OCCURRENCE OF UNUSUAL HAEMOGLOBINOPATHIES IN BALOCHISTAN: HB SD AND HB SE - PRESENTATION WITH OSTEOMYELITIS

Rev Paul Pediatr. 2021 Feb 3:39:e2019365. doi: 10.1590/1984-0462/2021/39/2019365. eCollection 2021.
[Article in English, Portuguese]

Abstract

Objective: To describe two cases of unusual variants of sickle cell disease.

Case description: We present two cases of sickle cell disease variants (haemoglobinopathies), from unrelated families, in the state of Balochistan (Pakistan). One was diagnosed with sickle cell disease in the haemoglobin electrophoresis, whereas the other was diagnosed with sickle cell SE disease. Both were diagnosed based on the presentation of osteomyelitis.

Comments: Haemoglobin SD disease (Hb SD) and haemoglobin SE disease (Hb SE) are rare haemoglobinopathies in the world. The lack of available literature suggests that both are variants of sickle cell disease (SCD), with heterogeneous nature. The prevalence of sickle cell disease with compound heterozygotes was found at a variable frequency in the population of the Asian Southeast. The frequency of osteomyelitis in SCD is 12 to 18%, but its occurrence among variant haemoglobinopathies is little reported. Both reported cases presented with osteomyelitis as a characteristic of the disease presentation.

Objetivo:: Descrever dois casos de variantes raras da hemoglobinopatia falciforme.

Descrição do caso:: Apresentamos aqui dois casos de hemoglobinopatias variantes das células falciformes, de famílias não relacionadas, no estado do Baluchistão (Paquistão), sendo um diagnosticado como doença da hemoglobina SD na eletroforese de hemoglobina, enquanto o outro com doença da hemoglobina SE. Ambos foram diagnosticados a partir da apresentação de osteomielite.

Comentários:: Hemoglobina SD (Hb SD) e hemoglobina SE (Hb SE) são hemoglobinopatias raras no mundo. A escassez de literatura disponível sugere que ambas são variantes da doença falciforme (DF) com natureza heterogênea. A prevalência de hemoglobinopatia falciforme com heterozigosidade composta foi encontrada com frequência variável na população do sudeste asiático. A frequência de osteomielite na DF é de 12 a 18%, mas sua ocorrência entre as hemoglobinopatias falciformes variantes é pouco relatada. Os dois casos reportados apresentaram osteomielite como característica de apresentação da doença.

Publication types

  • Case Reports

MeSH terms

  • Administration, Intravenous
  • Administration, Oral
  • Anemia, Sickle Cell / complications
  • Anemia, Sickle Cell / diagnosis*
  • Anemia, Sickle Cell / epidemiology
  • Anemia, Sickle Cell / genetics*
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use
  • Antisickling Agents / administration & dosage
  • Antisickling Agents / therapeutic use
  • Blood Protein Electrophoresis / methods*
  • Child
  • Female
  • Hemoglobinopathies / blood
  • Hemoglobinopathies / diagnosis
  • Hemoglobinopathies / genetics*
  • Heterozygote
  • Humans
  • Hydroxyurea / administration & dosage
  • Hydroxyurea / therapeutic use
  • Magnetic Resonance Imaging / methods
  • Male
  • Mass Screening / ethics
  • Mass Screening / standards
  • Osteomyelitis / diagnosis*
  • Osteomyelitis / drug therapy
  • Osteomyelitis / etiology
  • Pakistan / ethnology
  • Prevalence
  • Radiography / methods
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Antisickling Agents
  • Hydroxyurea