Haemoglobin D Iran With Beta Thalassemia in A Primigravida With Anaemia

Anaemia is quite common in female population of developing countries including Pakistan. Beside haemoglobinopathies are often seen in India, Pakistan and Iran due to traditional practices of consanguineous marriages. Haemoglobin D-Punjab is one of the most common subvariants (55%) of Haemoglobin D, which can be inherited as a homozygous or a heterozygous trait with other haemoglobinopathies. Although, Haemoglobin D-Punjab is commonly seen but another variant of HB D like Hb D Iran with heterozygous trait of β thalassemia is rarely reported. We present a rare case of co-inheritance of Haemoglobin D- Iran and β thalassemia in a young primigravida of Kashmiri origin in her twenties. She was six months pregnant and was diagnosed to have anaemia. She had history of diarrhea. On examination, she was pale looking and mildly icteric. Systemic examination was insignificant except for mild splenomegaly. The fundal height was normal for age to date. On investigation, she had mild anaemia with microcytic hypochromic blood picture. Hemoglobin electrophoresis showed a band of Hb A2+Hb F+S/D. Molecular studies of combined Haemoglobin D –Iran and beta thalassemia. She was counseled about his disease and advised follow-up up at 6 months after delivery after delivery.