Skip to main content

Hemoglobinopathies-Non-Sickle Cell

  • Reference work entry
Textbook of Clinical Pediatrics

Introduction

The globin part of the normal human hemoglobins (Hb A, F, and A2) consists of two alpha and two non-alpha chains (β in hemoglobin A, γ in hemoglobin F and δ in hemoglobin A2). Hemoglobinopathies result from genetic mutations causing structural changes in one of the globin chains by adding, deleting, or exchange of one or more amino acid. Over 800 mutations have been identified. The majority of these mutant hemoglobins are innocuous. A few of them, however, cause lifelong serious and sometimes fatal health problems. The following hemoglobinopathies will be discussed in this chapter, either because of high prevalence in certain ethnic groups or geographical area and/or their clinical severity either alone or in co-inheritance with sickle cell disease or thalassemia:

  • Hemoglobin C

  • Hemoglobin E

  • Hemoglobin D

  • Hemoglobin O Arab

  • Unstable hemoglobins

  • High oxygen affinity hemoglobins

Hemoglobin C

Pathogenesis and Incidence

Hemoglobin C results from a genetic mutation, resulting in...

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 999.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 1,299.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Adekile AD, Kazanetz EG, Leonova JY et al (1996) Co-inheritance of Hb D-Punjab (codon 121; GAA –> CAA) and β0 thalassemia (IVS-II-1; G–> A). J Pediatr Hematol Oncol 18:151–153

    Article  PubMed  CAS  Google Scholar 

  • Agarwal S, Gupta UR, Kohli N et al (1989) Prevalence of haemoglobin D in Uttar Pradesh. J Med Res 90:39–43

    CAS  Google Scholar 

  • Agarwal A, Guindo A, Cissoko Y et al (2000) Hemoglobin C associated with protection from severe malaria in the Dogon of Mali, a West African population with low prevalence of hemoglobin S. Blood 96:2358–2363

    PubMed  CAS  Google Scholar 

  • Agarwal N, Mojica-Henshaw MP, Simmons ED et al (2007) Familial polycythemia caused by a novel mutation in the beta globin gene: essential role of P50 in evaluation of familial polycythemia. Int J Med 4:232–236

    CAS  Google Scholar 

  • Ashtiani MT, Monajemzadeh M, Sina AH et al (2009) Prevalence of haemoglobinopathies in 34,000 healthy adults in Tehran, Iran. J Clin Pathol 62:924–925

    Article  PubMed  CAS  Google Scholar 

  • Atalay EO, Koyuncu H, Turgut B et al (2005) High incidence of Hb D-Los Angeles (β121(GH4) GLU – >Gln) in Denizli province, Aegean region of Turkey. Hemoglobin 29:307–310

    Article  PubMed  CAS  Google Scholar 

  • Athanasiou-Metaxa M, Economou M, Tsatra I et al (2002) Co-inheritance of hemoglobin D-Punjab and hemoglobin S: a case report (letter). J Pediatr Hematol Oncol 24:421

    Article  PubMed  Google Scholar 

  • Bachir DD, Galacteros F (2004) Hemoglobin C, Orphanet Encyclopedia www.orpha.net/data/patol/GB/uk. November

  • Bain BJ (2009) C/beta0 thalassemia. Am J Hematol 84:749

    Article  PubMed  Google Scholar 

  • Brugnara C, Kopin AS, Bunn HF et al (1985) Regulation of cation content and cell volume in hemoglobin erythrocytes from patients with homozygous hemoglobin C disease. J Clin Invest 75:1608–1617

    Article  PubMed  CAS  Google Scholar 

  • Cario H (2005) Childhood polycythemia/erythrocytosis: classification, diagnosis, clinical presentation and treatment. Ann Hematol 84:137–145

    Article  PubMed  CAS  Google Scholar 

  • Chernoff AI (1958) The hemoglobin D syndrome. Blood 13:116–127

    PubMed  CAS  Google Scholar 

  • Efremov GD, Simjanovska L, Plaseska-Karanfilska D et al (2007) Hb Jambol: a new hyperunstable hemoglobin causing severe hemolytic anemia. Acta Haematol 117:1–7

