Incorrect diagnosis of diabetes mellitus in a patient with persistence of fetal haemoglobin.
A 65-year-old woman, referred to the endocrine clinic for investigation of tiredness and arthritis, was diagnosed as having diabetes on the basis of a positive family history and a raised glycated haemoglobin (HbA1) measurement. Subsequently, she was shown not to have diabetes but to have a persistently raised haemoglobin F (HbF) level. Initial assessment of HbF level by electroendosmosis demonstrated a normal HbF level but high values were confirmed using HPLC. Thalassaemia was excluded following DNA analysis. This case illustrates the importance of a glucose tolerance test following WHO criteria for the diagnosis of diabetes and emphasises that HbA1 is not a diagnostic test for diabetes.
Leonard
M B
MB
Department of Clinical Biochemistry, Arrowe Park Hospital, Upton, Wirral, UK.
Leong
K S
KS
Neithercut
W D
WD
Galvani
D
D
Feltham
J
J
Bowen-Jones
D
D
D000368:Aged; D002851:Chromatography, High Pressure Liquid; D003920:Diabetes Mellitus / Q000175:diagnosis*; D003951:Diagnostic Errors; D005260:Female; D005319:Fetal Hemoglobin / Q000378:metabolism*; D006441:Hemoglobin A / Q000378:metabolism*; D006801:Humans
D006441:Hemoglobin A; D005319:Fetal Hemoglobin