罕见β-珠蛋白基因poly A(AATAAA>AATAGA)突变导致β-地中海贫血

Rare β-globin gene poly A (AATAAA>AATAGA) mutation causes β-thalassemia

  • 摘要: 目的: 分析罕见β-珠蛋白基因poly A(AATAAA>AATAGA)突变导致β-地中海贫血,为临床诊疗提供依据。方法: 收集2023年10月至2024年12月在广西医科大学第一附属医院进行地中海贫血筛查和诊断的患者,对患者进行血常规及血红蛋白(Hb)分析。应用荧光PCR熔解曲线法(FCMA)检测β-地中海贫血常见基因突变类型。应用Sanger测序技术检测未知或罕见的β-地中海贫血基因突变类型。结果: 共检出282例β-地中海贫血杂合子病例,其中2例为罕见的β-珠蛋白基因poly A(AATAAA>AATAGA,HBB:c.+112 A>G)突变;血常规结果显示,Hb为130.00~135.00 g/L,平均红细胞体积(MCV)为61.90~65.90 fL,平均红细胞血红蛋白含量(MCH)为19.20~21.70 pg,平均红细胞血红蛋白浓度(MCHC)为311.00~329.00 g/L,血细胞比容(HCT)为0.41~0.42 L/L,其中MCV和MCH水平降低。Hb分析结果显示,Hb A2水平升高,为4.6%~4.9%。当合并其它β-地中海贫血时,临床上有轻度至中度贫血。结论: 首次在国内发现罕见β-珠蛋白基因poly A(AATAAA>AATAGA)突变,该突变可导致β+-地中海贫血,需在临床诊疗、遗传咨询和产前诊断中加以重视。

     

    Abstract: Objective: To analyze the rare β-globin gene poly A (AATAAA>AATAGA) mutation that causes β -thalassemia, and provide a basis for clinical diagnosis and treatment. Methods: Patients undergoing thalassemia screening and diagnosis at the First Affiliated Hospital of Guangxi Medical University from October 2023 to December 2024 were collected. Blood routine and hemoglobin (Hb) analyses were performed on these patients. The fluorescence PCR melting curve assay (FCMA) was applied to detect common β -thalassemia gene mutations, while Sanger sequencing technique was used to detect unknown or rare β-thalassemia gene mutations. Results: A total of 282 cases of β -thalassemia heterozygotes were detected, including 2 cases with the rare β -globin gene poly A (AATAAA>AATAGA, HBB:c. +112 A>G) mutation. Their blood routine results showed that hemoglobin (Hb) was 130.00 g/L-135.00 g/L, mean corpuscular volume (MCV) was 61.90 fL-65.90 fL, mean corpuscular hemoglobin (MCH) was 19.20 pg-21.70 pg, mean corpuscular hemoglobin concentration (MCHC) was 311.00 g/ L-329.00 g/L, and hematocrit (HCT) was 0.41 l/L-0.42 L/L. Notably, MCV and MCH levels were decreased. The results of hemoglobin (Hb) analysis showed that the level of Hb A2 was elevated, ranging from 4.6% to 4.9%. When this mutation combined with other β-thalassemia mutations, mild to moderate anemia was observed clinically. Conclusion: The rare β-globin gene poly A (AATAAA>AATAGA) mutation was first identified in China. It causes β+-thalassemia, and needs to be attached importance to clinical diagnosis and treatment, genetic counseling, and prenatal diagnosis.

     

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