[An unusual etiology of erythrocytosis in a 23-year-old primiparous woman in the 22nd week of pregnancy].
METHODS
A 23-year-old pregnant woman presented with erythrocytosis and a spuriously elevated HbA1c. Family history revealed that her father has been treated with phlebotomies for the last 2 years because of erythrocytosis of unknown cause. An examination of the family members demonstrated that the patient and her father were carriers of the hemoglobin (Hb) variant Hb Andrew-Minneapolis.


CONCLUSIONS
Hb Andrew-Minneapolis belongs to a group of hemoglobin variants with a high oxygen affinity resulting in compensatory erythrocytosis. The carriers of such hemoglobin variants are usually clinically asymptomatic, exercise tolerance appears unimpaired and there is no higher incidence of cardiovascular diseases. There is no clear-cut evidence that a maternal hemoglobinopathy with high oxygen affinity is accompanied by negative consequences for the fetus or a higher abortion rate.


CONCLUSIONS
Hemoglobinopathies with a high oxygen affinity are a rare but important differential diagnosis of polycythemia. Under these circumstances erythrocytosis has to be accepted as the primary mode of compensation and does not require treatment, as long as blood viscosity is kept within tolerable limits. An excessively elevated or lowered HbA1c without a history or symptoms of diabetes should lead to further investigations concerning the possibility of hemoglobinopathy.
Maywald
O
O
Medizinische Klinik IV, Medizinische Einrichtungen der Rheinisch-Westfälischen Technischen Hochschule Aachen.
Galm
O
O
Fabry
U
U
Kohne
E
E
Osieka
R
R
D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006580:Genetic Carrier Screening; D006442:Glycated Hemoglobin / Q000378:metabolism; D006455:Hemoglobins, Abnormal / Q000235:genetics*; D006801:Humans; D011086:Polycythemia / Q000097:blood / Q000235:genetics*; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000097:blood* / Q000175:diagnosis; D011262:Pregnancy Trimester, Second
D006442:Glycated Hemoglobin; D006455:Hemoglobins, Abnormal; C060133:hemoglobin Andrew-Minneapolis
Ungewöhnliche Ursache einer Erythrozytose bei einer 23-jährigen Erstgebärenden in der 22. Schwangerschaftswoche.