Hemoglobin H disease
| Hemoglobin H disease | |
|---|---|
| Synonyms | HbH disease | 
| Pronounce | N/A | 
| Specialty | N/A | 
| Symptoms | Anemia, jaundice, splenomegaly, fatigue | 
| Complications | Iron overload, gallstones, heart failure | 
| Onset | Usually in childhood | 
| Duration | Lifelong | 
| Types | N/A | 
| Causes | Genetic mutation in the alpha-globin gene | 
| Risks | Family history of thalassemia | 
| Diagnosis | Blood test, genetic testing | 
| Differential diagnosis | Beta thalassemia, sickle cell disease | 
| Prevention | Genetic counseling | 
| Treatment | Blood transfusion, iron chelation therapy, folic acid supplementation | 
| Medication | N/A | 
| Prognosis | Variable, depends on severity | 
| Frequency | More common in Southeast Asia, Mediterranean, Middle East | 
| Deaths | N/A | 
Hemoglobin H disease is a form of alpha thalassemia, a genetic blood disorder that affects the production of hemoglobin. Hemoglobin is the protein in red blood cells responsible for carrying oxygen throughout the body. Hemoglobin H disease is characterized by the presence of an abnormal form of hemoglobin known as hemoglobin H (HbH).
Pathophysiology
Hemoglobin H disease occurs due to the deletion or mutation of three out of the four alpha-globin genes. The alpha-globin genes are responsible for producing the alpha-globin chains that form part of the hemoglobin molecule. In individuals with Hemoglobin H disease, the lack of sufficient alpha-globin chains leads to the formation of abnormal hemoglobin composed of beta-globin chains, known as hemoglobin H.
Symptoms
The symptoms of Hemoglobin H disease can vary widely but often include:
- Anemia
 - Jaundice
 - Splenomegaly (enlarged spleen)
 - Hepatomegaly (enlarged liver)
 - Fatigue
 - Pallor
 
Diagnosis
Diagnosis of Hemoglobin H disease typically involves:
- Complete blood count (CBC)
 - Hemoglobin electrophoresis
 - Genetic testing to identify mutations in the alpha-globin genes
 
Treatment
There is no cure for Hemoglobin H disease, but treatment focuses on managing symptoms and preventing complications. Treatment options may include:
- Blood transfusions
 - Folic acid supplements
 - Iron chelation therapy to prevent iron overload
 - Splenectomy in severe cases
 
Prognosis
The prognosis for individuals with Hemoglobin H disease varies. Some individuals may experience mild symptoms, while others may have more severe complications. Regular medical follow-up and appropriate management can help improve the quality of life for affected individuals.
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Contributors: Prab R. Tumpati, MD