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A rare haemoglobin variant (Hb Phnom Penh) manifesting as a falsely high haemoglobin A1c value on ion-exchange chromatography
Singapore medical journal ; : e126-8, 2014.
Article in English | WPRIM | ID: wpr-274210
ABSTRACT
Most haemoglobin (Hb) variants are clinically silent. However, some Hb variants may interfere with the measurement of haemoglobin A1c (HbA1c), resulting in spurious values depending on the assays used. We herein report the case of a 53-year-old Taiwanese man with type 2 diabetes mellitus, who presented with an abnormal HbA1c peak on ion-exchange chromatography. Additional investigations, including intensified self-monitored blood glucose tests, an alternative HbA1c assay, and a glycaemic indicator based on a different method, revealed that the HbA1c values were falsely elevated. Subsequent DNA analysis confirmed that the patient was heterozygous for the insertion of an isoleucine residue at codons 117/118 of the a1-globin gene, Hb Phnom Penh. Clinical laboratorians should be aware of the interfering factors in their HbA1c analysis. Cautious inspection of the chromatogram may provide a valuable clue to the presence of an Hb variant.
Subject(s)
Full text: Available Index: WPRIM (Western Pacific) Main subject: Taiwan / Blood / Hemoglobins, Abnormal / Reproducibility of Results / Chromatography, High Pressure Liquid / Chromatography, Ion Exchange / Sequence Analysis, DNA / Diabetes Complications / Diabetes Mellitus, Type 2 / Dyslipidemias Limits: Humans / Male Country/Region as subject: Asia Language: English Journal: Singapore medical journal Year: 2014 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Taiwan / Blood / Hemoglobins, Abnormal / Reproducibility of Results / Chromatography, High Pressure Liquid / Chromatography, Ion Exchange / Sequence Analysis, DNA / Diabetes Complications / Diabetes Mellitus, Type 2 / Dyslipidemias Limits: Humans / Male Country/Region as subject: Asia Language: English Journal: Singapore medical journal Year: 2014 Type: Article