Delta-beta thalassemia
Delta-beta thalassemia is a rare form of thalassemia in which there is a reduced production of hemoglobin subunit delta and hemoglobin subunit beta and raised levels of hemoglobin subunit gamma. It is an autosomal recessive disorder.

Signs and symptoms
An individual with delta-beta thalassemia is usually asymptomatic, however  microcytosis can occur where the  red blood cells are abnormally small.

Mechanism
Delta-beta thalassemia is autosomal recessive disorder, which means both parents are affected and two copies of the gene must be present. A carrier gets a normal gene to produce hemoglobin A, from one parent and the other parent supplies a gene which makes no hemoglobin A. Delta-beta thalassemia is considered rare.Delta-beta-thalassemia is caused by deletions of the entire delta and beta genes sequences and only gamma-globin and HbF are formed. Rarely, non-deletional forms have been reported.When two delta0 mutations are inherited, no hemoglobin A2 (alpha2, delta2) are formed.  This is innocuous because only 2-3% of normal adult hemoglobin is hemoglobin A2.  The individual will have normal hematological parameters (erythrocyte count, total hemoglobin, mean corpuscular volume).  The delta-beta thalassemia demonstrates one mutation is at the +69 position.

Relation to beta thalassemia
Delta-beta thalassemia can mask the diagnosis of beta thalassemia trait.  In beta thalassemia, an increase in hemoglobin A2 results, but the co-existence of a delta-beta thalassemia mutation will decrease the value of the hemoglobin A2 into the normal range, thereby obscuring the diagnosis of beta thalassemia trait

Diagnosis
Following the detection of hypochromic microcytic red blood cells, delta-beta thalassemia is confirmed by high-performance liquid chromatography.

Treatment
When needed, treatment for anemia, such as blood transfusions are used.Stem cell transplant is another option, but the donor and the individual who will receive the bone marrow transplant must be compatible, the risks involved should be evaluated.

See also
Alpha thalassemia
Beta-thalassemia
Hemoglobinopathy

References
Further reading
Verma, S; Bhargava, M; Mittal, SK; Gupta, R (1 January 2013). "Homozygous delta-beta Thalassemia in a Child: a Rare Cause of Elevated Fetal Hemoglobin". Iranian Journal of Pediatric Hematology and Oncology. 3 (1): 222–227. ISSN 2008-8892. PMC 3915439. PMID 24575268.
Kumar, B. Vinodh; Choccalingam, Chidambharam; Samuel, Premila (1 March 2016). "Incidental Identification of Possible Delta-Beta Thalassemia Trait in a Family: A Rare Cause of Elevated Hb F." Journal of Clinical and Diagnostic Research. 10 (3): BD01–BD02. doi:10.7860/JCDR/2016/16352.7409. ISSN 2249-782X. PMC 4843246. PMID 27134860.
"Public Health Information Network Vocabulary Access and Distribution System (PHIN VADS)". CDC. Centers for Disease Control. Retrieved 17 September 2016.


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