Table 1. Clinical and laboratory data for the two families.
Family of patient JKa |
Family of patient GH |
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---|---|---|---|---|---|---|---|---|---|---|
II 3 | II 4 | II 5 | III 1 | III 2 | I 1c | I 2 | II 1 | II 2 | ||
Identity | Father | Mother | Uncle | Proband | Cousin | Father | Mother | Proband | Brother | |
Age in years | 29 | 30 | 29 | 5 | 4 | 54 | 53 | 12 | 17 | |
Number of transfusions | − | − | − | <1 | − | − | − | 4 | − | |
Reference values | ||||||||||
Hematologic parameters | ||||||||||
Hb, g/l | 120–150 | 141 | 170 | 191 | 79 | 145 | 144 | 159 | 97d | 147 |
MCV, fl | 80–98 | 82.1 | 85.2 | 88.2 | 72.4 | 81.6 | 87.7 | 88.7 | 72.4 | 80.5 |
MCH, pg | 27–32 | 28.3 | 30.4 | 32.5 | 24.9 | 29.7 | 32.9 | 31.5 | 25.1 | 28.3 |
MCHC, g/l | 320–360 | 332 | 318 | 325 | 293 | 364 | 314 | 335 | 303 | 323 |
Ret, × 109 | 25–75 | 30 | 50 | 89 | 170 | 39 | 37.1 | 64.6 | 147 | 56.2 |
Splenomegaly | ||||||||||
Splenomegaly | 4~6 (age, years): 6.9~8.8 cm12~15 (age, years): 8.7~11.4 cm | 10.7 | 16.7 | |||||||
Hb analysis | ||||||||||
Hb F, % | <1.5 | 1.8 | 1.8 | 1.8 | 26.6 | 2.0 | 1.9 | 1.8 | 33.2 | 1.8 |
Hb A2, % | 2.5–3.5 | 3.3 | 3.3 | 3.3 | 4.8 | 3.4 | 2.9 | 3.5 | 3.9 | 3.2 |
Hb Bart's, % | 0 | 0 | 0 | 0 | 2 | 0 | 0 | 0 | 1 | 0 |
Biochemical data | ||||||||||
Bilirubin total, μmol/l | 3.4–17.1 | 9.2 | 5 | 8.9 | 60.8 | 4.3 | 16.2 | 17.8 | 34.3 | 11.7 |
Serum ferritin, ng/ml | 10–200 | 332 | 15.7 | 291 | 396 | 21.7 | 241.4 | 49.8 | >2000 | 111.3 |
Erythrocytes | ||||||||||
Zinc protoporphyrin, μmol/l | <1.20 | 1.17 | 0.92 | 0.58 | 5.51 | 0.69 | 1.42 | 1.48 | 11.66 | 1.21 |
InLu phenotype | − | + | + | + | + | + | + | + | + | + |
CD44 deficiency | − | ± | ± | ± | + | ± | ± | ± | + | ± |
Abnormality of erythroblast | ||||||||||
poikilocyte | + | − | + | |||||||
heterochromatin clumps | − | 35% | − | 55% | ||||||
Globin expression | ||||||||||
α/β | 0.96±0.05 (95%CI:0.94–0.98)b | 0.9 | 0.96 | 0.92 | 1.28 | 0.98 | 0.96 | 1.1 | 1.17 | 1.02 |
α/β+γ | 0.96±0.05 (95%CI:0.94–0.98)b | 0.9 | 0.96 | 0.92 | 0.62 | 0.98 | 0.96 | 1.1 | 0.68 | 1.02 |
+ and − indicate positive and negative phenotypes described in rows, ± indicates the expression is lower than normal individuals.
Four family members in family A without KLF1 mutation had normal hematologic parameters with Hb F between 1.3% and 1.7%.
Thirty healthy individuals were analyzed and used as normal control.
Ultrastructural analysis shows normal erythropoiesis and served as a control.
In order to maintain Hb level of 90 g/l to sustain the growth and development, regular transfusion was given after diagnosis at the age of 6 months.