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REVIEW ARTICLE
Year : 2011  |  Volume : 134  |  Issue : 5  |  Page : 597-610

Sickle cell disease in Middle East Arab countries


1 College of Medicine & Ash Shura Council (Saudi Parliament), Saudi Arabia
2 College of Health Services, King Saud University, Riyadh, Saudi Arabia
3 Department of Biochemistry, College of Science, King Saud University, Riyadh, Saudi Arabia

Correspondence Address:
Mohsen A.F. El-Hazmi
Member, Ash Shura Council, P.O. Box 231931, Riyadh 11321
Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-5916.90984

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The sickle cell (HbS) gene occurs at a variable frequency in the Middle Eastern Arab countries, with characteristic distribution patterns and representing an overall picture of blood genetic disorders in the region. The origin of the gene has been debated, but studies using β-globin gene haplotypes have ascertained that there were multiple origins for HbS. In some regions the HbS gene is common and exhibits polymorphism, while the reverse is true in others. A common causative factor for the high prevalence and maintenance of HbS and thalassaemia genes is malaria endemicity. The HbS gene also co-exists with other haemoglobin variants and thalassaemia genes and the resulting clinical state is referred to as sickle cell disease (SCD). In the Middle Eastern Arab countries, the clinical picture of SCD expresses two distinct forms, the benign and the severe forms, which are related to two distinct β-globin gene haplotypes. These are referred to as the Saudi-Indian and the Benin haplotypes, respectively. In a majority of the Middle Eastern Arab countries the HbS is linked to the Saudi-Indian haplotype, while in others it is linked to the Benin haplotype. This review outlines the frequency, distribution, clinical feature, management and prevention as well as gene interactions of the HbS genes with other haemoglobin disorders in the Middle Eastern Arab countries.


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