A novel

Background: Hereditary spherocytosis (HS) is a genetically inherited hemolytic anemia resulting from erythrocyte membrane defects, predominantly associated with genetic mutations in membrane protein genes such as Case presentation: The patient was a 29-day-old boy who had experienced persistent anemia and a medical history of neonatal hyperbilirubinemia since birth. Upon admission, the infant lacked typical HS manifestations such as splenomegaly, jaundice, and spherocytosis on the peripheral blood smear. Whole-exome sequencing identified a novel frameshift mutation c.3556delG (EX30, NM_000037.4), resulting in an amino acid alteration p.Glu1186Lysfs*3. Subsequent Sanger sequencing-based family segregation analysis confirmed that this mutation originated from the paternal allele. Based on the characteristic clinical manifestations and genetic findings, a definitive diagnosis of HS was established. Conclusions: In neonates presenting with unexplained recurrent anemia, particularly those with a history of neonatal hyperbilirubinemia, HS should be suspected. Due to the atypical manifestations, genetic analysis serves as a pivotal tool in the early diagnosis of HS, and novel genetic mutations may be identified, which can subsequently be added to the genetic database.