Abnormal Hemoglobin Variants Research Articles

Frequencies of Abnormal Haemoglobin Electrophoretic Patterns in Hemolytic Anemia cases in District Swat.

Background: Thalassemia is a genetic disorder due to deletion or mutation in the gene for alpha or beta chain of hemoglobin. Thalassemia, sickle cell disease, HbD, HbE, HbC and other such disorders are genetic defects associated with hemolytic anemia's and other complications. The prevalence of these are significantly growing in Pakistan especially in the northern areas of Pakistan. Its prompt detection is of paramount importance, both for the prevention of thalassemia major and clinically severe other hemoglobinopathies as well as for the epidemiological purposes.Objective: To assess the frequencies of abnormal hemoglobin variants in the suspected cases of hemolytic anemia's, in the population of district swat. Material and Methods: A total of 1832 suspected cases of hemolytic anemias admitted in SGTH/SMC were assessed after taking clinical and familial history. Whole blood samples were collected in EDTA tube; complete blood counts with peripheral smears were prepared. All samples were processed with fully automatic micro capillary hemoglobin electrophoretic movability (SEBEA micro capillary electrophoresis).Results: A normal Hb pattern was observed in 1224 (66.81%) cases and abnormalities were detected in 608 (33.18%) cases. â (beta) thalassemia trait was the commonest abnormality found in 477 (26.03 %) patients followed by â thalassemia major 53 (2.89 %), â thalassemia intermedia 24 (1.31 %), raised HbF for age review after one year 17 (0.92 %), Sickle cell trait 9 (0.49 %), Sickle cell disease 8 (0.43 %), sickle/beta-thalassemia 6 (0.32 %) HbD Trait 5 (0.27 %), HbE (0.21%) and HbC (0.10%) were common hemoglobinopathies.Conclusion: Amongst hemoglobinopathies, â- (beta) thalassemia and sick cell trait/disease is the most common of the hemoglobinopathies in the study area.

Hematological Analysis and Diagnosis of Two Rare Abnormal Hemoglobin

To analyze the hematological characteristics of Hb Broomhill and Hb Hornchurch, and prenatal diagnosis should be carried out in two families. RBC parameters and hemoglobin electrophoretogram were analyzed on the peripheral blood of all patients, and amniotic fluid was collected for prenatal diagnosis. PCR-Flow fluorescent hybridization and Sanger sequencing were performed for gene diagnosis of thalassemia. Three cases of Hb Broomhill were detected, including 2 cases with common SEA α-thalassemia, which was characterized by hypochromic microcytic mild anemia, the capillary electrophoregram revealed a tiny shoulder peak before the Hb A peak; 1 case was diagnosed as Hb Hornchurch combined with β-thalassemia, which also showed mild anemia. Hemoglobin electrophoretogram showed an abnormal hemoglobin variant peak at Hb A2 zone. The carriers of Hb Broomhill and Hb Hornchurch do not have microcytic hypochromic anemia, which do not aggravate the hematological symptoms, such as anemia when being combined with thalassemia of the same type.

Asymptomatic carriage of Plasmodium falciparum by individuals with variant blood groups and haemoglobin genotypes in southern Ghana

BackgroundThe ABO and the Rhesus blood group systems, as well as various abnormal haemoglobin (Hb) variants (haemoglobinopathies) are known to influence malaria parasite carriage and disease severity in individuals living in malaria endemic areas. This study identified the blood group and Hb variant distribution and Plasmodium falciparum infection status of afebrile individuals living in southern Ghana.MethodsAfebrile participants were recruited from Obom (358) in the Greater Accra Region and Ewim (100) and Simiw (329) in the Central Region of Ghana. Venous blood (1 ml) was collected into EDTA vacutainer tubes. Three 20 μl drops of blood were used for blood group analysis using the tile method. Another 500 μl aliquot was used for the qualitative sickling test using sodium metabisulphite and haemoglobin electrophoresis. Genomic DNA was extracted from 100 μl of whole blood and used in P. falciparum species-specific PCR.ResultsThe most abundant blood group and abnormal haemoglobin variant in both sites was blood group O + (47.4%) and HbAS (15.8%). A total of 13 (1.7%) of the participants had full haemoglobinopathies (SS, SC and CC), whilst 196 (25.4%) were carriers (AS and AC). Although there was a significantly higher prevalence of sickling positive participants from the Central Region, genotyping identified a similar prevalence of each of the abnormal haemoglobin genes in both sites. Asymptomatic parasite carriage estimated by PCR was 40.9% in the Central Region and 41.8% in the Greater Accra Region.ConclusionsAsymptomatic carriage of P. falciparum parasite in the study population was not associated with any particular blood group variant or haemoglobin genotype.

