title: Bilirubin peak can be mistaken as Hb Bart's or Hb H on High-performance liquid chromatography.
abstract: High-performance liquid chromatography (HPLC) has largely replaced electrophoresis for the identification of hemoglobin (Hb) variants. However, one needs to be vigilant to pick up undue interference such as the presence of a bilirubin peak, which can be mistaken for either Hb Bart's or Hb H on Hb HPLC. Correlation with the clinical context and biochemical parameters, coupled with repeating the run after washing the sample, can resolve this problem. Herein, we report one such case of an acute on chronic liver failure patient who was found to have heterozygous β-thalassemia (β-thal) on Hb HPLC with an incidental tall unknown peak that was identified as bilirubin.
authors.affiliation: Department of Clinical Haematology, Institute of Liver and Biliary Sciences, New Delhi, India. drrakheekar@gmail.com
authors.forename: Rakhee
authors.initials: R
authors.lastname: Kar
authors.forename: Chaggan Bihari
authors.initials: CB
authors.lastname: Sharma
mesh_terms: D001663:Bilirubin / Q000097:blood*; D002851:Chromatography, High Pressure Liquid / Q000592:standards; D058625:End Stage Liver Disease / Q000175:diagnosis; D006447:Hemoglobin H / Q000737:chemistry*; D006455:Hemoglobins, Abnormal / Q000737:chemistry*; D006801:Humans; D008297:Male; D017086:beta-Thalassemia / Q000175:diagnosis
chemical_list: D006455:Hemoglobins, Abnormal; D006447:Hemoglobin H; C030448:hemoglobin Bart's; D001663:Bilirubin