ABSTRACT
Hemoglobin (Hb) A2 electrophoresis has been used for prenatal screening for the beta-thalassemia trait (betaTT). We retrospectively reviewed Hb capillary electrophoresis performed in our laboratory. We found that of the 122 cases showing elevated HbA2 levels, 79 cases were due to hemoglobinopathies, mostly HbS. Review of the RBC indices suggested that 3 of 36 cases with elevation of HbA2 in the HbAA-pregnancy group had betaTT and 29 had normal RBC indices; data were not available for 4 patients. Among 7 cases with elevation of HbA2 in the HbAA-other group, 5 had betaTT and 2 were normal. The number of patients without betaTT but with HbA2 elevation in the pregnant group was significantly higher than that in the nonpregnant group. When a higher HbA2 cutoff (3.5%) was used, only 3 pregnant patients without betaTT had HbA2 elevation, similar to the nonpregnant group. We found that a significant number of pregnant women with mild HbA2 elevation had no evidence of betaTT, compared with the nonpregnant group.
Subject(s)
Hemoglobin A2/analysis , beta-Thalassemia/diagnosis , Electrophoresis, Capillary , Female , Humans , Pregnancy , Pregnancy Complications, Hematologic/blood , Pregnancy Complications, Hematologic/epidemiology , Prenatal Diagnosis , Prevalence , Retrospective Studies , beta-Thalassemia/geneticsABSTRACT
We evaluated the performance of the CAPILLARYS 2 (Sebia, Norcross, GA) capillary electrophoresis system for detection and identification of monoclonal proteins in serum samples. We analyzed 104 serum specimens by Sebia Hydragel serum protein electrophoresis (agarose gel electrophoresis [AGE]/immunofixation electrophoresis [IFE]) and CAPILLARYS 2 capillary zone electrophoresis (CZE)/immunosubtraction. AGE and CZE had sensitivities of 90% and 81%, respectively, based on IFE as the "gold standard," and all bands detected were confirmed by IFE (100% specificity). AGE and CZE had an overall agreement of 91% on serum protein electrophoresis. In the population tested, IgG was detected in 29% of samples by IFE and 30% using immunosubtraction. Similarly IgA was detected in 9% of cases by IFE and 8% by immunosubtraction. IgM and light chains were detected in 6% and 3% of cases, respectively, by IFE, whereas CZE/immunosubtraction did not detect any IgM or light chains. In our hands, AGE and CZE had the same specificity for detection of monoclonal proteins; however, CZE/immunosubtraction seems to be less sensitive than IFE for the detection of IgM and, possibly, serum light chains.