Study of abnormal haemoglobin variants in patients of anaemia using high performance liquid chromatography (HPLC) in Gujarat, India

Introduction: Haemoglobinopathies are the most common inherited red cell disorders world-wide. Identification of these disorders is immensely important epidemiologically, for early diagnosis, improved management protocols and prevention of disease in upcoming generation. Our aim is to study the abnormal haemoglobin variants in patients of anaemia using High Performance Liquid Chromatography (HPLC) BIO-RAD D-10 Dual Program analyser in Vadodara region of Gujarat. Methods: A total of 1890 cases of patient’s with anaemia having haemoglobin up to 11 gm% were studied for HPLC for diagnosing any abnormal haemoglobin disorder by BIO-RAD D-10 Dual Program analyser. Results: Out of 1890 cases of anaemia studied, 1236 (65.3%) cases showed abnormal haemoglobin, and rest 654 (52.9%) cases showed normal result on HPLC. Of these, 1236 cases, 686 cases of sickle cell trait (55.5%) the predominant abnormality, followed by 247 cases of sickle cell disease (19.9%). There were 208 cases of beta Thalassemia trait (16.8%), followed by 89 cases of double heterozygous state of beta thalassemia and sickle cell trait (7.2%). There were three cases of Thalassemia major with high Hb F (0.24%), two cases of Hb D Punjab heterozygous patients (0.16%) and one case of Hb E heterozygous (0.08%). Conclusion: HPLC is an accurate, simple and superior technique in detection of various haemoglobin disorders, which helps in management of patients and prognostic significance. It is also important in premarital and antenatal screening tests, to prevent birth of children with severe Haemoglobin disorders.

Study of abnormal haemoglobin variants using cation exchange high performance liquid chromatography (HPLC) in paediatric population of Gujarat, India

Study of abnormal haemoglobin variants using cation exchange high performance liquid chromatography (HPLC) in paediatric population of Gujarat, India

Molecular epidemiology, pathogenicity, and structural analysis of haemoglobin variants in the Yunnan province population of Southwestern China

Abnormal haemoglobin (Hb) variants result in the most commonly inherited disorders in humans worldwide. In this study, we investigated the molecular epidemiology characteristics of Hb variants, along with associated structural and functional predictions in the Yunnan province population of Southwestern China. A total of 41,933 subjects who sought haemoglobinopathy screening were included. Based on bioinformatics and structural analysis, as well as protein modeling, the pathogenesis and type of Hb genetic mutations were characterized. Among all individuals studied, 328 cases (0.78%) were confirmed as carriers of Hb variants, with 13 cases (0.03%) presenting α-globin variants, 313 (0.75%) β-globin variants, and two δ-globin variants. A total of 19 different mutations were identified, including three novel mutations. In addition, 48 cases of ααCS mutations and 14 cases of Hb H or Hb Bart’s were found. The isoelectric point, evolutionary conservation, and genotype-phenotype correlation for these mutations were predicted. Additionally, secondary and tertiary protein structure modeling were performed for three selected mutations. In conclusion, the prevalence of Hb variants in the Yunnan population is much higher than other regions of China. Complete characterization of these Hb variants is essential for generating a rational strategy to control the haemoglobinopathies in this region.

PB2417 SPECTRUM OF HAEMOGLOBINOPATHIES;A TERTIARY CARE HOSPITAL EXPERIENCE

Background:Inherited abnormalities of hemoglobin synthesis include a myriad of disorders ranging from thalassemia syndromes to structurally abnormal hemoglobin variants.Identification of these disorders is immensely important epidemiologically and aid in prevention of more serious hemoglobin disorders.Aims:This study presents the pattern of haemoglobinopathies amongst the referred patients of anaemia in a 1 year period, it helps to identify the cases of different hemoglobin disorders.Methods:Inherited abnormalities of hemoglobin synthesis include a myriad of disorders ranging from thalassemia syndromes to structurally abnormal hemoglobin variants. Identification of these disorders is immensely important epidemiologically and aid in prevention of more serious hemoglobin disorders.Results:Out of 747 cases, 558 (74.6%) were normal and 189 (25.3%) cases had abnormal haemoglobin pattern. 356 (47.6%) were males and 391 (52.3%) were females. Of all cases of Anaemia 278 (49.8%) were microcytic hypochromic, 22 (3.9%) macrocytic and the rest 258 (46.2%) had normocytic normochromic picture. Of the 189 abnormal cases, Spectrum of haemoglobinopathies prevalent were Beta Thalassemia trait 117 (61.9%), followed by Beta thalassaemia major 27 (14.2%). Other haemoglobinopathies in descending order of frequency were sickle cell disease 15 (7.9%), Hb D Disease 16 (8.4%), sickle cell trait 01 (0.5%), Sickle/beta thalassaemia in 02 (1.0%) and Hb E in 04 (2.1%).Summary/Conclusion:Our study showed higher frequency of Beta Thalassaemia trait. It is suggested that detection of HbA2 should be carried out in all the high‐risk groups with anaemia. Further larger studies are needed to screen our population to detect thalassaemia carrier state and Iron deficiency Anaemia.

