Fetal Hemoglobin and Female Sex Hormones

Alton I. Sutnick, MD; W. Thomas London, MD; Betty Jane S. Gerstley, MD; Veronica E. Zavatone, MD; Anita M. Woodside
JAMA. 1968;206(8):1795. doi:10.1001/jama.1968.03150080075026.
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To the Editor:—  Red cells containing abnormal hemoglobin variants have a shortened survival time in vivo. In such hemoglobinopathies higher levels of fetal hemoglobin (Hgb F) are associated with less severe anemia.1 Fetal hemoglobin has oxygen-carrying capacities similar to normal adult hemoglobin, and one would expect that any maneuver raising Hgb F levels would benefit patients with hemoglobinopathies. The stimulus to Hgb F production is not known, but some clinical observations may be relevant. Fetal hemoglobin levels are higher in females with sickle cell anemia than in males2; they increase during pregnancy, and are elevated in patients with choriocarcinoma.3,4 This suggests that chorionic gonadotrophin, estrogen, or progesterone may promote fetal hemoglobin synthesis.Four female patients, 21 to 32 years old, with hemoglobinopathies were investigated for fetal hemoglobin levels. Three had sickle cell thalassemia and one had sickle cell anemia. Chorionic gonadotrophin was administered to one patient with


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