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Diagnostic Dilemma of HbA1c Detection in Presence of a Hemoglobinopathy: A Case Report

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Abstract

We report a case of a diabetic, heterozygote with near normal hematology, marginally low level of hemoglobin A2(HbA2) having an increased level of hemoglobin F(HbF) that was pancellularly distributed among the red cells. BioRad DiaSTAT measurements gave a high glycated hemoglobin A1c(HbA1c) of 31.5% and the BioRad Variant analyzer recorded an HbA1c value which was very low, in discordance with the detected blood glucose levels. Flow cytometry and polymerization chain reaction (PCR) based studies were carried out which revealed the case to be that of the common hereditary persistence of fetal hemoglobin (HPFH)-3, an Asian Indian mutation. Fructosamine estimation and HbA1c by Boronate affinity chromatography were able to resolve the discordant value detected and was able to confirm the diabetes status. The case would have been a diagnostic dilemma, if reported without correlation.

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Authors and Affiliations

  1. Department of Biochemistry, Manipal Hospital Diagnostic Services, Manipal Hospital, Old Airport Road, Bangalore, 560017, India

    Vijay S. Bhat

  2. Cauvery Medical Center, 43/2 Sahakarnagar, Bellary Road, NH-7, Bangalore, 560092, India

    Kalyan Kumar Dewan & Patnam Rajagopalan Krishnaswamy

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  1. Vijay S. Bhat
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  2. Kalyan Kumar Dewan
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  3. Patnam Rajagopalan Krishnaswamy
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Correspondence to Vijay S. Bhat.

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Bhat, V.S., Dewan, K.K. & Krishnaswamy, P.R. Diagnostic Dilemma of HbA1c Detection in Presence of a Hemoglobinopathy: A Case Report. Ind J Clin Biochem 26, 91–95 (2011). https://doi.org/10.1007/s12291-010-0076-0

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  • DOI: https://doi.org/10.1007/s12291-010-0076-0

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