高速液体クロマトグラフィー測定のHbA1c値と血糖値との乖離により異常ヘモグロビンHb Montfermeil［β 130（H8）Tyr→Cys］と判明した1例

高速液体クロマトグラフィー測定のHbA1c値と血糖値との乖離により異常ヘモグロビンHb Montfermeil［β 130（H8）Tyr→Cys］と判明した1例

Profile of nutritional anemia and its correlation with serum iron, Vitamin B12, and folic acid level among the tribal population of northern districts of West Bengal, India

Background and Objective: Nutritional anemia is the most common and easily preventable cause of anemia. No comprehensive data regarding the magnitude of this problem are available in the literature in northern regions of West Bengal where a significant number of tribals inhabit. The present study was undertaken to assess the magnitude of anemia and the status of iron, Vitamin B12, and folic acid deficiency in tribals of North Bengal and to analyze their red blood cell (RBC) morphology. Materials and Methods: A descriptive study done on the individuals during a period of 1 year at North Bengal Medical College. Serum iron, ferritin, total iron-binding capacity, Vitamin B12, and folic acid were measured along with other relevant investigations. Results: Forty-eight out of 88 (54.51%) of the cases were found to be anemic. Thirty-four out of 48 (70.83%) of them had at least one of the nutritional deficiencies. Iron deficiency was most common, seen in 18 (37.5%) of cases. Abnormal hemoglobin was seen in 7 (14.58%), two of which also had nutritional deficiency. In combined iron and folate deficiency, 7 out of 10 (70%) showed microcytic hypochromic morphology and 3 (30%) were dimorphic. Conclusion: Iron and folic acid deficiency is quite common among the tribals of northern region of West Bengal. RBC morphology alone lacks the specificity for the diagnosis of causes. Furthermore, nutritional deficiencies may coexist with abnormal hemoglobin variants, complicating their diagnosis further. A proper clinical, hematological, and biochemical correlation is required for the accurate diagnosis and effective treatment of anemia, highlighting the need for a screening for the causes of anemia in this population.

Carrier Detection of Thalassaemia and Haemoglobinopathies in Tribal Population of Bangladesh

Tribal population constitutes 1.8 percent of total population of Bangladesh. The study was conducted in the tribal population of Bangladesh to detect haemoglobinopathies and beta thalassemia trait. Another purpose of the study was to create awareness about thalassaemia and haemoglobinopathies among these indigenous groups. It was a cross sectional study conducted from September 2015 to November 2015. A total of 460 random samples were collected from three tribal groups, 175 cases from Chakma, 187 cases from Garo and 98 cases from Marma. Two cc of venous blood were collected in EDTA tube. Haemoglobin variants were studied by HPLC method using Variant Hemoglobin Testing System (Variant II Beta Thalassemia Short Program). Statistical analysis was carried out using SPSS statistical package (version 15). Data was analyzed by frequency distribution. Abnormal Haemoglobin variants were seen in 287 cases (62.4%) out of 460 cases and only173 cases (37.6%) showed normal haemoglobin pattern. Haemoglobin E trait was the most common abnormality seen in 164 cases (35.6%) followed by Haemoglobin E disease which was seen in 101 cases (22%), Beta thalassaemia trait was seen in 22 cases (4.8%). This study shows a high percentage of Haemoglobin E trait and Haemoglobin E disease. Beta thalassaemia trait is also higher in comparison with randomly selected general population of Bangladesh. After calculating the estimate burden of child born per year by Harding Weinberg equation, it was to be found that the significant result which shows that 1552 new haemoglobin E beta thalassaemia and 22 new beta thalassaemia patients born per year in the tribal population. So, the tribal population should be properly screened and counseled for thalassaemia and haemoglobinopathies.

