Hemoglobin D-Ouled-Rabah in Morocco: First Case Report

Hemoglobin D-Ouled Rabah is a rare β-chain variant [β19(B1)Asn>Lys], mainly found in Tuareg tribes of Algeria and Mali. This paper reports the first documented heterozygous case in Morocco, confirmed by genetic analysis.

A hemoglobin variant was incidentally discovered in a 53-year-old patient during hemoglobin A1c measurement using high-performance liquid chromatography, where it was initially identified as hemoglobin E. However, subsequent capillary electrophoresis identified it as hemoglobin D. Due to this discrepancy, a genotypic analysis was performed.

DNA sequencing subsequently confirmed the hemoglobin D-Ouled Rabah variant by detecting a nucleotide substitution at position 60, where cytosine is replaced by adenine, resulting in a protein alteration with asparagine being substituted by lysine at position 20.

This case underscores the importance of enhancing genetic screening and monitoring programs in Morocco to gain deeper insights into the epidemiology of rare hemoglobinopathies and their public health impications.