Paper Information

Journal:   IRANIAN JOURNAL OF PATHOLOGY (IJP)   SPRING 2016 , Volume 11 , Number 2; Page(s) 133 To 137.
 
Paper: 

CAN TRIMODAL DISTRIBUTION OF HBS LEVELS IN SICKLE CELL TRAITS BE USED TO PREDICT THE ASSOCIATED ALPHA-THALASSEMIA FOR SCREENING CASES IN CENTRAL INDIA?

 
 
Author(s):  WARPE BHUSHAN M.*, SHRIKHANDE A.V., POFLEE S.V.
 
* QUARTER NO. D-3/1, HINDALCO COLONY, HINDALCO INDUSTRIES LTD, MIDC TALOJA, NAVI MUMBAI, MAHARASHTRA STATE, INDIA
 
Abstract: 

Background: Until now, trimodal distribution of HbS has been seen by six different studies in the world when associated with alpha-thalassemia with confirmation by corresponding alpha-genotyping studies. The RBC indices reduce as alpha-globin genes reduce in sickle cell trait (SCT) patients, which decreases the extent of intravascular sickling and thus betters the clinical course of the patients. This is a pioneer study conducted on Central Indian poor population to use the already proven six studies to screen associated alpha-thalassemia in SCT patients thus, circumventing the much costlier alpha-genotyping studies. Moreover, it aimed to study the haematological parameters in such cases.
Methods: The study was performed at RHDMC, IGGMC, Nagpur, India from 2003 to 2012. The sample population was suspected cases of haemolytic anaemia. CBC and RBC indices were obtained by a cell analyzer. The sickle solubility test positively screened cases were confirmed by agar-gel haemoglobin electrophoresis at pH 8.6.
Finally, quantitative assessment of haemoglobin variants was performed by HPLC.
Results: Out of total 5819 cases over ten years, 933 cases were sickle heterozygotes.
Overall, 180/933 subjects were predicted to be homozygous alpha-thalassemia and 338/933 were heterozygous alpha-thalassemia, based on trimodal distribution of HbS.
Conclusion: Genotyping is costlier for majority of the poor non-affording patients in Indian government set-ups, so this study is suitable to screen for associated alphathalassemia in SCT patients.

 
Keyword(s): TRIMODAL DISTRIBUTION, HBS, ALPHA-THALASSAEMIA, SICKLE CELL TRAIT, MCH, MCV, MCHC
 
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