical symptoms
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Hemolystate
 
 
 
 
 
Blood count, including RBC morphology
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Diagnosis of abnormal hemoglobin
 
 
 
 
Diagnosis of β-thalassemia
 
 
 
 
Diagnosis of α-thalassemia

References

  1. 1.0 1.1 1.2 1.3 Kohne E (August 2011). "Hemoglobinopathies: clinical manifestations, diagnosis, and treatment". Dtsch Arztebl Int. 108 (31–32): 532–40. doi:10.3238/arztebl.2011.0532. PMC 3163784. PMID 21886666.
  2. Cario H, Stahnke K, Sander S, Kohne E (January 2000). "Epidemiological situation and treatment of patients with thalassemia major in Germany: results of the German multicenter beta-thalassemia study". Ann. Hematol. 79 (1): 7–12. PMID 10663615.
  3. Herklotz R, Risch L, Huber AR (January 2006). "[Hemoglobinopathies--clinical symptoms and diagnosis of thalassemia and abnormal hemoglobins]". Ther Umsch (in German). 63 (1): 35–46. doi:10.1024/0040-5930.63.1.35. PMID 16450733.


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