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Why is the novel Hb Miguel Servet visualised by CE-HPLC newborn and not by the CE-HPLC β-thalassaemia programme?
  1. Valle Recasens1,
  2. Ángeles Montañés1,
  3. Carmen Rodríguez-Vigil2,
  4. Yolanda González3,
  5. Guillermo Hernández de Abajo3,
  6. Jorge M Nieto4,5,
  7. Beatriz González Fernández4,5,
  8. Fernando-Ataúlfo González-Fernández4,6,
  9. Ana Villegas4,
  10. Celina Benavente4,
  11. Paloma Ropero4,5
  1. 1 Hematology, Hospital Universitario Miguel Servet, Zaragoza, Aragón, Spain
  2. 2 Pediatría, Hospital Universitario Miguel Servet, Zaragoza, Aragón, Spain
  3. 3 Bioquímica, Hospital Universitario Miguel Servet, Zaragoza, Aragón, Spain
  4. 4 Hematología, Hospital Clínico San Carlos, Madrid, Spain
  5. 5 Instituto de Investigación Sanitaria Hospital Clínico San Carlos, Madrid, Spain
  6. 6 Haematology, Central Laboratory of Madrid, Madrid, Spain
  1. Correspondence to Dr Paloma Ropero, Haematology, Hospital Clínico San Carlos, 28040 Madrid, Spain; paloma.ropero{at}salud.madrid.org

Abstract

Screening of haemoglobinopathies is indicated for the detection of sickle cell anaemia; thus, neonates can benefit from early and adequate treatment that prevents neurological damage, reduces morbidity and mortality associated with the disease. These types of programmes sometimes lead to unexpected findings. We present a new haemoglobin (Hb) variant (Hb Miguel Servet) detected by newborn screening. During neonatal screening of haemoglobinopathies by cation-exchange high-performance liquid chromatography (CE-HPLC) newborn, an Hb variant was detected. An analysis at 8 months of age using capillary zone electrophoresis (CZE) confirmed the presence of this new Hb. The molecular characterisation was performed by automatic sequencing of the α and β globin genes in an ABI PRISM 3100 Genetic Analyzer. Hb analysis by CE-HPLC β-thalassaemia short programmedid not indicate the presence of abnormal Hbs. By CZE showed a peak in the zone 12 zone comprising 3.3% of the total Hb. A new analysis by CE-HPLC on a Tosoh G8-2 (Horiba) shown a peak, in the region of HbA1b, did not interfere with the quantification of HbA1c. Sequencing of the β gene revealed the substitution of a guanine for a thymine (GGT >TGT) in codon 69 of the second exon, resulting in substitution of cysteine for the amino acid glutamine (HBB:c.208G>T). Hb Miguel Servet is a β-chain globin variant detected by CE-HPLC newborn (BioRad), by CZE and by CE-HPLC-CE Tosoh G8-2 (Horiba), but no by CE-HPLC-CE β-thalassaemia short programme (BioRad). In fact, for all the techniques that are visualised, what would be detected would be the glutathione variant of Hb (Miguel Servet).

  • haemoglobinopathies
  • diagnostic screening programs
  • diagnostic techniques and procedures

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Footnotes

  • Handling editor Mary Frances McMullin.

  • Contributors VR, AM, CR-V, YG and GHdA have carried out neonatal screening and subsequent studies, both of the propositus and his mother at Hospital Universitario Miguel Servet. JMN, BGF, F-AG-F, AV, CB and PR have carried out the study at the ref lab as well as its molecular characterisation. All of themm have contributed to the writing and preparation of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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