RESUMO
BACKGROUND: In 2010 Singapore's National Health Survey reported 11.3% of the population between 18-69 years of age with diabetes, compared to 8.2% in 2006. This increasing trend reinforces the dependence on HbA(1c) for management of glycemic control. METHODS: To determine the incidence of hemoglobin variants received from our diabetic population who are attending the National University Hospital for testing of their HbA(1c) and determine whether the hemoglobin variant caused an interpretation issue, we reviewed all chromatograms from patients sending a sample for HbA(1c) analysis for a three-month period. Analysis was performed on the Variant II using the HbA(2)/HbA(1c) Dual program. RESULTS: Our sub-analysis identified 2 cases of α thalassemia, 2 cases of ß thalassemia; 5 cases of hemoglobin E variant homozygous, 1 case of hemoglobin J variant, 110 cases of hemoglobin E, 7 cases of hemoglobin S, 1 case of hemoglobin C and 1 case of hemoglobin D, all heterozygous. HbA(1c) results could be confidently reported in all cases except the homozygote variant and the hemoglobin J variant. CONCLUSIONS: Overall we obtained a prevalence of 2.3% of hemoglobin variants in our diabetic population being screened by HbA(1c) using Variant II.
Assuntos
Diabetes Mellitus/sangue , Diabetes Mellitus/diagnóstico , Hemoglobinas Glicadas/análise , Hemoglobinopatias/sangue , Hemoglobinopatias/diagnóstico , Adolescente , Adulto , Idoso , Diabetes Mellitus/etnologia , Diabetes Mellitus/genética , Feminino , Hemoglobinas Glicadas/genética , Hemoglobinopatias/etnologia , Hemoglobinopatias/genética , Homozigoto , Humanos , Masculino , Pessoa de Meia-Idade , Singapura/epidemiologiaRESUMO
Macro-creatine kinase (CK) is a cause of falsely elevated CK. Macro-CK type 1 is immunoglobulin-associated CK; type 2 is polymeric mitochondrial-CK. An elderly asymptomatic lady had an elevated CK level after receiving statin therapy. Her CK gel electrophoresis analysis demonstrated coexisting macro-CK type 1 and type 2 patterns. Further analysis by immunofixation and mixing this patient's serum with CK control material revealed an IgG-associated macro-CK that mimicked the electrophoretic pattern of macro-CK type 2. This highly unusual discovery suggests the possibility of the misinterpretation of macro-CK type 1 as macro-CK type 2. Falsely elevated CK is still common despite modern laboratory instrumentation and should be investigated.