Prevalence of anemia among the women of childbearing age belonging to the tea garden community of Assam, India: A community-based study

Background:Anemia is a condition in which the number of red blood cells becomes insufficient to meet the body's physiologic needs. Anemia is one of the major public health problems in India. The aim of this study was to find the prevalence and determinants of anemia among the adult females of tea garden community of Assam.Materials and Methods:A community-based cross-sectional study was conducted among 770 numbers of adult females belonging to the tea garden community. For all the samples, complete blood count, abnormal hemoglobin variants screening by high-performance liquid chromatography (HPLC), serum iron level, total iron binding capacity (TIBC), and serum ferritin concentrations were determined.Results:Out of 770 patients, 19.7% were severely anemic. Hb S and β-thalassemia were the only hemoglobin types detected in the study. Hemoglobin type, mean corpuscular volume, TIBC, and serum ferritin level were the important determinants of anemia in the present study.Conclusion:To reduce the burden of anemia among the adult females of tea garden community, the females should be screened periodically, and appropriate measures should be taken.

Prevalences of inherited red blood cell disorders in pregnant women of different ethnicities living along the Thailand-Myanmar border.

Background: Inherited red blood cell disorders are prevalent in populations living in malaria endemic areas; G6PD deficiency is associated with oxidant-induced haemolysis and abnormal haemoglobin variants may cause chronic anaemia. In pregnant women, microcytic anaemia caused by haemoglobinopathies mimics iron deficiency, complicating diagnosis and treatment. Anaemia during pregnancy is associated with morbidity and mortality. The aim of this study was to characterise the prevalence of G6PD deficiency and haemoglobinopathies among the pregnant population living along the Thailand-Myanmar border. Pregnant women attending antenatal clinics in this area belong to several distinct ethnic groups. Methods: Data were available for 13,520 women attending antenatal care between July 2012 and September 2016. Screening for G6PD deficiency was done by fluorescent spot test routinely. G6PD genotyping and quantitative phenotyping by spectrophotometry were analysed in a subsample of women. Haemoglobin variants were diagnosed by HPLC or capillary electrophoresis and molecular methods. The prevalence and distribution of inherited red blood cell disorders was analysed with respect to ethnicity. Results: G6PD deficiency was common, especially in the Sgaw Karen ethnic group, in whom the G6PD Mahidol variant allele frequency was 20.7%. Quantitative G6PD phenotyping showed that 60.5% of heterozygous women had an intermediate enzymatic activity between 30% and 70% of the population median. HbE, beta-thalassaemia trait and Hb Constant Spring were found overall in 15.6% of women. Only 45.2% of women with low percentage of HbA 2 were carriers of mutations on the alpha globin genes. Conclusions: Distribution of G6PD and haemoglobin variants varied among the different ethnic groups, but the prevalence was generally high throughout the cohort. These findings encourage the implementation of an extended program of information and genetic counselling to women of reproductive age and will help inform future studies and current clinical management of anaemia in the pregnant population in this region.

Prevalences of inherited red blood cell disorders in pregnant women of different ethnicities living along the Thailand-Myanmar border

Background: Inherited red blood cell disorders are prevalent in populations living in malaria endemic areas; G6PD deficiency is associated with oxidant-induced haemolysis and abnormal haemoglobin variants may cause chronic anaemia. In pregnant women, microcytic anaemia caused by haemoglobinopathies mimics iron deficiency, complicating diagnosis and treatment. Anaemia during pregnancy is associated with morbidity and mortality. The aim of this study was to characterise the prevalence of G6PD deficiency and haemoglobinopathies among the pregnant population living along the Thailand-Myanmar border. Pregnant women attending antenatal clinics in this area belong to several distinct ethnic groups. Methods: Data were available for 13,520 women attending antenatal care between July 2012 and September 2016. Screening for G6PD deficiency was done by fluorescent spot test routinely. G6PD genotyping and quantitative phenotyping by spectrophotometry were analysed in a subsample of women. Haemoglobin variants were diagnosed by HPLC or capillary electrophoresis and molecular methods. The prevalence and distribution of inherited red blood cell disorders was analysed with respect to ethnicity. Results: G6PD deficiency was common, especially in the Sgaw Karen ethnic group, in whom the G6PD Mahidol variant allele frequency was 20.7%. Quantitative G6PD phenotyping showed that 60.5% of heterozygous women had an intermediate enzymatic activity between 30% and 70% of the population median. HbE, beta-thalassaemia trait and Hb Constant Spring were found overall in 15.6% of women. Only 45.2% of women with low percentage of HbA 2 were carriers of mutations on the alpha globin genes. Conclusions: Distribution of G6PD and haemoglobin variants varied among the different ethnic groups, but the prevalence was generally high throughout the cohort. These findings encourage the implementation of an extended program of information and genetic counselling to women of reproductive age and will help inform future studies and current clinical management of anaemia in the pregnant population in this region.

