A 15-year-old African American female presents to
the emergency room with complaints of bilateral thigh and hip pain. The pain
has been present for one day and is steadily increasing in severity.
Acetaminophen and ibuprofen have not relieved her symptoms. She denies any
recent trauma or excessive exercise. She does report feeling fatigued. She
reports having similar pain episodes in the past, sometimes requiring
hospitalization. On examination she is afebrile (without fever) and in no acute
distress. No one in her family has similar episodes. The remainder of her
examination is completely normal. Her white blood cell count is elevated at
17,000/mL (nl: 5,000-10,000/mL), and her hemoglobin (Hb) level is decreased at 7.1 g/dL (nl: 12-16
g/dL).
1.
What is the most likely diagnosis??
2.
What is the molecular genetics behind this disorder??
3.
Define the following terms:
Globin:
Heme:
Hemoglobin:
Primary (10) Protein
Structure:
Secondary (20) Protein
Structure:
Tertiary (30) Protein
Structure:
© Dr. Noel Sturm 2014