ObjectiveTo characterize alpha-chain variant hemoglobins with electric mobility similar to
that of hemoglobin S in a newborn screening program. MethodsβS allele and alpha-thalassemia deletions were investigated in
14 children who had undefined hemoglobin at birth and an electrophoretic profile
similar to that of hemoglobin S when they were six months old. Gene sequencing and
restriction enzymes (DdeI, BsaJI, NlaIV, Bsu36I and TaqI) were used to identify
hemoglobins. Clinical and hematological data were obtained from children who
attended scheduled medical visits. ResultsThe following alpha chain variants were found: seven children with hemoglobin
Hasharon [alpha2 47(CE5) Asp>His, HbA2:c.142G>C], all
associated with alpha-thalassemia, five with hemoglobin Ottawa [alpha1
15(A13) Gly>Arg, HBA1:c.46G>C], one with hemoglobin St Luke's
[alpha1 95(G2) Pro>Arg, HBA1:c.287C>G] and another one
with hemoglobin Etobicoke [alpha212 84(F5) Ser>Arg,
HBA212:c.255C>G]. Two associations with hemoglobin S were found: one
with hemoglobin Ottawa and one with hemoglobin St Luke's. The mutation underlying
hemoglobin Etobicoke was located in a hybrid α212 allele in one child.
There was no evidence of clinically relevant hemoglobins detected in this study.
ConclusionApparently these are the first cases of hemoglobin Ottawa, St Luke's, Etobicoke
and the α212 gene described in Brazil. The hemoglobins detected in this
study may lead to false diagnosis of sickle cell trait or sickle cell disease when
only isoelectric focusing is used in neonatal screening. Additional tests are
necessary for the correct identification of hemoglobin variants.