Acquired methemoglobinemia after hydroxocobalamin administration in a patient with burns and inhalation injury

Context: Hydroxocobalamin is an effective cyanide antidote. While erythema, hypertension, and chromaturia are recognized side effects, methemoglobinemia has not been reported. Methemoglobin levels are most accurately measured by co-oximetry. We describe an extensively burned patient who developed methemoglobinemia within an hour of hydroxocobalamin administration.Case details: A 47-year old man without genetic deficiencies or abnormal hemoglobin variants presented with 61% body surface area thermal burns and grade 1 inhalation injury sustained during a tugboat engine explosion. On admission, lactate was 9.24 mmol/L, methemoglobin 1%, and carboxyhemoglobin 0.2% by blood gas analysis with co-oximetry. Despite large-volume resuscitation, lactate remained elevated (7–8 mmol/L). Intravenous hydroxocobalamin (5 g) was administered at postburn hour 19 for possible cyanide toxicity. Immediately thereafter, he became hypertensive with reflex bradycardia. Lactate decreased to 5.51 mmol/L, methemoglobin rose to 4.10%, and oxygen saturation by pulse oximetry decreased to 74–80% (despite arterial oxygen saturation of 95% by cooximetry). Methemoglobin concentration peaked at 13.40% at postburn hour 33. Methylene blue was not administered.Conclusions: Methemoglobinemia in our patient was temporally associated with hydroxocobalamin administration.

Prevalences of inherited red blood cell disorders in pregnant women of different ethnicities living along the Thailand-Myanmar border

Background: Inherited red blood cell disorders are prevalent in populations living in malaria endemic areas; G6PD deficiency is associated with oxidant-induced hemolysis and abnormal hemoglobin variants may cause chronic anemia. In pregnant women, microcytic anemia caused by hemoglobinopathies mimics iron deficiency, complicating diagnosis and treatment. Anemia during pregnancy is associated with morbidity and mortality. The aim of this study was to characterize the prevalence of G6PD deficiency, hemoglobinopathies, ABO and Rhesus blood groups among the pregnant population living along the Thailand-Myanmar border. Pregnant women attending antenatal clinics in this area belong to several distinct ethnic groups. Methods: Data was available for 13,520 women attending antenatal care between July 2012 and September 2016. Screening for G6PD deficiency was done by fluorescent spot test routinely. G6PD genotyping and quantitative phenotyping by spectrophotometry were analyzed in a subsample of women. Hemoglobin variants were diagnosed by HPLC or capillary electrophoresis and molecular methods. Blood groups were diagnosed by agglutination test. The prevalence and distribution of inherited red blood cell disorders and blood groups was analyzed with respect to ethnicity. Results: G6PD deficiency was common, especially in the Sgaw Karen ethnic group, in whom the G6PD Mahidol variant allele frequency was 20.7%. Quantitative G6PD phenotyping showed that 60.5% of heterozygote women have an intermediate enzymatic activity between 30% and 70% of the population median. HbE, beta-thalassemia trait and alpha-thalassemia trait were found in 31.2% of women. Only 0.15% of women were Rhesus negative. Conclusions: Distribution of G6PD and hemoglobin variants varied among the different ethnic groups, but the prevalence was generally high throughout the cohort. These findings encourage the implementation of an extended program of information and genetic counseling to women of reproductive age and will help inform future studies and current clinical management of anemia in the pregnant population in this region.

