A family study is reported in which the simultaneous presence of C-thalassemia and S-thalassemia disease is noted. Marked interaction of the genes for the abnormal hemoglobins and for thalassemia is evident.

The value of the accessory hemoglobins for the diagnosis of thalassemia minor is discussed.

The Hb S + F pattern can no longer be assumed to be diagnostic of sickle cell anemia. Evaluation of all hematologic data and the family background of the patient may be necessary to rule out the presence of the thalassemia gene.

A discussion of the genetics of the double heterozygous states for thalassemia and an abnormal hemoglobin is presented.

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