Hemoglobin cagliari (β 60 [E4] VAL → GLU): A novel unstable thalassemic hemoglobinopathy

Antonello Podda, R. Galanello, L. Maccioni, M. A. Melis, C. Rosatelli, L. Perseu, A. Cao

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

This report describes a patient with thalassemia intermedialike phenotype born to normal parents in whom globin gene sequencing detected a novel abnormal hemoglobin (Hb) due to a T to A substitution at codon 60 of the β-globin gene arising as a de novo mutation. Normal sequences were detected at the homologous β-globin locus. This mutation results in the substitution of a polar (glutamic acid) for a nonpolar (valine) residue near the corner of the heme pocket of the β-globin chain. The novel variant has been designated Hb Cagliari, from the place of birth of the propositus. Kinetics of globin synthesis performed following splenectomy suggest that this new Hb variant is synthesized at a near normal rate but undergoes rapid breakdown. The extreme lability of the variant explains the clinical and hematologic picture characterized by marked ineffective erythropoiesis, thalassemia-like bone changes, iron overload, high proportion of Hb F in the peripheral blood, reduced β/α-globin chain synthesis ratio in peripheral blood reticulocytes, and absence of the abnormal Hb in peripheral blood at extensive protein structural analysis before splenectomy. This case indicates that a thalassemic hemoglobinopathy should be suspected in the presence of a patient with a thalassemia intermedia-like phenotype born to normal parents, even when protein structural analysis fails to detect an abnormal Hb. DNA sequencing may allow to define the mutation, thus making the proper diagnosis.

Original languageEnglish
Pages (from-to)371-375
Number of pages5
JournalBlood
Volume77
Issue number2
StatePublished - Jan 15 1991
Externally publishedYes

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Hemoglobinopathies
Globins
Hemoglobins
Abnormal Hemoglobins
Blood
Thalassemia
Splenectomy
Structural analysis
Mutation
Substitution reactions
Genes
Parents
Phenotype
Fetal Hemoglobin
Iron Overload
Erythropoiesis
beta-Thalassemia
Reticulocytes
Valine
Heme

ASJC Scopus subject areas

  • Hematology

Cite this

Podda, A., Galanello, R., Maccioni, L., Melis, M. A., Rosatelli, C., Perseu, L., & Cao, A. (1991). Hemoglobin cagliari (β 60 [E4] VAL → GLU): A novel unstable thalassemic hemoglobinopathy. Blood, 77(2), 371-375.

Hemoglobin cagliari (β 60 [E4] VAL → GLU) : A novel unstable thalassemic hemoglobinopathy. / Podda, Antonello; Galanello, R.; Maccioni, L.; Melis, M. A.; Rosatelli, C.; Perseu, L.; Cao, A.

In: Blood, Vol. 77, No. 2, 15.01.1991, p. 371-375.

Research output: Contribution to journalArticle

Podda, A, Galanello, R, Maccioni, L, Melis, MA, Rosatelli, C, Perseu, L & Cao, A 1991, 'Hemoglobin cagliari (β 60 [E4] VAL → GLU): A novel unstable thalassemic hemoglobinopathy', Blood, vol. 77, no. 2, pp. 371-375.
Podda A, Galanello R, Maccioni L, Melis MA, Rosatelli C, Perseu L et al. Hemoglobin cagliari (β 60 [E4] VAL → GLU): A novel unstable thalassemic hemoglobinopathy. Blood. 1991 Jan 15;77(2):371-375.
Podda, Antonello ; Galanello, R. ; Maccioni, L. ; Melis, M. A. ; Rosatelli, C. ; Perseu, L. ; Cao, A. / Hemoglobin cagliari (β 60 [E4] VAL → GLU) : A novel unstable thalassemic hemoglobinopathy. In: Blood. 1991 ; Vol. 77, No. 2. pp. 371-375.
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