We report a fourth case of Hb Nottingham [alpha(2) beta(2) 98 (FG5) Va
l-->Gly] observed in an 8-year-old girl in the Czech Republic with cli
nical and laboratory symptoms of severe hemolytic anemia. The unstable
hemoglobin probably represents a de novo mutation, since the parents
of the patient and the two siblings do not exhibit any hematological a
bnormalities. Splenectomy had a beneficial effect on the degree of hem
olysis, as well as on the Hb level.