Title: HPLC based evaluation of Haemoglobinopathies in a tertiary care setting in North Kerala
Authors: Thundiparambil Raghavan Nisha, Chettithodi Sivasankaran Bindu
DOI: https://dx.doi.org/10.18535/jmscr/v6i1.102
Abstract
Introduction-Inherited Haemoglobin disorders are the most common single gene disorders in the world with the highest prevalence in regions where malaria was endemic. The burden of this disorder is of such a magnitude that it represents a major public health concern in the majority of the regions. The common variants prevalent in India are Hb S, Hb D-, and Hb E . Hb S and Hb E are the common variants prevalent in tribals of India.In Kerala, Hb S is prevalent in tribals of Wayanad and Attapadi, also in a nontribal Chetty community in Wayanad. But the existence of other hemoglobinopathies is still not properly evaluated.
The aim of the present study was to analyze laboratory aspects- hematological profile and HPLC findings of the various hemoglobin variants detected from our Laboratory.
Materials and methods-A total of 4200 cases received from January 2010 to December 2016which came for HPLC to evaluate anaemia. The tests were performed on HPLC instrument BIO-RAD –D10.The principle of the Instrument is Cation Exchange High-Performance Liquid Chromatography. Complete blood count and the peripheral smear of the samples were done in every case. Hb electrophoresis - both acid and alkali were done in selected cases. Family studies were also done in needed cases whenever the situation demanded it.
Results-A total of 4200 cases were studied. Of these, in 1258 cases we could detect abnormal hemoglobin on HPLC, Out of the 4200 case, 2395 cases were from the tribal population of Wayanad, Malappuram, and Palakkad. The major abnormality detected were Hb S and Beta –thalassemia syndromes.
Conclusion- HPLC forms a rapid, accurate and reproducible tool for early detection and management of hemoglobinopathies and variants. Hb S and thalassemias are the common abnormalities found in Northern Kerala.