Table 99-3 Representative Abnormal Hemoglobins with Altered Synthesis or Function

Designation	Mutation	Population	Main Clinical Effectsa
Sickle or S	6GluVal	African	Anemia, ischemic infarcts
C	6GluLys	African	Mild anemia; interacts with HbS
E	26GluLys	Southeast Asian	Microcytic anemia, splenomegaly, thalassemic phenotype
Köln	98ValMet	Sporadic	Hemolytic anemia, Heinz bodies when splenectomized
Yakima	99AspHis	Sporadic	Polycythemia
Kansas	102AsnLys	Sporadic	Mild anemia
M. Iwata	87HisTyr	Sporadic	Methemoglobinemia