3 cases of variant hemoglobin Hb A2-Niigata detected by falsely high HbA1c values.

Clin Chim Acta

Department of Internal Medicine, Hakuhoukai Central Hospital, Hyogo, Japan.

Published: November 2020

AI Article Synopsis

  • * In these cases, the HbA1c levels were elevated when measured by high-performance liquid chromatography (HPLC), while other testing methods showed normal values.
  • * This report suggests that Hb A2-Niigata may be more common in certain regions and emphasizes the need to consider this variant when interpreting HbA1c results.

Article Abstract

Background: HbA1c measurements in blood are used to monitor diabetes status.

Methods: We detected 3 cases (1 diabetic case, 1 borderline diabetic case, and 1 case with normal glucose tolerance) of variant hemoglobin Hb A2-Niigata based on falsely high HbA1c values measured by high-performance liquid chromatography (HPLC).

Results: In all 3 cases, HbA1c values measured by the HPLC method were higher than the reference range whereas the HbA1c values measured by immunoassay, plasma glucose and glycated albumin were within the reference range. The results of the genetic test revealed heterozygous mutation GTG (Val) → GCG (Ala) in codon 1 of the δ-globin gene in all 3 cases, based on which Hb A2-Niigata was found. Although until now Hb A2-Niigata has been reported in 3 cases, this is the first report on Hb A2-Niigata with falsely high HbA1c values.

Conclusions: In this report, 3 cases of Hb A2-Niigata were found in a single institution in a short period; therefore, Hb A2-Niigata would exist frequently in a certain area. As a pathology causing falsely high HbA1c values, Hb A2-Niigata should be kept in mind.

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Source
http://dx.doi.org/10.1016/j.cca.2020.08.036DOI Listing

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