Prenatal Diagnosis of HbE-β-Thalassemia: Experience of a Center in Western India
- 48 Downloads
The clinical presentation of HbE-β-thalassemia is extremely variable, however, many cases are severe and transfusion dependent. We offered prenatal diagnosis to 108 couples, 20 of whom came prospectively. CVS was done in 93 cases (9.5–13 weeks of gestation) while amniocentesis/cordocentesis was done for 15 cases in the second trimester. Diagnosis was done by reverse dot blot hybridization, ARMS, DNA sequencing and in a few cases by HPLC analysis of fetal blood. The genetic combinations in the couples at-risk were the following: HbE trait/β-thal trait-95, HbE-thal/HbE trait-5, HbE homozygous/β-thal trait-3, HbE-thal/β-thal trait-3, HbE Lepore/β-thal trait-1, HbE trait/HbDPunjab trait-1. IVS1-5(G>C) was the commonest β-thalassemia mutation followed by codon15(G>A), codon30(G>C), codons41/42(-CTTT), the 619 bp deletion and codon8/9(+G) in the β-thalassemic parent. However, several rare mutations seen in India like -90(C>T), -88(C>T),codon15(-T), IVS1-129(A>C), IVS1-130(G>C), IVSII-1(G>A), IVSII-837(C>T) and IVSII 848(C>A) were also encountered. Twenty-one fetuses were affected (HbE-β-thal-20, β-thal major-1) and all the couples opted for termination of the pregnancies. Couples with affected children wish to undergo prenatal testing for HbE-β-thal in subsequent pregnancies. More regional centers are needed for these services, particularly in West Bengal and the North-East where HbE is very common.
KeywordsHbE-β-thalassemia β-thalassemia Prenatal diagnosis Chorionic villus sampling Amniocentesis Cordocentesis
This work was supported by the Indian Council of Medical Research.
Compliance with Ethical Standards
Conflicts of interest
There is no conflict of interest.
This article does not contain any studies with animals performed by any of the authors.
Human and Animal Rights
All procedures performed in this study involving human participants were in accordance with the ethical standards of the institution. and/or National Research Committee.
Informed consent was taken from all the couples who went for prenatal diagnosis.
- 10.Mohanty D, Colah RB, Gorakshakar AC, Patel RZ, Master DC, Mahanta J, Sharma SK, Chaudhari U, Ghosh M, Das S, Britt RP, Singh S, Ross C, Jagannathan L, Kaul R, Shukla DK, Muthuswamy V (2013) Prevalence of β-thalassemia and other haemoglobinopathies in six cities in India: a multicentre study. J Community Genet 4:33–42CrossRefPubMedGoogle Scholar
- 12.Colah RB, Gorakshakar AC, Lu CY et al (1997) Application of covalent reverse dot blot hybridization for rapid prenatal diagnosis of the common Indian thalassemia syndromes. Indian J Hematol Blood Transf 15:10–13Google Scholar
- 13.Old JM (2001) DNA based diagnosis of the haemoglobin disorders. In: Steinberg MH, Forget BG, Higgs DR, Nagel RL (eds) Disorders of haemoglobin—genetics, pathophysiology and clinical management. Cambridge University Press, Cambridge, pp 941–948Google Scholar
- 35.Viprakasit V, Limwongse C, Sukpanichnant S, Ruangvutilert P, Kanjanakorn C, Glomglao W, Sirikong M, Utto W, Tanphaichitr VS (2013) Problems in determining thalassemia carrier status in a program for prevention and control of severe thalassemia syndromes: a lesson from Thailand. Clin Chem Lab Med 51:1605–1614PubMedGoogle Scholar
- 37.Colah R, Gorakshakar A (2014) Control of thalassemia in India. Thalass Rep 4:84–89Google Scholar
- 38.Mohanty D, Colah R, Gorakshakar A (eds) (2008) Report of the Jai Vigyan S & T Mission Project on community control of thalassaemia syndromes—awareness, screening, genetic counselling and prevention. A national multicentric task force study of Indian Council of Medical Research. ICMR, New DelhiGoogle Scholar