1例罕见β-珠蛋白基因IVS Ⅰ-2(T>A)突变所致β-地中海贫血病例分析

Rare IVSⅠ-2 (T>A) mutation in the β-globin gene causing β-thalassemia: a case report

  • 摘要: 目的:探讨1例罕见β-珠蛋白基因IVSⅠ-2(T>A)突变杂合子的血液学参数及临床表型。方法:收集经血常规红细胞计数(red blood cell count,RBC)、血红蛋白(hemoglobin,Hb)、平均红细胞体积(mean corpuscular volume,MCV)、平均红细胞血红蛋白含量(mean corpuscular hemoglobin,MCH)、平均红细胞血红蛋白浓度(mean corpuscular hemoglobin concentration,MCHC)、红细胞压积(hematocrit,HCT)、红细胞分布宽度(red blood cell distribution width,RDW)检测及血红蛋白血红蛋白A2(hemoglobin A2,Hb A2)和胎儿血红蛋白(fetal hemoglobin,Hb F)分析初筛疑似为β-地中海贫血的病例。应用荧光PCR熔解曲线法检测常见的β-地中海贫血基因突变类型。上述方法未检出基因突变者,进一步采用DNA测序技术,对罕见或未知的β-地中海贫血基因突变进行检测。结果:在235例β-地中海贫血病例中,检出1例罕见β-地中海贫血病例,基因型为β-珠蛋白基因IVSⅠ-2(T>A)(HBB:c.92+2 T>A)杂合突变,合并有αα/-α3.7缺失型α-地中海贫血。血常规分析显示:RBC 5.89×1012/L、Hb 107.00 g/L、MCV 55.40 fL、MCH 18.15 pg、MCHC 327.70 g/L、HCT 0.327、RDW 0.18。血红蛋白分析显示:Hb A2 5.0%,Hb F 4.0%。结论:国内首次报道罕见β-珠蛋白基因IVSⅠ-2(T>A)突变杂合子导致β-地中海贫血,临床上有轻度贫血,MCV、MCH降低,Hb A2增高。此类突变较为罕见,容易漏诊。

     

    Abstract: Objective: To investigate the hematological parameters and clinical phenotypes of a heterozygote carrying the rare IVSⅠ-2(T>A) mutation in the β-globin gene. Methods: Patients suspected of having β-thalassemia who underwent initial screening via routine blood tests red blood cell count(RBC), hemoglobin(Hb), mean corpuscular volume(MCV), mean corpuscular hemoglobin(MCH), mean corpuscular hemoglobin concentration(MCHC), hematocrit(HCT), red blood cell distribution width(RDW), and analyses of hemoglobin A2(Hb A2) and fetal hemoglobin(Hb F) were enrolled in this study. Common β-thalassemia gene mutations were detected using fluorescent polymerase chain reaction(PCR) melting curve analysis. For individuals in whom no mutations were identified by the above methods, DNA sequencing was further performed to detect rare or unknown β-thalassemia gene mutations. Results: Among 235 patients with β-thalassemia, 1 patient with rare β-thalassemia was identified. The patient harbored a heterozygous IVSⅠ-2(T>A)(HBB:c.92+2 T>A) mutation in the β-globin gene coexisting with α-thalassemia of the αα/-α3.7 deletion type. The patient's routine blood test results were as follows: RBC 5.89×1012/L, Hb 107.00 g/L, MCV 55.40 fL, MCH 18.15 pg, MCHC 327.70 g/L, HCT 0.327 and RDW 0.18. The hemoglobin analysis results of the patient revealed an Hb A2 level of 5.0% and an Hb F level of 4.0%. Conclusion: β-Thalassemia caused by the rare heterozygous IVS Ⅰ-2(T>A) mutation in the β-globin gene is reported for the first time in China. Clinically, the patient presents with mild anemia, decreased MCV and MCH levels, and elevated Hb A2. This mutation is relatively rare and prone to missed diagnosis.

     

/

返回文章
返回