title: Challenges in HbA1c analysis and reporting: an interesting case illustrating the many pitfalls.
abstract: This case study illustrates the challenges in the analysis and interpretation of HbA(1c) testing. The patient is homozygous HbS with a high HbF concentration. Immunoassay methods give an HbA(1c) result that probably reflects glycated hemoglobin species (although falsely low) while HPLC methods gave a zero HbA(1c) result. The equating of glycated hemoglobin variant species to published target HbA(1c) values may not be relevant in patients with homozygous variants due to potential difference in glycation rates and analytical (in this case HbF interference with the immunoassay method) and physiological challenges (markedly decreased the red cell survival).
authors.affiliation: DynaLIFE Dx, Chemistry Department, Edmonton, Canada. trefor.higgins@dynalifedx.com
authors.forename: Trefor
authors.initials: T
authors.lastname: Higgins
authors.forename: Debbie
authors.initials: D
authors.lastname: Stewart
authors.forename: Eugene
authors.initials: E
authors.lastname: Boehr
mesh_terms: D000755:Anemia, Sickle Cell / Q000097:blood; D002675:Child, Preschool; D002851:Chromatography, High Pressure Liquid; D005188:False Negative Reactions; D005319:Fetal Hemoglobin / Q000032:analysis; D006442:Glycated Hemoglobin / Q000032:analysis*; D006451:Hemoglobin, Sickle / Q000032:analysis / Q000235:genetics; D006720:Homozygote; D006801:Humans; D007118:Immunoassay; D008297:Male
chemical_list: D005319:Fetal Hemoglobin; D006442:Glycated Hemoglobin; D006451:Hemoglobin, Sickle; C517652:hemoglobin A1c protein, human