罕见β-珠蛋白基因Codon 24(GGT>GGA)突变导致β-地中海贫血1例及文献分析

Rare β-globin gene Codon 24 (GGT>GGA) mutation causing β-thalassemia: a case report and literature analysis

  • 摘要: 目的:分析罕见β-珠蛋白基因突变类型、血液学及临床特征。方法:收集疑为β-地中海贫血的病例120例。对病例进行全血细胞分类及计数、血红蛋白(Hb)电泳分析检测。用跨越断裂点PCR方法、荧光PCR熔解曲线方法、DNA测序等分析α-和β-珠蛋白基因突变类型。结果:120例β-地中海贫血病例中, 检出1例为罕见β-珠蛋白基因突变,基因分析为Codon 24(GGT> GGA,HBB:c.75T> A)杂合子。该病例为男性,39岁,血常规检测显示:Hb 127.3 g/L,血红细胞(RBC)5.81×1012/L,红细胞平均体积(MCV)70.29 fL,红细胞平均血红蛋白量(MCH)21.94 pg,红细胞平均血红蛋白浓度(MCHC)312.10 g/L。Hb 分析显示Hb A2 4.5%,Hb F 0.4%。α-地中海贫血基因分析未发现常见的基因突变类型。结论:首次在国内发现罕见β-珠蛋白基因Codon 24(GGT> GGA,HBB:c.75T> A)突变导致β-地中海贫血。该病例在临床上易漏诊,应引起重视。

     

    Abstract: Objective: To study the mutation types, hematological characteristics and clinical manifestations of rare β-globin gene. Methods: A total of 120 suspected cases of β-thalassemia were collected. The whole blood cells were classified and counted, and hemoglobin (Hb) was analyzed by electrophoresis for all the cases.The mutation types of α-and β-globin genes were analyzed by cross break point PCR, fluorescence PCR melting curve analysis and DNA sequencing. Results: A total of 120 cases of β-thalassemia were detected, of which 1 case was a rare mutation of β-globin gene, and the genotype was Codon 24 (GGT> GGA, HBB:c.75T> A) heterozygote. The case was a 39-year-old male, and the routine blood test showed the following results:Hb 127.3 g/L, red blood cell (RBC) 5.81x1012/L, mean corpuscular volume (MCV) 70.29 fL, mean corpuscular haemoglobin (MCH) 21.94 pg and mean corpuscular hemoglobin concentration (MCHC) 312.10 g/L. Hb analysis showed that Hb A2 was 4.5% and Hb F was 0.4%.The α-thalassemia genetic analysis did not identify common types of mutations. Conclusion: The rare β-globin gene Codon 24 (GGT> GGA, HBB:c.75T> A) mutation causing β-thalassemia is found in China for the first time. This type of case is clinically prone to misdiagnosis and should be given more attention.

     

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