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LETTER TO THE EDITOR |
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Year : 2015 | Volume
: 8
| Issue : 4 | Page : 575-576 |
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Screening of sickle cell anemia and thalassemia in college students
Rittu S Chandel, Leela G Abhichandani
Department of Biochemistry, Grant Government Medical College and Sir J.J. Group of Hospitals, Byculla, Mumbai, Maharashtra, India
Date of Web Publication | 14-Jul-2015 |
Correspondence Address: Rittu S Chandel Department of Biochemistry, Grant Government Medical College and Sir J.J. Group of Hospitals, Byculla, Mumbai - 400 008, Maharashtra India
Source of Support: None, Conflict of Interest: None | Check |
DOI: 10.4103/0975-2870.160796
How to cite this article: Chandel RS, Abhichandani LG. Screening of sickle cell anemia and thalassemia in college students. Med J DY Patil Univ 2015;8:575-6 |
Sir,
In India, hemoglobinopathies are a significant problem. The prevalence of beta thalassemia mutations in India has been reported to be as high as 17% in some populations. Sickle cell anemia, an autosomal recessive disorder is prevalent in many parts of India. [1] Thalassemia is a major hemoglobinopathy, a single gene hereditary disorder. It is seen that one out of fourteen people is carriers of different types of thalassemias. [2] Sickle cell anemia occurs due to mutation in beta globin chain that changes the sixth amino acid from glutamic acid to valine. [3] The diagnosis of thalassemias and sickle cell anemia is based on clinical history, hematologic profile (including hemoglobin level, complete blood count [CBC], reticulocyte count, and red blood cell morphology], Hb electrophoresis and high performance liquid chromatography [HPLC]). [4] The college going students form the part of the next generation and hence, their screening would be helpful to the society.
Two ml blood sample was collected in EDTA bulb from engineering college students and stored at 2-8°C. Broad screening for hemoglobinopathies was done on the basis of CBC and red cell indices.
The test for both sickle cell anemia and thalassemia was performed on automated HPLC, bio-rad variant automated analyzer with the "β thalassemia short" program. It utilizes the principles of cation - exchange HPLC.
We observed that of 300 students, 28 (9.33%) suffered from thalassemia and none was diagnosed to have sickle cell anemia. 30 students had affected red cell indices.
The hemoglobinopathies are autosomal recessive disorders characterized by either the reduced synthesis of one or more normal globin chains (the thalasemias), the synthesis of a structurally abnormal globin chain. The inherited hemoglobinopathies are a large group of disorders that include the thalasemias and sickle cell disease. Carrier detection methods must be able to detect alpha-hemoglobin variants through accurate measurement of mean cell hemoglobin, mean cell volume HbA(2), and HbF values. [5] The results indicate that the thalassemia trait is more prevalent in the Sindhi community. Vaishyavani, Brahmin, Maheshwari, Vaishnav, and Patel were the other contributing castes [Table 1]. Screening of a healthy population is required to determine the carrier rates and gene frequencies in this region. Birth of a thalassemic child places immense stress on the family as it is associated with regular hospital visits, expensive treatment, and painful procedures. Only 10-15% of all thalassemic children born per year get optimal therapy in the form of regular blood transfusions and chelation. The only curative treatment currently relevant in India in the form of bone marrow transplant is beyond the reach of all but a lucky few. | Table 1: Caste-wise distribution of thalassemia in the sample population
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It is only through extensive awareness campaigns, proactive screening that these diseases can be prevented in further generations, and the society and community can be spared of the psychological and economic burden.
References | | |
1. | Moorchung N, Phillip J, Sarkar RS, Prasad R, Dutta V. Is high pressure liquid chromatography an effective screening tool for characterization of molecular defects in hemoglobinopathies? Indian J Pathol Microbiol 2013;56:36-9. [ PUBMED] |
2. | Panja A, Ghosh TK, Basu A. Genetics of thalassemia in Indian population. J Community Nutr Health 2012;1:39-46. |
3. | Benz EJ Jr. Disorders of Hemoglobin Harrison's Principles of Internal Medicine. 17 th ed. Vol. 1. New York: McGraw Hill; 2008. |
4. | Rao S, Kar R, Gupta SK, Chopra A, Saxena R. Spectrum of haemoglobinopathies diagnosed by cation exchange-HPLC & modulating effects of nutritional deficiency anaemias from north India. Indian J Med Res 2010;132:513-9. [ PUBMED] |
5. | Eastman JW, Wong R, Liao CL, Morales DR. Automated HPLC screening of newborns for sickle cell anemia and other hemoglobinopathies. Clin Chem 1996;42:704-10. |
[Table 1]
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