Case Report: Abnormally Low Glycosylated Hemoglobin A1c Caused by Clinically Silent Rare β-Thalassemia in a Tujia Chinese Woman.
Hb J-Bangkok
HbA1c
hemoglobinopathy
high-pressure liquid chromatography (HPLC)
β-thalassemia
Journal
Frontiers in endocrinology
ISSN: 1664-2392
Titre abrégé: Front Endocrinol (Lausanne)
Pays: Switzerland
ID NLM: 101555782
Informations de publication
Date de publication:
2022
2022
Historique:
received:
24
02
2022
accepted:
07
04
2022
entrez:
23
5
2022
pubmed:
24
5
2022
medline:
25
5
2022
Statut:
epublish
Résumé
Glycosylated hemoglobin A1c (HbA1c) is an important means of monitoring blood glucose and diagnosing diabetes. High-performance liquid chromatography (HPLC) is the most widely used method to detect HbA1c in clinical practice. However, the results of HbA1c by HPLC are susceptible to hemoglobinopathy. Here, we report a case of discordantly low HbA1c with an abnormal chromatogram caused by rare β-thalassemia. A 36-year-old Tujia Chinese woman presented with an abnormally low HbA1c level of 3.4% by HPLC in a health check-up. The chromatogram of HbA1c showed an abnormal peak. Fasting blood glucose, routine blood tests and serum bilirubin were normal. Her body mass index was 27.86 kg/m Clinically silent β-thalassemia may lead to low HbA1c values and abnormal chromatograms by HPLC. In these circumstances, differential diagnosis is important. Checking the chromatogram may be helpful in interpreting HbA1c as well as identifying hemoglobinopathy. Further tests, such as GA, OGTT, hemoglobin electrophoresis and genetic tests, are needed for differential diagnosis.
Sections du résumé
Background
Glycosylated hemoglobin A1c (HbA1c) is an important means of monitoring blood glucose and diagnosing diabetes. High-performance liquid chromatography (HPLC) is the most widely used method to detect HbA1c in clinical practice. However, the results of HbA1c by HPLC are susceptible to hemoglobinopathy. Here, we report a case of discordantly low HbA1c with an abnormal chromatogram caused by rare β-thalassemia.
Case Description
A 36-year-old Tujia Chinese woman presented with an abnormally low HbA1c level of 3.4% by HPLC in a health check-up. The chromatogram of HbA1c showed an abnormal peak. Fasting blood glucose, routine blood tests and serum bilirubin were normal. Her body mass index was 27.86 kg/m
Conclusions
Clinically silent β-thalassemia may lead to low HbA1c values and abnormal chromatograms by HPLC. In these circumstances, differential diagnosis is important. Checking the chromatogram may be helpful in interpreting HbA1c as well as identifying hemoglobinopathy. Further tests, such as GA, OGTT, hemoglobin electrophoresis and genetic tests, are needed for differential diagnosis.
Identifiants
pubmed: 35600576
doi: 10.3389/fendo.2022.878680
pmc: PMC9114733
doi:
Substances chimiques
Blood Glucose
0
Glycated Hemoglobin A
0
Hemoglobins, Abnormal
0
Types de publication
Case Reports
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
878680Informations de copyright
Copyright © 2022 Gao, Jin, Wang, Huang and Tang.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Références
Diabetes Care. 2008 Aug;31(8):1473-8
pubmed: 18540046
Clin Chem. 2003 Aug;49(8):1245-7
pubmed: 12881436
Hemoglobin. 1981;5(2):199-204
pubmed: 7216820
JAMA. 2017 Feb 7;317(5):507-515
pubmed: 28170479
Clin Chim Acta. 2004 Dec;350(1-2):123-8
pubmed: 15530468
Clin Chem. 2011 Aug;57(8):1204-6
pubmed: 21571810
Clin Chem. 2001 Feb;47(2):153-63
pubmed: 11159762
Clin Chem Lab Med. 2012 Feb 02;50(7):1243-8
pubmed: 22850056
Clin Chem Lab Med. 2003 Sep;41(9):1182-90
pubmed: 14598868
Clin Chim Acta. 2013 Mar 15;418:63-71
pubmed: 23318564
Clin Biochem. 2015 Nov;48(16-17):1144-50
pubmed: 26247176
Diabetes Care. 2012 Dec;35(12):2674-80
pubmed: 23173136
Clin Chem. 2005 Apr;51(4):753-8
pubmed: 15684277
Clin Chem Lab Med. 2021 Jan 14;59(6):1127-1132
pubmed: 33554549
Clin Chim Acta. 2020 Jul;506:44-49
pubmed: 32169421
Diabetes Care. 2010 Jan;33 Suppl 1:S62-9
pubmed: 20042775
J Clin Pathol. 2021 Mar;74(3):182-186
pubmed: 32719015
Exp Clin Endocrinol Diabetes. 2017 Nov;125(10):655-660
pubmed: 28931179
Hemoglobin. 2015;39(6):393-7
pubmed: 26290351