We describe the hematological and
DNA characterization of
Hb D-Punjab [beta121(GH4)Glu-->Gln] in Thailand. Nine patients from five unrelated families were studied; four patients were simple carriers of
Hb D-Punjab, two were compound heterozygotes for
Hb D-Punjab/
beta+-thalassemia; another two patients were double heterozygotes for
Hb D-Punjab and alpha-thalassemia-2, and one patient was a compound heterozygote for
Hb D-Punjab and Hb E [beta26(B8)Glu-->Lys]. Typical thalassemic indices with hypochromic microcytosis were observed in compound
Hb D-Punjab/
beta+-thalassemia and
Hb D-Punjab/Hb E but normal hematological profiles were observed in the remaining cases.
DNA sequencing of the
beta-globin gene identified the GAA-->CAA substitution at
codon 121 causing
Hb D-Punjab in all cases, and the -28 (A-->G) mutation for the
beta+-thalassemia alleles.
beta-Globin gene haplotype analysis demonstrated, for the first time, that all these Asian beta(D-Punjab)
globin genes were associated with haplotype [-++-+++], previously undescribed in other populations. The finding of
Hb D-Punjab in Thailand is compatible either with an independent origin of this abnormal
hemoglobin or a spread of the
Hb D-Punjab gene with a single origin among Asians.