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Frequency of beta-thalassemia or beta-hemoglobinopathy carriers simultaneously affected with alpha-thalassemia in Iran.
[alpha-thalassemia]
Beta
-thalassemias
are
prevalent
heritable
single
gene
disorders
affecting
the
quantity
of
the
hemoglobin
molecule
.
Rarely
,
a
co
-inheritance
of
these
impairments
with
alpha-thalassemia
and
/
or
a
hemoglobinopathy
occurs
and
makes
an
important
double
heterozygote
or
homozygous
state
.
Thus
finding
these
cases
is
essential
for
genetic
counseling
.
The
present
study
aimed
to
identify
the
prevalence
of
coexistent
alpha-thalassemia
mutations
,
hemoglobinopathies
,
and
beta-thalassemia
determinants
.
This
descriptive
study
was
performed
on
5760
patients
.
We
used
complete
blood
cell
count
,
Hb
electrophoresis
,
and
HbA
2
measurement
for
thalassemia
carrier
identification
.
Increased
HbA
2
(
>
or
=
3
.
5
%
)
is
the
standard
diagnostic
marker
for
beta-thalassemia
,
while
normal
HbA
2
with
low
MCH
and
MCV
can
indicate
an
alpha-thalassemia
carrier
or
atypical
beta-thalassemia
minor
.
Individuals
with
MCV
<
80
fL
,
MCH
<
27
pg
,
and
hemoglobin
<
or
=
15
.
3
g
/
dL
in
men
or
<
or
=
14
g
/
dL
in
women
,
were
candidates
for
molecular
thalassemia
investigations
.
Patients
with
abnormal
hemoglobin
varieties
in
hemoglobin
electrophoresis
were
referred
to
a
genetics
laboratory
for
hemoglobinopathy
detection
.
141
subjects
out
of
5760
were
affected
by
alpha
and
beta-thalassemia
or
a
beta
-hemoglobinopathy
simultaneously
,
including
:
13
(
11
.
1
%
)
fetuses
,
55
(
38
.
2
%
)
male
cases
,
and
73
(
50
.
7
%
)
females
.
Among
these
141
alpha-thalassemia
patients
,
92
cases
(
65
.
24
%
)
were
beta-thalassemia
carriers
and
3
(
2
.
12
%
)
were
beta-thalassemia
major
,
43
(
30
.
49
%
)
had
beta
-hemoglobinopathies
,
and
3
cases
(
2
.
12
%
)
had
co
-inherited
beta-thalassemia
and
variant
hemoglobins
.
31
beta
-
gene
mutations
were
observed
in
this
population
,
the
most
common
being
HbS
Cd
6
(
A
>
T
)
(
24
%
)
.
These
thalassemia
determinants
account
for
about
46
%
of
all
detected
mutations
.
As
for
alpha-
gene
mutations
,
-
3
.
7
detection
was
the
most
prevalent
.
The
relatively
high
prevalence
of
co
-inherited
alpha-thalassemia
and
hemoglobinopathies
among
beta-thalassemia
carriers
indicates
the
importance
of
molecular
analysis
to
diagnose
these
double
heterozygous
or
sole
homozygous
cases
for
prenatal
diagnostic
purposes
and
putting
forth
strategies
to
prevent
more
complicated
and
dangerous
combinations
.
Diseases
Validation
Diseases presenting
"important double heterozygote"
symptom
alpha-thalassemia
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