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Hemoglobin Lepore-Beta-Thalassemia Syndrome

Hemoglobinopathy


Presentation

  • Hb Barts, Hb H, and Hb Portland are present in significant quantities. It is the most common cause of hydrops fetalis in Southeast Asia and southern China.[mayomedicallaboratories.com]
  • Improve your interpretation of presenting symptoms with 38 new topics and 40 new images in the Differential Diagnosis section, and optimize patient care with more than 250 new figures and tables.[books.google.com]
  • Pitfall: both and chains are decreased in thalassemia, which is not rare and presents like thalassemia, except that the Hb A 2 is not elevated. You would expect this since Hb A 2 contains chains).[web2.iadfw.net]
Pathologist
  • It will be a valuable tool in the every day practice of pathologists, pediatric pathologists, and hematopathologists, and a ready educational resource for fellows, pathology residents, medical students, clinical scientists in the field, and pediatric[books.google.com]
  • When any questions arise about the interpretation in a given case, please feel free to call our laboratory and ask to speak with the pathologist about the case. Top References Akar, N and Ekim, M. Further notes on hemoglobin C and hematuria.[wardelab.com]
Severe Pain
  • People with sickle cell: can have episodes of very severe pain can get serious, life-threatening infections are usually anaemic – their bodies have difficulty carrying oxygen Babies with sickle cell disease can receive early treatment, including immunisations[nhs.uk]
  • A strong painkiller such as morphine may be needed for severe pain - this is usually given in hospital. Good hydration.[patient.info]
Vietnamese
  • The Thai and Khmer groups have the highest frequency, followed by Burmese and Malays, then Vietnamese and Bengalis. The gene does not occur in ethnic Han Chinese or Japanese.[web2.iadfw.net]
Cyanosis
  • Many are clinically harmless and others cause symptoms including microcytosis, sickling disorders, hemolysis, erythrocytosis, cyanosis/hypoxia, long-standing or familial anemia, compensated or episodic anemia, and increased methemoglobin or sulfhemoglobin[mayomedicallaboratories.com]
  • If the level of blue hemoglobin exceeds 5 g/dL in capillary blood, the clinical result is cyanosis, a bluish discoloration of skin and mucous membranes.[web2.iadfw.net]
  • Several hemoglobinopathies, designated hemoglobin M variants, closely resemble methemoglobin but have slightly different absorption spectra.1 This group of hemoglobinopathies has an altered oxygen affinity that results in a cyanosis that is usually asymptomatic[zdoc.site]
Hematuria
  • Further notes on hemoglobin C and hematuria. Pediatr Nephrol 2002;17:72. Fishleder, AJ and Hoffman, GC. A practical approach to the detection of hemoglobinopathies: Part III. Lab Med 1987;18:513.[wardelab.com]
  • Even sickle cell trait individuals may experience episodes of hematuria, presumably due to this mechanism. Infarctive (painful) crisis. Increased sickling activity may be brought about by any general stress on the body, especially infection.[web2.iadfw.net]

Workup

  • […] sickle cell exacerbations of 0% for tonsillectomy, 2.9% for hip surgery, 3.9% for myringotomy, 7.8% for intra-abdominal nonobstetric surgery, 16.9% for cesarean section and hysterectomy, and 18.6% for dilation and curettage.39 Preoperative Assessment and Workup[zdoc.site]
Erythrocytosis
  • Many are clinically harmless and others cause symptoms including microcytosis, sickling disorders, hemolysis, erythrocytosis, cyanosis/hypoxia, long-standing or familial anemia, compensated or episodic anemia, and increased methemoglobin or sulfhemoglobin[mayomedicallaboratories.com]
  • Erythropoiesis then is stimulated, even though there is no anemia, and erythrocytosis (increased total body rbc mass, increased blood hemoglobin concentration, increased hematocrit) is the result.[web2.iadfw.net]
  • Target Cells Basophillic stippling Beta Thalassemia minor: Electrophoresis Hereditary Persistence of Fetal Hemoglobin: pathology Absence of α- & β-chains γ-chains 3 types: Black Swiss Greek Hereditary Persistence of Fetal Hemoglobin: Lab findings M/H erythrocytosis[studyblue.com]
  • The RBCs are microcytic and hypochromic; often with associated erythrocytosis. The anemia is usually mild. High Hemoglobin A2 levels are classic for ß-thalassemia trait. Hemoglobin F levels are mildly increased.[med-ed.virginia.edu]
Hematocrit Increased
  • Rarely, for obscure reasons, they experience a catastrophic fall in hematocrit, increasing intensity of jaundice, and increasing reticulocyte count. This is called a "hemolytic crisis." b. Effects of vaso-occlusion Dactylitis.[web2.iadfw.net]

