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. 1997 May;50(5):434–435. doi: 10.1136/jcp.50.5.434

Haemoglobin O Padova and falsely low haemoglobin A1c in a patient with type I diabetes.

W J Schnedl 1, E C Reisinger 1, S Katzensteiner 1, R W Lipp 1, F Schreiber 1, P Hopmeier 1, G J Krejs 1
PMCID: PMC499948  PMID: 9215129

Abstract

Glycated haemoglobin (HbA1c) measured by high performance liquid chromatography (HPLC) in a 20 year old female with insulin dependent diabetes mellitus was consistently within the normal range although her daily blood glucose values were > 11.1 mmol/l. HbA1c measured by immunoagglutination and fructosamine was elevated and correlated with the patient's blood glucose values. The HPLC chromatogram showed an additional peak at HbA0. Electrophoresis of haemoglobin on citrate agar gel revealed an abnormal haemoglobin anodal of HbS. Cellulose acetate electrophoresis and isoelectric focusing demonstrated an additional haemoglobin migrating close to HbA2. Amino acid analysis and DNA sequencing revealed an alpha 30 (B11) Glu-->Lys replacement, that is, haemoglobin O Padova. Investigations of two family members without diabetes revealed the same rare haemoglobin variant. This case showed that this silent haemoglobin mutation caused an additional peak and falsely low HbA1c values when measured by HPLC, the gold standard for this evaluation.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aebi-Ochsner C. H., Grey V. L. Fructosamine measurements in the adolescent with type I diabetes. Diabetes Care. 1995 Dec;18(12):1619–1620. doi: 10.2337/diacare.18.12.1619. [DOI] [PubMed] [Google Scholar]
  2. Aleyassine H. Low proportions of glycosylated hemoglobin associated with hemoglobin S and hemoglobin C. Clin Chem. 1979 Aug;25(8):1484–1486. [PubMed] [Google Scholar]
  3. Briere R. O., Golias T., Batsakis J. G. Rapid qualitative and quantitative hemoglobin fractionation. Cellulose acetate electrophoresis. Am J Clin Pathol. 1965 Dec;44(6):695–701. doi: 10.1093/ajcp/44.6.695. [DOI] [PubMed] [Google Scholar]
  4. Goldstein D. E., Little R. R., Wiedmeyer H. M., England J. D., Rohlfing C. L., Wilke A. L. Is glycohemoglobin testing useful in diabetes mellitus? Lessons from the diabetes control and complications trial. Clin Chem. 1994 Aug;40(8):1637–1640. [PubMed] [Google Scholar]
  5. Kilinç Y., Kumi M., Gurgey A., Altay C., Webber B. B., Wilson J. B., Kutlar A., Huisman T. H. Hemoglobin O-Padova or alpha(2)30(B11)Glu----Lys beta 2 observed in members of a Turkish family. Hemoglobin. 1985;9(6):621–625. doi: 10.3109/03630268508997044. [DOI] [PubMed] [Google Scholar]
  6. Milner P. F., Gooden H. M. Rapid citrate-agar electrophoresis in routine screening for hemoglobinopathies using a simple hemolysate. Am J Clin Pathol. 1975 Jul;64(1):58–64. doi: 10.1093/ajcp/64.1.58. [DOI] [PubMed] [Google Scholar]
  7. Nathan D. M., Francis T. B., Palmer J. L. Effect of aspirin on determinations of glycosylated hemoglobin. Clin Chem. 1983 Mar;29(3):466–469. [PubMed] [Google Scholar]
  8. Robertson D. A., Tunbridge F. K., John W. G., Home P. D., Alberti K. G. Diagnostic confusion in diabetes with persistence of fetal haemoglobin. BMJ. 1992 Sep 12;305(6854):635–637. doi: 10.1136/bmj.305.6854.635. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Schnedl W. J., Reisinger E. C., Lipp R. W., Krejs G. J., Hopmeier P. Hemoglobin variants recently detected in Austria. Ann Hematol. 1995 Oct;71(4):185–187. doi: 10.1007/BF01910316. [DOI] [PubMed] [Google Scholar]
  10. Schnedl W. J., Reisinger E. C., Pieber T. R., Lipp R. W., Schreiber F., Hopmeier P., Krejs G. J. Hemoglobin Sherwood Forest detected by high performance liquid chromatography for hemoglobin A1c. Am J Clin Pathol. 1995 Oct;104(4):444–446. doi: 10.1093/ajcp/104.4.444. [DOI] [PubMed] [Google Scholar]
  11. Turpeinen U., Sipilä I., Anttila P., Karjalainen U., Kuronen B., Kalkkinen N., Ahola T., Stenman U. H. Two alpha-chain hemoglobin variants, Hb Broussais and Hb Cemenelum, characterized by cation-exchange HPLC, isoelectric focusing, and peptide sequencing. Clin Chem. 1995 Apr;41(4):532–536. [PubMed] [Google Scholar]
  12. Vettore L., De Sandre G., Di Iorio E. E., Winterhalter K. H., Lang A., Lehmann H. A new abnormal hemoglobin O Padova, alpha 30 (B11) Glu -- Lys, and a dyserythropoietic anemia with erythroblastic multinuclearity coexisting in the same patient. Blood. 1974 Dec;44(6):869–877. [PubMed] [Google Scholar]
  13. Weykamp C. W., Penders T. J., Muskiet F. A., van der Slik W. Effect of calibration on dispersion of glycohemoglobin values determined by 111 laboratories using 21 methods. Clin Chem. 1994 Jan;40(1):138–144. [PubMed] [Google Scholar]

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