Inoue et al. analyzed the genetic backgrounds of Japanese HS patients using sodium dodecyl sulfate–polyacrylamide gel electrophoresis and reported band 3 deficiency (SPH4) in 32% of the patients, spectrin deficiency (corresponding to SPH2 and SPH3) in 15%, protein 4.2 deficiency (SPH5) in 6%, ankyrin deficiency (SPH1) in 2%, combined deficiency in 36%, and no abnormality in 9%14. This evidence concerns the gene SPTA1 and hyperinsulinemic hypoglycemia, familial, 4.