    Article  PubMed  CAS  Google Scholar 

  • Fairhurst RM, Fujioka H, Hayton K et al (2003) Aberrant development of Plasmodium falciparum in hemoglobin CC red cells: implications for the malaria protective effect of the homozygous state. Blood 101:3309–3315

    Article  PubMed  CAS  Google Scholar 

  • Fort JA, Graham-Pole JR, Chopik J (1988) Vaso occlusion with homozygous hemoglobin C disease. Am J Pediatr Hematol Oncol 10:323–325

    Article  PubMed  CAS  Google Scholar 

  • Fucharoen S, Winichagoon P (2000) Clinical and hematologic aspects of hemoglobin E beta-thalassemia. Curr Opin Hematol 7:106–112

    Article  PubMed  CAS  Google Scholar 

  • Fucharoen S, Ketvichit P, Pootrakul P et al (2000) Clinical manifestation of beta thalassemia/hemoglobin E disease. J Pediatr Hematol Oncol 22:552–557

    Article  PubMed  CAS  Google Scholar 

  • Hafsia R, Gouider S, Ben Moussa S et al (2007) Hemoglobin O Arab: about 20 cases. Tunis Méd 85:637–640

    PubMed  Google Scholar 

  • Kishore B, Khare P, Gupta RJ et al (2007) Hemoglobin E disease in North Indian population: a report of 11 cases. Hematology 12:343–347

    Article  PubMed  CAS  Google Scholar 

  • Mantovani A, Figinin I (2008) Sickle cell-hemoglobin C retinopathy: transient obstruction of retinal and choroidal circulations and transient drying out of retinal neovessels. Int Ophthalmol 28:135–137

    Article  PubMed  Google Scholar 

  • Masiello D, Heeney MM, Adewoye AH et al (2007) Hemoglobin SE disease a concise review. Am J Hematol 82:643–649

    Article  PubMed  CAS  Google Scholar 

  • Masmas TN, Garly ML, Lisse IM et al (2006) Inherited hemoglobin disorders in Guinea- Bissau, West Africa: a population study. Hemoglobin 30:355–364

    Article  PubMed  CAS  Google Scholar 

  • Olivieri NF, Muraca GM, O’Donnell A et al (2008) Studies in haemoglobin E – beta thalassemia. Br J Haematol 141:388–397

    Article  PubMed  CAS  Google Scholar 

  • Owaidah TM, Al-Saleh MM, Al-Hellani AM (2005) Hemoglobin D/beta-thalassemia and beta-thalassemia major in a Saudi family. Saudi Med J 26:674–677

    PubMed  Google Scholar 

  • Papadopoulos V, Vassiliadou D, Xanthopoulidis G et al (2003) The implications of haemoglobin O-Arab mutation. Haema 6:479–485

    CAS  Google Scholar 

  • Papadopoulos V, Dermitzakis E, Konstantinidou D et al (2005) Hb O-Arab mutation originated in the Pomak population of Greek Thrace (letter). Haematologica 90:255–257

    PubMed  CAS  Google Scholar 

  • Pegelow CH, Mack AK (1989) Incidence of hemoglobins S and C in infants born in Miami to recent Haitian immigrants. Trop Geogr Med 41:316–319

    PubMed  CAS  Google Scholar 

  • Percy MJ, Butt NN, Crotty GM et al (2009) Identification of high oxygen affinity hemoglobin variant in the investigation of patients with erythrocytosis. Haematologica 94:1321–1322

    Article  PubMed  CAS  Google Scholar 

  • Perea FJ, Casas-Castaneda M, Villalobos-Arambula AR et al (1999) Hb D-Los Angeles associated with Hb S or beta-thalassemia in four Mexican Mestizo families. Hemoglobin 23:231–237

    Article  PubMed  CAS  Google Scholar 

  • Petkov GH, Simjanovska L, Tchakarova P et al (2005) Hb Stara Zagora: a new hyper-unstable hemoglobin causing severe hemolytic anemia. Hemoglobin 29:249–256

