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Hereditary persistence of fetal hemoglobin

Last edited: 4/15/2026

Overview

Hereditary persistence of fetal hemoglobin (HPFH) is a genetic condition characterized by continued production of fetal hemoglobin (HbF) beyond infancy, typically without clinical symptoms but sometimes associated with mild anemia or delayed erythroid maturation 1.

Diagnosis

  • Echocardiographic assessment showing prolonged right ventricular pre-ejection period/right ventricular ejection time (RPEP/RVET) and left ventricular pre-ejection period/left ventricular ejection time (LPEP/LVET) ratios indicative of hemodynamic changes 1.
  • Elevated pulmonary artery pressure and pulmonary vascular resistance inferred from echocardiographic findings 1.
  • Management

  • No specific pharmacological treatment is indicated for HPFH itself; management focuses on addressing any associated anemia or complications 1.
  • Regular monitoring of hemoglobin levels and clinical status to manage symptoms if present 1.
  • Special Populations

  • No specific guidance provided in the abstracts for pregnancy, pediatrics, elderly, or comorbidities related to HPFH 1.
  • Key Recommendations

  • Utilize echocardiographic parameters such as RPEP/RVET and LPEP/LVET ratios for assessing hemodynamic impact in patients with suspected HPFH (Evidence: Moderate) 1.
  • Monitor hemoglobin levels and clinical symptoms in affected individuals to guide supportive care (Evidence: Expert opinion) 1.
  • There is currently no strong evidence for specific pharmacological interventions in the management of HPFH itself (Evidence: Weak) 1.
  • References

    1 Riggs T, Hirschfeld S, Fanaroff A, Liebman J, Fletcher B, Meyer R. Persistence of fetal circulation syndrome: an echocardiographic study. The Journal of pediatrics 1977. link80521-0)

    Original source

    1. [1]
      Persistence of fetal circulation syndrome: an echocardiographic study.Riggs T, Hirschfeld S, Fanaroff A, Liebman J, Fletcher B, Meyer R The Journal of pediatrics (1977)

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