ANK1 and hyperinsulinemic hypoglycemia, familial, 4: In contrast, Yawata et al. analyzed 60 Japanese patients with HS using a similar method and detected protein 4.2 deficiency (SPH5) in 45% of the patients, band 3 deficiency (SPH4) in 20%, and ankyrin deficiency (SPH1) in 7%, while 28% of the patients had an unknown etiology15,16.