Title: Variant hemoglobin (Hb hope) may enhance glycosylated hemoglobin (HbA1c) results of cation exchange high performance liquid chromatography
Authors: AK Kapoor, Rajesh Kumar Srivastava
DOI: https://dx.doi.org/10.18535/jmscr/v6i9.129
Abstract
HbA1c estimation is routinely done in our lab by cation exchange high performance liquid chromatography (HPLC) method. During 2 year period, we estimated the EDTA venous blood samples of ~5000 patients. Surprisingly, in 2 patients abnormally raised Hb1Ac values were detected which were not in line with blood glucose levels (abnormal separation). One of the patients gave HbA1c value of 19.9% which suggested coelution of an hemoglobin variant along with glycosylated hemoglobin. Later, capillary electrophoresis (CE) of the sample showed an abnormal minor peak of a variant Hb adjacent to HbA; its concentration was 1.2%. Similarly, another patient also gave high A1c value of 21.2% by HPLC; CE electrophoregram of the sample showed a minor variant peak (1.4%) abutting HbA. Hb variant appeared to alter the HbA1c result and later required correction using another method.
Keywords: Abnormal hemoglobins falsely interfere A1c results.
