title: Molecular and hematologic features of hemoglobin E heterozygotes with different forms of alpha-thalassemia in Thailand.
abstract: We describe the hematological and DNA characterization of hemoglobin (Hb) E heterozygote with various forms of alpha-thalassemia in Thai individuals. Altogether, 202 unrelated adult subjects with Hb E heterozygotes either with or without alpha-thalassemia determinant were studied. The most prevalent interaction was found to be a double heterozygote for Hb E/alpha-thalassemia 2, followed by a double Hb E/alpha-thalassemia 1 and a Hb E/Hb Constant Spring (CS), even though the Hb CS was not detected. Double heterozygotes for Hb E and homozygous alpha-thalassemia 2 and Hb E with a compound alpha-thalassemia 2/Hb CS were also encountered with lower frequencies. Unexpectedly, as many as 18 cases previously diagnosed as Hb E carriers at routine Hb analysis were indeed Hb E heterozygotes with compound alpha-thalassemia 1/alpha-thalassemia 2, indicating a need for globin genotyping for accurate diagnosis. A change in Hb E level was observed which was related to a concomitant inheritance of alpha-thalassemia. The hematological expression of these Hb E heterozygotes with various forms of alpha-thalassemia, including a hitherto undescribed condition of double heterozygosity for Hb E/Hb Paksé identified in two subjects, is presented comparatively with those of the 80 cases of pure Hb E carriers. A multiplex allele-specific polymerase chain reaction (PCR) assay for simultaneous detection of Hb E and Hb CS genes is also described.
authors.affiliation: Department of Clinical Microscopy, Faculty of Associated Medical Sciences, Khon Kaen University, 40002 Khon Kaen, Thailand.
authors.forename: K
authors.initials: K
authors.lastname: Sanchaisuriya
authors.forename: G
authors.initials: G
authors.lastname: Fucharoen
authors.forename: N
authors.initials: N
authors.lastname: Sae-ung
authors.forename: A
authors.initials: A
authors.lastname: Jetsrisuparb
authors.forename: S
authors.initials: S
authors.lastname: Fucharoen
mesh_terms: D000328:Adult; D000483:Alleles; D004247:DNA / Q000032:analysis / Q000235:genetics; D005786:Gene Expression Regulation; D005838:Genotype; D005914:Globins / Q000096:biosynthesis / Q000235:genetics; D006446:Hemoglobin E / Q000235:genetics*; D006455:Hemoglobins, Abnormal / Q000235:genetics; D006579:Heterozygote; D006720:Homozygote; D006801:Humans; D010641:Phenotype; D016133:Polymerase Chain Reaction / Q000379:methods; D017422:Sequence Analysis, DNA; D013785:Thailand; D017085:alpha-Thalassemia / Q000097:blood / Q000175:diagnosis / Q000235:genetics*
chemical_list: D006455:Hemoglobins, Abnormal; D005914:Globins; D004247:DNA; D006446:Hemoglobin E