Hereditary Spherocytosis

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Erythrocytes are naturally a biconcave disc, which results in a larger membrane surface to volume ratio than a sphere shaped disc. These cells have the strength and flexibility needed to survive for 120 days in circulation. Their peripheral proteins stabilize the membrane and are responsible for their shape. These proteins include sprectrin, actin, ankryn, and band-4-protein. Peripheral proteins are attached to the red blood cell (RBC) membrane. Ankyrin-1 stabilizes the membrane by linking beta spectrin to band-3. The band-3-protein is part of the integral membrane and functions as an anion exchanger, glucose transporter, and water channel (Hamasaki, 1999).

A genetic disorder weakening the vertical linkage between the peripheral protein membrane and the integral protein membrane can cause reduction of membrane surface, reduction ratio of surface area to volume, and formation of spherocytes, sphere shaped RBCs. An example of this would be a weaken linkage between the band-3-protein and ankryin-1 (Perrotta, Gallagher, & Mohandas, 2008). This is a result of heterogeneous alterations in genes encode for proteins responsible for binding cite of the RBC’s inner membrane skeleton to its outer lipid bilayer. An inherited abnormality in RBC’s cause by membrane protein defects is known as Hereditary Spherocytosis (HS). The most common cause of HS is the mutations in the gene encoding the membrane protein ankyrin-1 (Gallagher, Steiner, Liem, Owen, Cline, Seidel, Garrett, & Bodine, 2010).

Hereditary Spherocytosis is the most common form of inherited hemolytic anemia in the US, northern Europe, and notably in Japan, affecting one person in 2000. HS can be found in most racial groups, but it is less common in African American and south Asia...

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... 1999). The role of band 3 protein in oxygen delivery by the red blood cells. Indian Journal of Clinical Biochemistry, 14 (1), 49-58. Retrieved on Feb. 23, 2014 from http://www.ncbi.nlm.nih.gov/pmc/articles/PM3453557/

Garg, P., Kumar, A., Teckchandani, N., Hadke, N., (2008). Hereditary spherocytosis coexisting with Gilbert’s syndrome: a diagnostic dilemma. Singapore Med J. Retrieved on Feb. 22, 2014 from http://smj.sma.org.sg/4911/4911cr5.pdf

Perrotta, S., Gallagher, P., Mohandas, N., (Oct. 2008). Hereditary spherocytosis. The Lancet, Vol. 372, pp. 1411-1426. Retrieved on Feb. 22, 2014 from http://www.medicine.wisc.edu/~williams/spherocytosis_lancet_2008.pdf

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