Haemoglobinopathies are a frequent cause of anaemia in Northwestern India 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. Though,
haemoglobin D-Punjab is commonly seen, a heterozygous trait with
beta thalassemia is a very rare presentation. Here, we present a rare case of co-inheritance of
haemoglobin D-Punjab and
beta thalassemia in a 19-year-old male of Indian origin. He came with gradually progressive generalised weakness with easy fatigability for the past two months. No history of similar complaints in the past. On examination, he was pale and icteric with
splenomegaly and Grade I
hemorrhoids on systemic examination. On investigation, there was severe anaemia,
pancytopenia (mixed picture on smear),
vitamin B12 deficiency and raised
Lactate Dehydrogenase (LDH). Haemoglobin electrophoresis showed co-inheritance of
haemoglobin D-Punjab and
beta thalassemia. After Pack Cell Volume (PCV) and B12 supplements, haemoglobin improved. He was counseled about his disease and advised regular follow-up.