Hemoglobin Electrophoresis

• Acquired elevation of HGB A2 & HGB F 

• Both images are for the same patient with 2 months interval.

• Image 1 : elevated HGB A2 & HGB F due to severe Vitamin B12 deficiency.

• Image  2:  After  2  months of treatment with vitamin B12 injection, HGB A2 & HGB F is normal.

• A case of sickle cell disease βS β0 thalassaemia 

• The patient has microcytic hypochromic RBC with normal iron profile.

• A case of sickle cell disease βS β0 thalassaemia 

• The patient has microcytic hypochromic RBC with normal iron profile.

• Effect of blood transfusion on HGB HPLC for a patient with Compound heterozygous sickle cell βs/β+ thalassemia. 

• HGB Pattern by HPLC (At Admission):

Pattern of Compound heterozygous sickle cell βs/β+ thalassemia. (Elevated A0  Band in HPLC print out). HGB A=16.1%

• Post-transfusion HGB HPLC:

Increased A0  more than the previous one is due to transfused blood effect. Patient received 2 units of packed RBCs. HGB A= 32.6%

• Pattern of β thalassaemia trait 

• The case has microcytic hypochromic RBCs with normal serum iron.

• Pattern of Homozygous sickle cell disease.

• Elevated HGB F is secondary to Hydroxyurea therapy (Sign of response to hydroxyurea therapy)

• Co-inheritance of non-deletional hereditary persistence of fetal haemoglobin is a differential diagnosis.