中国循证儿科杂志 ›› 2025, Vol. 20 ›› Issue (2): 154-156.DOI: 10.3969/j.issn.1673-5501.2025.02.012

• 病案报告 • 上一篇    下一篇

β珠蛋白变体所致的高铁血红蛋白血症家族病例报告

吴帅, 朱志威田鑫张兵贺湘玲   

  1. 湖南省人民医院(湖南师范大学附属第一医院)儿童医学中心血液肿瘤科 长沙, 410002
  • 收稿日期:2024-07-16 修回日期:2025-01-24 出版日期:2025-04-25 发布日期:2025-04-25
  • 通讯作者: 贺湘玲

Case report of a family with methemoglobinemia caused by β-globin variant

WU Shuai, ZHU Zhiwei, TIAN Xin, ZHANG Bing, HE Xiangling   

  1. Department of Hematology and Oncology, Children's Medical Center, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha 410002, China
  • Received:2024-07-16 Revised:2025-01-24 Online:2025-04-25 Published:2025-04-25
  • Contact: HE Xiangling

摘要: 回顾性分析1例湖南省人民医院收治的β珠蛋白变体所致的高铁血红蛋白血症患儿的临床表现、实验室检查和基因检测结果。患儿,男,14岁,出生6个月起出现发绀,显示血红蛋白电泳3.23 min处可见异常Hb为24.8%,先证者存在HBB基因c.320T>A位点(遗传自母亲)及c.52A>T位点(遗传自父亲、奶奶和叔叔)的双杂合突变。结合文献复习,先天性高铁血红蛋白血症多由系细胞还原酶系统缺陷或珠蛋白结构异常导致,在无心肺系统疾病情况下仍可出现发绀,且可伴随终生,血红蛋白电泳和基因检测有助于明确诊断。

关键词: 儿童, β珠蛋白变体, 高铁血红蛋白血症, HBB基因, 临床表型

Abstract: A retrospective analysis was conducted on the clinical manifestations, laboratory findings, and genetic test results of a 14-year-old male patient with methemoglobinemia caused by a β-globin variant, who was admitted to Hunan Provincial People's Hospital due to cyanosis appearing at 6 months of age. Hemoglobin electrophoresis revealed an abnormal Hb peak at 3.23 min, accounting for 24.8%. The proband carried a double heterozygous mutation at the HBB gene c.320T>A (inherited from the mother) and c.52A>T (inherited from the father, grandmother, and uncle). A literature review indicated that congenital methemoglobinemia is often caused by defects in the erythrocyte reductase system or structural abnormalities in globin. Cyanosis may persist lifelong even in the absence of cardiopulmonary diseases, and hemoglobin electrophoresis and genetic testing are instrumental in confirming the diagnosis.

Key words: Child, β-globin variant, Methemoglobinemia, HBB gene, Clinical phenotype