• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of cmajCMAJ Information for AuthorsCMAJ Home Page
CMAJ. Jul 1, 1987; 137(1): 39–42.
PMCID: PMC1492394

Hemoglobin E: a common hemoglobinopathy among children of Southeast Asian origin.


With the recent immigration of Southeast Asians to Canada, hemoglobin E has become a frequent diagnosis. The clinical and hematologic findings in 42 children (mean age 4.3 years) with hemoglobin E are presented. There were 33 heterozygotes (having hemoglobin E trait), 6 homozygotes (having hemoglobin EE) and 3 double heterozygotes (having hemoglobin E-beta-thalassemia). The heterozygotes had low-normal hemoglobin levels and mean corpuscular volumes; coexisting iron deficiency, present in 62% of these children, resulted in substantially lower hemoglobin levels, very low mean corpuscular volumes and lower than expected levels of hemoglobin E on electrophoresis. The children with hemoglobin EE were only slightly anemic, but those with hemoglobin E-beta-thalassemia had severe anemia and required long-term transfusion therapy. Nutritional factors and parasitic infestations were the main causes of iron depletion, which was common, particularly in children less than 2 years old (87%). Physicians of patients of Southeast Asian origin should be aware of the clinical and hematologic presentation of these hemoglobinopathies.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (895K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Ali MA, Quinlan A, Wong SC. Identification of hemoglobin E by the isopropanol solubility test. Clin Biochem. 1980 Aug;13(4):146–148. [PubMed]
  • Flatz G. Hemoglobin E: distribution and population dynamics. Humangenetik. 1967;3(3):189–234. [PubMed]
  • Wasi P, Winichagoon P, Baramee T, Fucharoean S. Globin chain synthesis is heterozygous and homozygous hemoglobin E. Hemoglobin. 1982;6(1):75–78. [PubMed]
  • Monzon CM, Fairbanks VF, Burgert EO, Jr, Sutherland JE, Elliot SC. Hematologic genetic disorders among Southeast Asian refugees. Am J Hematol. 1985 May;19(1):27–36. [PubMed]
  • Winichagoon P, Fucharoen S, Weatherall D, Wasi P. Concomitant inheritance of alpha-thalassemia in beta 0- thalassemia/Hb E disease. Am J Hematol. 1985 Nov;20(3):217–222. [PubMed]
  • Dallman PR, Siimes MA. Percentile curves for hemoglobin and red cell volume in infancy and childhood. J Pediatr. 1979 Jan;94(1):26–31. [PubMed]
  • Dallman PR, Barr GD, Allen CM, Shinefield HR. Hemoglobin concentration in white, black, and Oriental children: is there a need for separate criteria in screening for anemia? Am J Clin Nutr. 1978 Mar;31(3):377–380. [PubMed]
  • Fairbanks VF, Gilchrist GS, Brimhall B, Jereb JA, Goldston EC. Hemoglobin E trait reexamined: a cause of microcytosis and erythrocytosis. Blood. 1979 Jan;53(1):109–115. [PubMed]
  • Dorléac E, Morlé L, Gentilhomme O, Jaccoud P, Baudonnet C, Delaunay J. Thalassemia-like abnormalities of the red cell membrane in hemoglobin E trait and disease. Am J Hematol. 1984 Apr;16(3):207–217. [PubMed]
  • Hurst D, Tittle B, Kleman KM, Embury SH, Lubin BH. Anemia and hemoglobinopathies in Southeast Asian refugee children. J Pediatr. 1983 May;102(5):692–697. [PubMed]
  • Na-Nakorn S, Wasi P. Alpha-thalassemia in Northern Thailand. Am J Hum Genet. 1970 Nov;22(6):645–651. [PMC free article] [PubMed]
  • Fairbanks VF, Oliveros R, Brandabur JH, Willis RR, Fiester RF. Homozygous hemoglobin E mimics beta-thalassemia minor without anemia or hemolysis: hematologic, functional, and biosynthetic studies of first North American cases. Am J Hematol. 1980;8(1):109–121. [PubMed]
  • Tittle BS, Harris JA, Chase PA, Morrell RE, Jackson RJ, Espinoza SY. Health screening of Indochinese refugee children. Am J Dis Child. 1982 Aug;136(8):697–700. [PubMed]
  • Goldenring JM, Davis J, McChesney M. Pediatric screening of Southeast Asian immigrants. Clin Pediatr (Phila) 1982 Oct;21(10):613–616. [PubMed]
  • Wasi P, Na-Nakorn S, Pootrakul S, Sookanek M, Disthasongchan P, Panich V, Pornpatkul M. Alpha- and beta-thalassemia in Thailand. Ann N Y Acad Sci. 1969 Nov 20;165(1):60–82. [PubMed]
  • Mehta BC, Agarwal MB, Varandani DG, Joshi RH, Bhargava AB. Hemoglobin E-thalassemia: a study of 16 cases. Acta Haematol. 1980;64(4):201–204. [PubMed]

Articles from CMAJ : Canadian Medical Association Journal are provided here courtesy of Canadian Medical Association


Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...


  • MedGen
    Related information in MedGen
  • PubMed
    PubMed citations for these articles
  • Substance
    PubChem Substance links

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...