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Beta Globin Case Study

Decent Essays

Point mutations affecting the beta globin expression belong to three different categories:
1. Mutations leading to defective beta-gene transcription (promoter and 5′ UTR mutations)
2. Mutations affecting messenger RNA (mRNA) processing (splice-junction and consensus sequence mutations, polyadenylation, and other 3′ UTR mutations)
3. Mutations resulting in abnormal mRNA translation (nonsense, frameshift, and initiation codon mutations).
In rare instances, the defect does not lie in the beta globin gene cluster. Some mutations in the X-linked transcription factor GATA-1 may produce thrombocytopenia associated with thalassemia trait, whereas molecular lesions affecting the general transcription factor TFIIH result, in addition to …show more content…

Cardiac decompensation starts the Hb level falls below 4gm/dl or less. Fatigue, poor appetite and lethargy occur late. There is associated growth failure with failure to thrive, feeding difficulties, and bouts of fever, diarrhea and gastrointestinal symptoms.

OTHER HEMATOLOGICAL PROBLEMS: Progressive splenomegaly in poorly managed thalassemics leads to secondary thrombocytopenia and leukopenia. Bleeding tendencies may be present with or without associated thrombocytopenia mostly in the form of epistaxis. Dental caries is also common in Indian subcontinent.

SKELETAL CHANGES: Due to ongoing anemia, there is ongoing extramedullary hematopoiesis which leads to expansion of marrow cavities and thinning of cortices which produces a variety of bony abnormalities which leads to various clinical manifestations. The earliest changes occur in the hands and feet that gives rectangular or frankly convex appearance to the metacarpals, metatarsals and phalanges. There is expansion of diploe of the skull to several times normal thickness. The outer and inner tables are thin and perpendicular striations appear the tables resulting in the classical ‘hair-on-end’ appearance. There are deformities of facial features- maxillary hyperplasia, flat bridge of nose, frontal bossing which is so called thalassemic facies/ chipmunk facies. Maxillary deformities often lead to dental problems with malocclusion. There is delayed pneumatization of the sinuses. In the long bones,

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