Spectrum of Types of Thalassemias and Hemoglobinopathies: Study in a Tertiary Level Children Hospital in Bangladesh

Thalassemias and hemoglobinopathies are the most common hemolytic congenital disorders in Bangladesh as in many parts of the world. This study was done to find the common types of thalassemias and abnormal hemoglobin variants seen in Bangladeshi populations. A total of 4813 samples were analyzed for hemoglobin disorders out of which 2308 (49.95%) showed abnormalities. The samples were analyzed by Bio Rad D 10 Analyzer in 3914 (81.32%) cases, BIORAD VARIANTβ thalassemia short program using the principle of high performance liquid chromatography in 474 (9.85%) cases and by CAPILLARYS 2 FLEX PIERCING utilizing capillary electrophoresis in 425 (8.83%) cases. The samples were analyzed in the Department of Biochemistry and Molecular Biology of Dhaka Shishu (Children) Hospital, Dhaka, Bangladesh. The common hemoglobin disorders seen were β trait 863 (17.94%), Hb E trait 601 (12.50%), Hb E β thalassemia 524 (10.87%), β thalassemia major 192 (4.00 %), Hb E disease 99 (2.05%). Other Hb abnormalities detected were Hb D trait 17 (0.35%), Sickle cell trait 4 (0.08%), hereditary persistence of fetal hemoglobin (HPFH) 2 (0.04%), and Hb Lepore, δ β thalassemia, sickle cell β thalassemia, Sickle cell disease, compound heterozygote for HbE+D and Hb Q band one case each (0.02%).

Variant Hemoglobin Spectrum By Cation Exchange High Performance Liquid Chromatography: A Study 0f 2035 Subjects

Introduction Hemoglobinopathies and thalassemia are hereditary disorders of hemoglobin (Hb) affecting mankind at prevalent regional level. Automated cation exchange high performance liquid chromatography is being increasingly used as the initial diagnostic method for identifying normal and abnormal hemoglobin variants. Methodology Total 2035 sample received and studied. All samples run on cation exchange high performance liquid chromatography machine by BIO-RAD. Results: Total 386(18.96%) cases had abnormal hemoglobin fractions. Beta thalassemia major cases were 17(0.83%). Beta thalassemia intermedia cases were 4(0.19%). Sickle cell trait (heterozygous Hb S) cases were 96(4.71%). Double heterozygous for sickle cell-beta thalassemia cases were 14(0.68%). There were 06 cases (0.29%) of Hb D heterozygous. There were one each case of Hb E heterozygous and Hb E-beta thalassemia (0.04% each). Hb F was raised in 7 adult cases (0.34%). Conclusion: To conclude, cation exchange high performance liquid chromatography is less time consuming, cost effective, labor saving, reproducible, accurate, sensitive and specific method to detect hemoglobinopathies and thalassemia. Most of the abnormal cases are diagnosed with this method, with few inconclusive cases require further genetic and molecular workup. DOI: 10.21276/APALM.1393

Sickle cell disease

The haemoglobinopathies are the most common monogenetic diseases in the world. They include the thalassaemias and sickle cell syndromes. The sickle cell syndromes encompass several abnormal haemoglobin variants, of which homozygosity for the sickle cell gene – that is, sickle cell anaemia is the most common and most severe. Originally characteristic of the tropics and subtropics, recent mobility and migratory trends have meant that the prevalence of sickle cell disease (SCD) has significantly increased in the UK. It is important that GPs have an understanding of this disease, in order to help their patients deal with complications of every-day life. This article will address three main aspects of SCD: diagnosis, health maintenance, and some acute and chronic complications of SCD.

Erythrocyte and platelet proteomics in hematological disorders.

Erythrocytes undergo ineffective erythropoesis, hemolysis, and premature eryptosis in sickle cell disease and thalassemia. Abnormal hemoglobin variants associated with hemoglobinopathy lead to vesiculation, membrane instability, and loss of membrane asymmetry with exposal of phosphatidylserine. This potentiates thrombin generation resulting in activation of the coagulation cascade responsible for subclinical phenotypes. Platelet activation also results in the release of microparticles, which express and transfer functional receptors from platelet membrane, playing key roles in vascular reactivity and activation of intracellular signaling pathways. Over the last decade, proteomics had proven to be an important field of research in studies of blood and blood diseases. Blood cells and its fluidic components have been proven to be easy systems for studying differential expressions of proteins in hematological diseases encompassing hemoglobinopathies, different types of anemias, myeloproliferative disorders, and coagulopathies. Proteomic studies of erythrocytes and platelets reported from several groups have highlighted various factors that intersect the signaling networks in these anucleate systems. In this review, we have elaborated on the current scenario of anucleate blood cell proteomes in normal and diseased individuals and the cross-talk between the two major constituent cell types of circulating blood.

Abnormal Hemoglobin Variants Detected by HPLC Method in Okmeydanı Training and Research Hospital Medical Biochemistry Laboratory

Abnormal Hemoglobin Variants Detected by HPLC Method in Okmeydanı Training and Research Hospital Medical Biochemistry Laboratory