Treatment

  • Without treatment, people with SCD may die in childhood, from problems such as infection. Good treatment makes a great difference. Improvements in treatment mean that life expectancy has increased.[patient.info]
  • There is no single best treatment for all people with SCD. Treatment options are different for each person depending on the symptoms.[nhsggc.org.uk]
  • Treatments include blood transfusions and treatment to remove excess iron from the body. If you have mild symptoms or no symptoms, you may not need treatment. In some severe cases, you may need a bone marrow transplant.[icdlist.com]
  • Continued Treatment With a mild case, you may feel tired and not need treatment. But if it’s more serious, your organs may not get the oxygen they need. You might have to get regular blood transfusions.[webmd.com]
  • […] as compared with DFO and placebo treatment [ 63 ].[ojrd.biomedcentral.com]

Prognosis

  • The prognosis of homozygous Hb C disease is excellent. An individual may inherit a Hb S gene from one parent and a Hb C gene from the other. The result of this double whammy is Hb SC disease.[web2.iadfw.net]
  • Prognosis Prognosis of thalassemia minor subjects is excellent. An increased risk for cholelithiasis, especially in association with the Gilbert mutation has been demonstrated [ 92 ].[ojrd.biomedcentral.com]
  • […] association with a beta thalassemia gene mutation, lead to thalassemia intermedia via a combined heterozygous condition [1] Patients with HbE/beta thalassemia (in which HbE interacts with beta thalassemia) exhibit the clinical course of thalassemia intermedia Prognosis[emedicine.medscape.com]
  • There is a lot of individual variation in the severity and outlook (prognosis) for SCD. Some people get very few problems from their SCD; others have more symptoms or more complications.[patient.info]

Etiology

  • Thrombotic Thrombocytopenic Purpura (TTP)/Hemolytic Uremic Syndrome (HUS) Mechanical RBC Damage Target Cells Etiology Liver Disease (see xxxx , [[xxxx]]): especially extrahepatic biliary obstruction Thalassemia (see xxxx , [[xxxx]]) Spur Cells Etiology[mdnxs.com]
  • Etiology More than 200 mutations have been so far reported; the large majority are point mutations in functionally important regions of the beta globin gene [ 16, 17 ]. Deletions of the beta globin gene are uncommon.[ojrd.biomedcentral.com]

Epidemiology

  • (PMID: 15921167) Frischknecht H … Dutly F (Hemoglobin 2005) 3 4 22 58 Epidemiology of the delta globin alleles in southern Italy shows complex molecular, genetic, and phenotypic features.[genecards.org]
  • […] beta-thalassemia - Lepore - beta-thalassemia Classification (Orphanet): - Rare genetic disease - Rare hematologic disease Classification (ICD10): - Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism - Epidemiological[csbg.cnb.csic.es]
  • Identification of these disorders is immensely important epidemiologically and aid in prevention of more serious hemoglobin disorders.[ijpmonline.org]
  • There is no anemia or, if there is, it is very mild. [12] Epidemiology [ edit ] The Hb Lepore trait has a worldwide distribution and may affect individuals of various ethnicities however the three main varieties which been defined tend to be more prevalent[en.wikipedia.org]
Sex distribution
Age distribution

Pathophysiology

  • Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test This consultative study has the ability to test for the detection of almost all known hemoglobin disorders in an economical manner[mayomedicallaboratories.com]
  • Genetics – (see "Introduction to hemoglobin mutations" and "Molecular genetics of the thalassemic syndromes" ) Pathogenesis – (see "Pathophysiology of alpha thalassemia" and "Pathophysiology of beta thalassemia" ) Literature review current through: Dec[uptodate.com]
  • PATHOPHYSIOLOGY OF Β-THALASSAEMIA 19. CLINICAL PRESENTATION 20.[slideshare.net]

Prevention

  • Rapidly find the answers you need with separate sections on diseases and disorders, differential diagnosis, clinical algorithms, laboratory results, and clinical preventive services, plus an at-a-glance format that uses cross-references, outlines, bullets[books.google.com]
  • There are a number of different treatments which help to prevent sickling episodes, or prevent related problems such as infection.[patient.info]
  • Identification of these disorders is immensely important epidemiologically and aid in prevention of more serious hemoglobin disorders.[ijpmonline.org]

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