Hemoglobin K-Woolwich (Hb KW): Its Combination with Sickle Cell Trait

Ruchika Sharma, Melissa Rhodes, Elizabeth Varga, Samir B. Kahwash

Department of Pathology and Laboratory Medicine, Nationwide Children’s Hospital, Columbus, Ohio, USA.
Department of Pediatrics, University of Mississippi Medical Center, Jackson, Mississippi, USA.
Division of Hematology/Oncology, Nationwide Children’s Hospital, Columbus, Ohio, USA.

DOI: 10.4236/ojpathology.2014.43017                

Abstract

Hemoglobin K-Woolwich (Hb KW) is a rare hemoglobin variant with very few cases reported. It is most prevalent in West African countries, particularly Nigeria, Ghana, and the Ivory Coast. Some reports suggest Hb KW may be a clinically benign trait, whereas others indicate it may behave similarly to a β+ thalassemia. The combination of hemoglobin S and hemoglobin KW (Hb S/KW) is a rare double heterozygous disorder with little known clinical characteristics. We report the hematologic and clinical data on three patients with Hb S/KW to help describe the characteristics of this patient population. The first two cases represent first cousins, ages 3 and 2 years. They are clinically asymptomatic. They have normal hemoglobin and mean corpuscle volume (MCV) levels without reticulocytosis. The third case is of a 14-year-old male who is non-anemic with no microcytosis. He has been clinically well except for abdominal pain upon dehydration. On hemoglobin electrophoresis, these patients have Hb S levels slightly higher than typically observed with sickle cell trait and a delay of hemoglobin F to adult levels. There exists a need for more reports to better delineate the clinical course and management of these patients.

Keywords

Hemoglobin K-Woolwich, Hemoglobin Electrophoresis, Fast Hemoglobin Variant, Sickle-Cell Anemia

Conflicts of Interest

The authors declare no conflicts of interest.

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