å¡ CASE REPORT å¡ /T-Thalassemia with Hemochromatosis Masakatsu Uchihara****, Toshihiko Noucm**, Teruo Harano****, Michio Yamane*, Hideki Sakai*, Kazuhiko Takabe*, Sunao Mae*, Shinya Maekawa*, Toshiko Fukuma*, Yasuhiro Miyahara*, Chifumi Sato**'*** and Fumiaki Marumo** A 64-year-old man was admitted due to ascites. Laboratory data showed hemoglobin 6.7 g/dl, mean corpuscular volume 82 fl, and ferritin 2,360 ng/ml. Liver biopsy showed hemochromatosis. The diagnosis of /Mhalassemia was suggested by a decreased ratio of y8/a -globin synthesis in vitro (0.26). Cloning of the /?-globin gene showed A-to-G mutation in the first base of the ATA box. He was confirmed to be homozygous for this specific allele by /}-gene complex analysis and analysis of Southern blot hybridization of the a- and j3-globin genes. His two sons were confirmed to be heterozygous for this allele. (Internal Medicine 31: 1060-1064, 1992) Key words: liver cirrhosis, microcytic anemia, gene cloning, DNA sequencing, ATA box

Introduction

mean corpuscular hemoglobin (MCH) 24. 8 pg. Biochemical data revealed total bilirubin 3.1 mg/dl, indirect bilirubin jS -Thalassemia is a heterogeneous inherited disorder 1.7 mg/dl, albumin 3.4 g/dl, alanine aminotransferase 56 IU/1 (normal value: 4-35 IU/1), asparate aminotransferase characterized by defective synthesis of /S-globin of normal 40 IU/1 (normal value: 9-35 IU/1), lactic dehydrogenase adult hemoglobin A (HbA, subunit structure a2fi2) 0) 471 IU/1 (normal value: 180-460 IU/1), serum iron 170 Hemochromatosis is often associated with homozygous j3 {i g/d\, total iron binding capacity 194^g/dl, ferritin 2,360 thalassemia (2). In Japan, however, such concomitance has rarely been reported to date. Recently we experienced a case ng/ml, and haptoglobin