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Iron overload in an African American woman with SS hemoglobinopathy and a promoter mutation in the X-linked erythroid-specific 5-aminolevulinate synthase (ALAS2) gene.

Abstract
We report the case of an African American woman with sickle cell anemia and iron overload incompletely explained by erythrocyte transfusion who is heterozygous for a promoter mutation in the X-linked erythroid-specific 5-aminolevulinate synthase gene (ALAS2): a C to G transversion at nucleotide -206 from the transcription start site, as defined by primer extension (-258 from the start ATG). This mutation has previously been associated with sideroblastic anemia and iron overload in members of a Welsh kinship. No coding region mutation of HFE, FPN1, TFR2, HAMP, or HJV genes was detected. The mother of the proband has mild, chronic anemia and is also heterozygous for the same proximal promoter region mutation of ALAS2. However, she has no evidence of iron overload. We conclude that an ALAS2 promoter region mutation could partly account for iron overload in the present proband, and that this or other ALAS2 mutations could explain the occurrence of iron overload in other whites or blacks with or without anemia. The occurrence of anemia and iron overload may be discordant in women heterozygous for ALAS2 mutations.
AuthorsJames C Barton, Pauline L Lee, Luigi F Bertoli, Ernest Beutler
JournalBlood cells, molecules & diseases (Blood Cells Mol Dis) 2005 May-Jun Vol. 34 Issue 3 Pg. 226-8 ISSN: 1079-9796 [Print] United States
PMID15885606 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)
Chemical References
  • 5-Aminolevulinate Synthetase
  • ALAS2 protein, human
Topics
  • 5-Aminolevulinate Synthetase (genetics)
  • Adult
  • Black or African American (genetics)
  • Anemia (genetics)
  • Anemia, Sickle Cell (genetics)
  • Family Health
  • Female
  • Heterozygote
  • Humans
  • Iron Overload (genetics)
  • Point Mutation
  • Promoter Regions, Genetic (genetics)

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