    Article  PubMed  CAS  Google Scholar 

  • Prehu C, Pissard S, Al-Sheikh M et al (2005) Two French Caucasian families with dominant thalassemia-like phenotypes due to hyperunstable hemoglobin variant: Hb Sainte Seve [codon 118(-T)] and codon 127 (CA→TAG [GIn→Stop]). Hemoglobin 29:229–233

    Article  PubMed  CAS  Google Scholar 

  • Premawardhena A, Fisher CA, Olivieri NF et al (2005) Hemoglobin E beta thalassemia in Sri Lanka. Lancet 366:1467–1470

    Article  PubMed  CAS  Google Scholar 

  • Rachmilewitz EA, Tamari H, Liff F et al (1985) The interaction of hemoglobin O Arab with HbS and beta+ thalassemia among Israeli Arabs. Hum Genet 70:119–125

    Article  PubMed  CAS  Google Scholar 

  • Richet P, Flori L, Tall F (2004) Hemoglobin C is associated with reduced Plasmodium falciparum parasitemia and low risk of malaria attack. Hum Mol Genet 13:1–6

    Article  Google Scholar 

  • Rivera-Ruiz M, Varon J, Sternbach GL (2008a) Acute splenic sequestration in an adult with hemoglobin S-C disease. Am J Emerg Med 26(1064):e5–e8

    Google Scholar 

  • Rivera-Ruiz M, Varon J, Sternbach GL (2008b) Acute splenic sequestration in an adult with hemoglobin S-C disease. Am J Emerg Med 26(1064):e5–e8

    PubMed  Google Scholar 

  • Sangare A, Sango M, Meite M et al (1992) Hemoglobin O Arab in Ivory Coast and Western Africa. Med Trop 52:163–167

    CAS  Google Scholar 

  • Thomburg CD, Zimmerman SA, Schultz WH et al (2001) An infant with homozygous hemoglobin D-Iran. J Pediatr Hematol Oncol 23:67–68

    Article  Google Scholar 

  • Vichinsky E (2007) Hemoglobin E syndrome. Hematol Am Soc Hematol Educ Program 2007:79–83

    Article  Google Scholar 

  • Vichinsky EP, MacKlin EA, Waye JS et al (2005) Changes in the epidemiology of thalassemia in North America: a new minority disease. Pediatrics 116:e818–e825

    Article  PubMed  Google Scholar 

  • Wajcman H, Galacteros F (2005) Hemoglobins with high oxygen affinity leading to erythrocytosis. New variants and new concept. Hemoglobin 29:91–106

    Article  PubMed  CAS  Google Scholar 

  • Wajcman H, Traeger-Synodinos J, Papassotiriou I et al (2008) Unstable and thalassemic alpha chain hemoglobin variants: a cause of Hb H disease and thalassemia intermedia. Hemoglobin 32:327–349

    Article  PubMed  CAS  Google Scholar 

  • Ware OJF, RE SWH et al (1994) Hemoglobin C in infancy and childhood. J Pediatr 125:745–747

    Article  PubMed  Google Scholar 

  • Weatherall DJ (2000) Introduction to the problem of hemoglobin EB thalassemia. J Pediatr Hematol Oncol 22:551

    Article  PubMed  CAS  Google Scholar 

  • Williamson D (1993) The unstable haemoglobins. Blood Rev 7:146–163

    Article  PubMed  CAS  Google Scholar 

  • Zimmerman SA, O’Branski EE, Rosse WF et al (1999) Hemoglobin S/O Arab: thirteen new cases and review of the literature. Am J Hematol 60:279–284

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ahmad A. Mallouh M.D. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Springer-Verlag Berlin Heidelberg

About this entry

Cite this entry

Mallouh, A.A. (2012). Hemoglobinopathies-Non-Sickle Cell. In: Elzouki, A.Y., Harfi, H.A., Nazer, H.M., Stapleton, F.B., Oh, W., Whitley, R.J. (eds) Textbook of Clinical Pediatrics. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-02202-9_325

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-02202-9_325

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-02201-2

  • Online ISBN: 978-3-642-02202-9

  • eBook Packages: MedicineReference Module Medicine

Publish with us

Policies and ethics