Related Experiment Video
Updated: Dec 30, 2025
A Precision Medicine Tool for Measurement and Monitoring of Hemoglobin S in Sickle Cell Disease Patients Receiving Transfusion Therapy
HEMOGLOBIN WAYNE VARIANT INTERFERING WITH HEMOGLOBIN A1C MEASUREMENT
Insights
The hemoglobin Wayne variant can interfere with hemoglobin A1c (HbA1c) test accuracy, leading to misdiagnosis and inappropriate diabetes treatment. Patient-physician communication is crucial for identifying such discrepancies.
Area of Science:
- Clinical Chemistry
- Hematology
- Genetics
Background:
- Hemoglobin A1c (HbA1c) is a key biomarker for diabetes mellitus (DM) management.
- Accurate HbA1c measurement is critical for effective DM treatment titration.
Observation:
- Two patients with diabetes mellitus presented with discordant HbA1c results and blood glucose logs.
- Hemoglobin electrophoresis revealed the presence of the hemoglobin Wayne variant in both patients.
Findings:
- The hemoglobin Wayne variant significantly interfered with high-performance liquid chromatography-based HbA1c assays, yielding falsely elevated results.
- Subsequent immunoassay testing showed accurate HbA1c levels within the target range, with one patient not meeting DM diagnostic criteria.
Implications:
- Clinicians must consider hemoglobin variants as a potential cause of inaccurate HbA1c readings.
- Establishing trust and open communication between patients and physicians is vital for recognizing and resolving such analytical interferences.
- Accurate HbA1c testing is essential to prevent treatment errors and adverse patient outcomes.
Objective:
To describe the effect of hemoglobin Wayne variant on hemoglobin A1c (A1c) accuracy and to stress the importance of patient-physician communication and trust.
Methods:
We present the clinical history and laboratory findings of 2 patients, with a review of related literature.
Results:
Two older patients were diagnosed with diabetes mellitus (DM) and suffered from frequent hypoglycemia resulting from titrating their diabetes medications based on an extremely elevated A1c (>11% [97 mmol/mol]) obtained through high-performance liquid chromatography. Discrepancies were noticed between their blood glucose logs and their A1c results. Ultimately, both were found to have heterogenous hemoglobin Wayne variant by hemoglobin electrophoresis. Repeat immunoassay found the A1c to be very low, in the 5 to 6.2% (31 to 44 mmol/mol) range. One of the patients did not even meet diagnostic criteria for DM.
Conclusion:
A1c testing is susceptible to misinterpretation due to multiple interfering factors. Hemoglobin variants should be considered as a differential when there are discrepancies between A1c and blood glucose levels. Trust between the patient and the physician is essential in raising clinical suspicion and avoiding potentially lethal outcomes.
Related Concept Videos
01:49Multiple Allele Traits
01:24Hemoglobin
When all four heme groups are bound to oxygen, the resulting molecule is called oxyhemoglobin. As a result, arterial blood...
02:20Blood Types
ABO blood group
ABO antigens are glycoproteins encoded by genes present on...
01:10Blood Typing
Antigens are protein molecules that reside on the surface of red blood cells (RBCs). The ABO and Rh blood typing systems target...
02:45Blood Transfusion and Agglutination
History
The history of blood transfusion dates back to the 17th century, when early attempts were made in animals. In 1818 James Blundell, a British doctor, performed the first successful human blood transfusion. Later in 1900, Karl...
01:19Rh Blood Group