Clinical and haematological characteristics of 38 individuals with Hb G‐Makassar in Malaysia

Abstract Haemoglobin (Hb) G‐Makassar is a rare Hb variant. It presents a diagnostic challenge as it imitates sickle Hb (Hb S) in standard electrophoresis and high‐performance liquid chromatography assays requiring DNA analysis to confirm diagnosis. Both have point mutations in codon 6, exon 1 in the...

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Main Authors: Ezalia Esa, Ahmad Sabry Mohamad, Roszymah Hamzah, Faidatul Syazlin Abdul Hamid, Nur Aisyah Aziz, Veena Sevaratnam, Jameela Sathar, Guo Chen, Norafiza Mohd Yasin
Format: Article
Language:English
Published: Wiley 2023-11-01
Series:eJHaem
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Online Access:https://doi.org/10.1002/jha2.750
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author Ezalia Esa
Ahmad Sabry Mohamad
Roszymah Hamzah
Faidatul Syazlin Abdul Hamid
Nur Aisyah Aziz
Veena Sevaratnam
Jameela Sathar
Guo Chen
Norafiza Mohd Yasin
author_facet Ezalia Esa
Ahmad Sabry Mohamad
Roszymah Hamzah
Faidatul Syazlin Abdul Hamid
Nur Aisyah Aziz
Veena Sevaratnam
Jameela Sathar
Guo Chen
Norafiza Mohd Yasin
author_sort Ezalia Esa
collection DOAJ
description Abstract Haemoglobin (Hb) G‐Makassar is a rare Hb variant. It presents a diagnostic challenge as it imitates sickle Hb (Hb S) in standard electrophoresis and high‐performance liquid chromatography assays requiring DNA analysis to confirm diagnosis. Both have point mutations in codon 6, exon 1 in the β‐globin (HBB) gene with different pathogenicities. This study describes the clinical phenotype, haematology and genotype of Hb G‐Makassar. Clinical and laboratory data of 38 cases of Hb G‐Makassar over 8 years were analysed. Hb G‐Makassar was confirmed by a direct sequencing of HBB gene and co‐inheritance of α‐thalassaemia determined through multiplex gap‐PCR and multiplex Amplification Refractory Mutation System polymerase chain reaction. All cases were Malays, predominantly from Terengganu (n = 20, 52.6%). There were 14 (36.8%) males and 24 (63.2%) females with median age of 25 years. Majority (n = 33, 86.8%) had features of thalassaemia trait with mean ± SD for Hb, mean cell volume (MCV) and mean cell haemoglobin (MCH) as 13.21 g/dL ± 1.69, 73.06 ± 4.48 fL and 24.71 ± 1.82 pg, respectively. None had evidence of haemolysis or thromboembolic complications. Six genotypes were identified; ßG‐Makassar/ß,αα/αα (n = 19, 50.0%), ßG‐Makassar/ßE,αα/αα (n = 4, 10.5%), ßG‐Makassar/ßNewYork,αα/αα (n = 1, 2.6%), ßG‐Makassar/ß,αα/‐α (n = 11, 28.9%), ßG‐Makassar/ß,αα/αAdanaα (n = 2, 5.3%) and ßG‐Makassar/ß,αα/–SEA (n = 1, 2.6%). The ßG‐Makassar/ß,αα/αα showed that features of thalassaemia trait with mean ± SD for Hb, MCV and MCH were 13.74 g/dL ± 2.40, 76.18 ± 6.02 fL and 25.79 ± 2.41 pg, respectively. This is the largest study reporting a significant number of Hb G‐Makassar in Malaysia. Although the mutation is similar to Hb S, the phenotype is benign.
