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Bhat V.S.,Manipal Hospital Diagnostic Services | Dewan K.K.,Cauvery Medical Center | Krishnaswamy P.R.,Cauvery Medical Center
Indian Journal of Clinical Biochemistry | Year: 2010

We report a case of hemolytic anemia that was subsequently identified to be a case of α-thalassaemia harboring the common rightward 3.7 kb deletion/HbH. The diagnosis was based on sequential analyses using BioRad D10 HPLC, Alkaline gel electrophoresis, GPO α THAL-IC strips and the identification of the specific genetic lesion using an α Globin reverse dot blot hybridization assay. Supravital stain of RBCs helped in identifying classical HbH inclusions. In a background of a variable clinical presentation, lack of definitive hematological markers, and general under-diagnosis of α-thalassaemias we have used this case to highlight the features and sequence of techniques involved in identifying and characterizing an α-globin chain mutation, starting from a diffuse clinical history and presentation up to the identification of a specific genetic lesion involved. © Association of Clinical Biochemists of India 2010.


Bhat V.S.,Manipal Hospital Diagnostic Services | Dewan K.K.,Cauvery Medical Center | Krishnaswamy P.R.,Cauvery Medical Center | Mandal A.K.,St Johns Research Institute | Balaram P.,Indian Institute of Science
Indian Journal of Clinical Biochemistry | Year: 2010

Hemoglobin Q-India (alpha) 64 Asp →His is an alpha chain variant which is generally found in heterozygous state and presents normal hematological blood picture. Here we report a rare case of HbQ-India with a thalassemic phenotype that has been analyzed using a combination of mass spectrometry, gene sequencing and PCR analysis. This combined analyses revealed the HbQ variant to be associated with a beta chain mutation, IVS 1-1 [G>T]. Though HbQ has earlier been reported with thalassemic trait using different techniques, this is the first report of a compound α and β chain Hb heterozygous mutant involving HbQ and IVS1-1 being validated using Mass Spectrometry and Reverse dot blot hybridization.


Bhat V.S.,Manipal Hospital Diagnostic Services | Dewan K.K.,Cauvery Medical Center | Krishnaswamy P.R.,Cauvery Medical Center
Indian Journal of Clinical Biochemistry | Year: 2011

We report a case of a diabetic, heterozygote with near normal hematology, marginally low level of hemoglobin A2(HbA2) having an increased level of hemoglobin F(HbF) that was pancellularly distributed among the red cells. BioRad DiaSTAT measurements gave a high glycated hemoglobin A1c(HbA1c) of 31.5% and the BioRad Variant analyzer recorded an HbA1c value which was very low, in discordance with the detected blood glucose levels. Flow cytometry and polymerization chain reaction (PCR) based studies were carried out which revealed the case to be that of the common hereditary persistence of fetal hemoglobin (HPFH)-3, an Asian Indian mutation. Fructosamine estimation and HbA1c by Boronate affinity chromatography were able to resolve the discordant value detected and was able to confirm the diabetes status. The case would have been a diagnostic dilemma, if reported without correlation. © 2010 Association of Clinical Biochemists of India.


PubMed | Cauvery Medical Center
Type: Journal Article | Journal: Indian journal of clinical biochemistry : IJCB | Year: 2012

Mass spectrometry provides a convenient platform for the study of different protein post translational modifications from clinical specimen. Analysis of different post translational modifications of hemoglobin like glycation and glutathionylation can provide useful information on the disease progression and the possible outcome of therapies. In the present study, we have addressed post translational modifications of hemoglobin like glutathionylation and glycation in relation to diabetes and chronic renal failure. We found that both alpha and beta chains of human hemoglobin are glycated irrespective of the extent of glycemia as evidenced by a mass increment of 162 Da. The phenomenon of glutathionylation was observed with only the beta globin chain of hemoglobin probably due to the presence of an accessible cysteine residue indicated by a mass increment of 305 Da. Also, the extent of gltuathionylation observed in the CRF patients could correlate with the severity of the oxidative stress owing to renal replacement therapies like dialysis and transplantation.

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