Sample dilution to resolve mistaken identification of haemoglobin D as haemoglobin E using the variant automated system.
High performance liquid chromatography (HPLC) is increasingly being used to estimate variant haemoglobins. A case of haemoglobin S/D (HbS/D) is presented, which was misdiagnosed as haemoglobin S/E (HbS/E) by HPLC. The patient was a 22 year old woman with sickle cell anaemia. Subsequent haemodilution by blood transfusion clearly elucidated the haemoglobin D peak on HPLC. Sample dilution experiments, using the pretransfusion sample, were done resulting in correct elution of the peak in the D window. Troubleshooting in similar problematic haemoglobin variant peaks seen on HPLC can be done by sample dilution.
Thomas
S
S
Department of Pathology, Christian Medical College Hospital, Vellore, India.
D000328:Adult; D000755:Anemia, Sickle Cell / Q000097:blood* / Q000175:diagnosis; D002851:Chromatography, High Pressure Liquid; D003951:Diagnostic Errors; D005260:Female; D006446:Hemoglobin E / Q000032:analysis*; D006455:Hemoglobins, Abnormal / Q000032:analysis*; D006801:Humans; D013048:Specimen Handling / Q000379:methods
D006455:Hemoglobins, Abnormal; C032001:hemoglobin D; D006446:Hemoglobin E