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Premarital and antenatal screening of Hb-Los Angeles Reply

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Received: April 20, 2009

Letter to the Editor

To the Editor,

I have read with admiration the paper by Bahadır et al. entitled “HbD Los Angeles [beta 121(GH4) Glu→Gln] and Hb Beograd [beta 121(GH4) Glu→Val]: implications for their laboratory diagno-sis and genetic origins” in the recent issue of the journal [1].

However, I was puzzled regarding the reasons for these studies of HbD Los Angeles, since the presence of this hemo-globinopathy trait even in homozygous forms does not have hematologic consequences, with the exception of HbS-D, as was shown by us 40 years ago [2,3]. Although Hb-D was reported from this country prior to our studies, we were the first to report the mutation site.

Therefore, I do not believe that premarital and antenatal determination of this hemoglobinopathy has clinical impor-tance, except for double heterozygosity with sickle cell or thalassemias. Thus, the applications of these implications require some explanation.

Şinasi Özsoylu

Fatih University Medical Faculty, Department of Pediatrics and Hematology, Ankara, Turkey

References

1. Bahadır A, Köseler A, Atalay A, Koyuncu H, Akar E, Akar N, Atalay EO. Hb D-Los Angeles [beta121(GH4)Glu>Gln] and Hb Beograd

[beta121(GH4)Glu>Val]: Implications for their laboratory diagnosis and genetic origins. Turk J Hematol 2009;26:17-20.

2. Özsoylu Ş. Homozygous hemoglobin D Punjab. Acta Haematol 1970;43:353-9.

Received: April 21, 2009

Author Reply

We appreciate Professor Şinasi Özsoylu for his valuable contribution and his interest in our published article.

As Dr. Özsoylu clearly stated, Hb D-Los Angeles does not cause any hematological problem except in a few cases like Hb S. Therefore, Hb D-Los Angeles is not an important issue in prenatal diagnosis. In our prenatal control program, Hb D-Los Angeles is also not the primary issue. On the other hand, in the Denizli province of Turkey, Hb D-Los Angeles is observed frequently. In the premarital screening program, iden-tification of the abnormal hemoglobins has an important role in this program leading to the prenatal diagnosis. Hb D-Los Angeles and Hb S show similar electrophoretic and chromato-graphic behavior. We would like to emphasize this issue in the premarital control programs. We would also like to point out the importance of inter-institutional collaborations for the suc-cess of hemoglobinopathy control programs.

Anzel Bahadır1, Aylin Köseler1, Ayfer Atalay1,

Hasan Koyuncu2, Ece Akar3, Nejat Akar3, Erol Ömer Atalay1 1Pamukkale University Medical Faculty Department of

Biophysics, Denizli, Turkey

2Turkish Ministry of Health Denizli Hemoglobinopathy

Center, Denizli, Turkey

3Ankara University Medical Faculty Department of Pediatric

Hematology, Ankara, Turkey

Premarital and antenatal screening of Hb-Los Angeles

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