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HEMOGLOBIN HbCC-HbEE
Developed by-Dr.Abdulrazzaq Othman Alagbare
M.D M.S.c C.P - Lecturer of Hematology and Immunohematology
1
HEMOGLOBIN HbCC
Definition and
causes
HbC  caused by a mutation in β chains (β6 Glu→ Lys) which
is associated Insoluble hemoglobin like HbSS.
Hemolytic anemia varies from moderate to severe, similar With
crystals forming in or out of RBC and folded cells
2
HEMOGLOBIN HbCC
Diagnostic test Electrophoresis: HbCC
HbA Nil
HbA2: Normal
HbF: 7%
HbC: >90 %
Hemoglobin trait HbAC
HbA: 55-60 %
HbA2: Normal
HbF: Normal
HbC: 35-45 %
3
HEMOGLOBIN E–β-THALASSEMIA
Definition
and causes
HbE  caused by a mutation in β chains (β26 Glu→ Lys)
which is associated with the phenotype of β thalassaemia.
Hemolytic anemia varies from moderate to severe, similar to β-
thalassemias  Very small RBC with MCV lower than 60 fl
4
HEMOGLOBIN E–β-THALASSEMIA
Diagnostic
test
Electrophoresis: HbEE (Homo.)
HbA Nil
HbA2: Normal
HbF: 7%
HbE: >90 %
Hemoglobin trait (Hetro.) HbEA
HbA: 55-60 %
HbA2: Normal
HbF: Normal
HbE: 35-45 %
5
β- chain - Hemoglopinopathies
Hb Defect Hb type RBC changes
HbSS Valine Replace Glu at
6th position of β- chain
Produce insoluble Hb Sickling shape
HbCC Lysin Replace Glu at 6th
position of β- chain
Produce insoluble Hb Crystals inside the RBC
And folded cells
HbEE Lysin Replace Glu at
26th position of β-
chain
Produce unstable Hb Microcyte with MCV 55
fl
6
7
β/βcβ/βs
β/β0
βs/βc
Sickle-cell / HbC disease
β/βs
β0/βs
 Sickle-cell / β-thalassaemia
Hemoglopinopathies combinations
Hemoglopinopathies combinations OCCUR among the heterozygous individuals
Hemoglopinopathies combinations
SC disease is a variant of homozygous sickle
cell anemia (SS disease) which is of almost
equal severity and has a similar clinical
presentation
Clinical phenotype of
HbE/β thalassaemia resembles
either thalassaemia major
8
SUMMARY ……Sickle-cell syndromes
Mostly the following clinical syndrome types
are observed
Type
Sickle-cell Disease – HbSS Homozygous βs/βs
Sickle-cell trait - HbAS Heterozygous β/βs
Sickle-cell haemoglobin / C disease βs/βc
 Sickle-cell / β-thalassaemia βs/β0 9
‫رب‬ ‫هلل‬ ‫الحمد‬
‫العالمين‬
‫وجه‬ ‫ابتغاء‬ ‫الجهد‬ ‫هذا‬
‫الكريم‬ ‫هللا‬

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Hemoglobin HbCC & HbEE

  • 1. HEMOGLOBIN HbCC-HbEE Developed by-Dr.Abdulrazzaq Othman Alagbare M.D M.S.c C.P - Lecturer of Hematology and Immunohematology 1
  • 2. HEMOGLOBIN HbCC Definition and causes HbC  caused by a mutation in β chains (β6 Glu→ Lys) which is associated Insoluble hemoglobin like HbSS. Hemolytic anemia varies from moderate to severe, similar With crystals forming in or out of RBC and folded cells 2
  • 3. HEMOGLOBIN HbCC Diagnostic test Electrophoresis: HbCC HbA Nil HbA2: Normal HbF: 7% HbC: >90 % Hemoglobin trait HbAC HbA: 55-60 % HbA2: Normal HbF: Normal HbC: 35-45 % 3
  • 4. HEMOGLOBIN E–β-THALASSEMIA Definition and causes HbE  caused by a mutation in β chains (β26 Glu→ Lys) which is associated with the phenotype of β thalassaemia. Hemolytic anemia varies from moderate to severe, similar to β- thalassemias  Very small RBC with MCV lower than 60 fl 4
  • 5. HEMOGLOBIN E–β-THALASSEMIA Diagnostic test Electrophoresis: HbEE (Homo.) HbA Nil HbA2: Normal HbF: 7% HbE: >90 % Hemoglobin trait (Hetro.) HbEA HbA: 55-60 % HbA2: Normal HbF: Normal HbE: 35-45 % 5
  • 6. β- chain - Hemoglopinopathies Hb Defect Hb type RBC changes HbSS Valine Replace Glu at 6th position of β- chain Produce insoluble Hb Sickling shape HbCC Lysin Replace Glu at 6th position of β- chain Produce insoluble Hb Crystals inside the RBC And folded cells HbEE Lysin Replace Glu at 26th position of β- chain Produce unstable Hb Microcyte with MCV 55 fl 6
  • 7. 7 β/βcβ/βs β/β0 βs/βc Sickle-cell / HbC disease β/βs β0/βs  Sickle-cell / β-thalassaemia Hemoglopinopathies combinations Hemoglopinopathies combinations OCCUR among the heterozygous individuals
  • 8. Hemoglopinopathies combinations SC disease is a variant of homozygous sickle cell anemia (SS disease) which is of almost equal severity and has a similar clinical presentation Clinical phenotype of HbE/β thalassaemia resembles either thalassaemia major 8
  • 9. SUMMARY ……Sickle-cell syndromes Mostly the following clinical syndrome types are observed Type Sickle-cell Disease – HbSS Homozygous βs/βs Sickle-cell trait - HbAS Heterozygous β/βs Sickle-cell haemoglobin / C disease βs/βc  Sickle-cell / β-thalassaemia βs/β0 9
  • 10. ‫رب‬ ‫هلل‬ ‫الحمد‬ ‫العالمين‬ ‫وجه‬ ‫ابتغاء‬ ‫الجهد‬ ‫هذا‬ ‫الكريم‬ ‫هللا‬