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Different forms of Hb Le Lamentin. An unexpected finding in Hba1c quantification
Rosalina Martínez-López1, Félix de la Fuente-Gonzalo2, Jorge M Nieto2
1Servicio de Análisis Clínicos. Hospital General de Albacete, Spain.
Clinical Biochemistry
|October 6, 2015
Summary
Hemoglobin Le Lamentin variants can interfere with glycated hemoglobin (HbA1c) measurements using ion-exchange HPLC, leading to falsely reduced values. Alternative methods or recalculation are necessary for accurate diabetes monitoring.
Area of Science:
- Clinical Chemistry
- Hematology
- Biochemistry
Background:
- Glycated hemoglobin (HbA1c) is crucial for diabetes mellitus management.
- Ion-exchange HPLC is a standard method for HbA1c quantification.
- Hemoglobin variants can interfere with accurate HbA1c results.
Observation:
- Two male patients presented with anomalous peaks during routine HbA1c analysis via ion-exchange HPLC.
- The cases involved Hb Le Lamentin, a variant that can be mistaken for different hemoglobinopathies.
- The study identified the first homozygous Hb Le Lamentin and a double-heterozygous case (Hb Le Lamentin/Hb City of Hope).
Findings:
- Hb Le Lamentin variants, including homozygous and double-heterozygous forms, do not cause clinical or hematologic abnormalities.
- These variants interfere with ion-exchange HPLC by altering retention times, leading to falsely decreased HbA1c values.
- The interference stems from the variant's elution time overlapping with HbA1c.
Implications:
- Accurate HbA1c monitoring in patients with Hb Le Lamentin requires careful consideration of HPLC results.
- Alternative HbA1c measurement methods or recalculation of results are essential.
- Awareness of hemoglobin variants like Hb Le Lamentin is critical for laboratory professionals.