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spelling doaj.art-b43e13c9ad3e447b8414029b066c9f172023-11-21T07:58:46ZengWileyeJHaem2688-61462023-11-014494094810.1002/jha2.750Clinical and haematological characteristics of 38 individuals with Hb G‐Makassar in MalaysiaEzalia Esa0Ahmad Sabry Mohamad1Roszymah Hamzah2Faidatul Syazlin Abdul Hamid3Nur Aisyah Aziz4Veena Sevaratnam5Jameela Sathar6Guo Chen7Norafiza Mohd Yasin8Institute for Medical Research Setia AlamSelangorMalaysiaMedical Engineering Universiti Kuala Lumpur British Malaysian Institute GombakSelangorMalaysiaHematology Department Ampang Hospital AmpangSelangorMalaysiaInstitute for Medical Research Setia AlamSelangorMalaysiaInstitute for Medical Research Setia AlamSelangorMalaysiaHematology Department Ampang Hospital AmpangSelangorMalaysiaHematology Department Ampang Hospital AmpangSelangorMalaysiaBeam Therapeutics Inc. CambridgeMassachusettsUSAInstitute for Medical Research Setia AlamSelangorMalaysiaAbstract Haemoglobin (Hb) G‐Makassar is a rare Hb variant. It presents a diagnostic challenge as it imitates sickle Hb (Hb S) in standard electrophoresis and high‐performance liquid chromatography assays requiring DNA analysis to confirm diagnosis. Both have point mutations in codon 6, exon 1 in the β‐globin (HBB) gene with different pathogenicities. This study describes the clinical phenotype, haematology and genotype of Hb G‐Makassar. Clinical and laboratory data of 38 cases of Hb G‐Makassar over 8 years were analysed. Hb G‐Makassar was confirmed by a direct sequencing of HBB gene and co‐inheritance of α‐thalassaemia determined through multiplex gap‐PCR and multiplex Amplification Refractory Mutation System polymerase chain reaction. All cases were Malays, predominantly from Terengganu (n = 20, 52.6%). There were 14 (36.8%) males and 24 (63.2%) females with median age of 25 years. Majority (n = 33, 86.8%) had features of thalassaemia trait with mean ± SD for Hb, mean cell volume (MCV) and mean cell haemoglobin (MCH) as 13.21 g/dL ± 1.69, 73.06 ± 4.48 fL and 24.71 ± 1.82 pg, respectively. None had evidence of haemolysis or thromboembolic complications. Six genotypes were identified; ßG‐Makassar/ß,αα/αα (n = 19, 50.0%), ßG‐Makassar/ßE,αα/αα (n = 4, 10.5%), ßG‐Makassar/ßNewYork,αα/αα (n = 1, 2.6%), ßG‐Makassar/ß,αα/‐α (n = 11, 28.9%), ßG‐Makassar/ß,αα/αAdanaα (n = 2, 5.3%) and ßG‐Makassar/ß,αα/–SEA (n = 1, 2.6%). The ßG‐Makassar/ß,αα/αα showed that features of thalassaemia trait with mean ± SD for Hb, MCV and MCH were 13.74 g/dL ± 2.40, 76.18 ± 6.02 fL and 25.79 ± 2.41 pg, respectively. This is the largest study reporting a significant number of Hb G‐Makassar in Malaysia. Although the mutation is similar to Hb S, the phenotype is benign.https://doi.org/10.1002/jha2.750clinical phenotypegenotypehaematological characteristicsHb G‐Makassar
spellingShingle Ezalia Esa
Ahmad Sabry Mohamad
Roszymah Hamzah
Faidatul Syazlin Abdul Hamid
Nur Aisyah Aziz
Veena Sevaratnam
Jameela Sathar
Guo Chen
Norafiza Mohd Yasin
Clinical and haematological characteristics of 38 individuals with Hb G‐Makassar in Malaysia
eJHaem
clinical phenotype
genotype
haematological characteristics
Hb G‐Makassar
title Clinical and haematological characteristics of 38 individuals with Hb G‐Makassar in Malaysia
title_full Clinical and haematological characteristics of 38 individuals with Hb G‐Makassar in Malaysia
title_fullStr Clinical and haematological characteristics of 38 individuals with Hb G‐Makassar in Malaysia
title_full_unstemmed Clinical and haematological characteristics of 38 individuals with Hb G‐Makassar in Malaysia
title_short Clinical and haematological characteristics of 38 individuals with Hb G‐Makassar in Malaysia
title_sort clinical and haematological characteristics of 38 individuals with hb g makassar in malaysia
topic clinical phenotype
genotype
haematological characteristics
Hb G‐Makassar
url https://doi.org/10.1002/jha2.750
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