MRCP UK EXAMINATIONS

Detailed explanation-1: -The distinguishing finding in beta thalassemia is a hemoglobin electrophoresis with the finding of elevated Hgb A2 and F. Both will be increased in beta thalassemia trait without iron deficiency, and will be normal or decreased in alpha thalassemia and isolated iron deficiency anemia.

Detailed explanation-2: -Hemoglobin (Hb) F levels are high and variable in Hb E/beta-thalassemia, ranging from 10% to 80%. The high levels are secondary to expansion of the erythron with ineffective erythropoiesis and selection in favor of cells able to make more gamma-globin.

Detailed explanation-3: -These data suggest that the high HbF levels in HbE/beta thalassemia, and other beta thalassemia syndromes, result from increased erythropoietin levels leading to bone marrow expansion, and possibly increased F-cell production, combined with ineffective erythropoiesis giving a survival advantage to F cells.