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Lab Manual for Moffitt-Long and Mount Zion

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Hemoglobinopathy Evaluation

Item Value
Approval req'd? No
Available Stat? No
Test code HBEP
Performed by China Basin Chemistry
In House Availability Set up Thursday, reports next day unless electrophoresis required
Method HPLC (+/- Electrophoresis)
Collection Instructions If collecting in citrate, check the expiration date on the label of the blue top vacutainer before drawing the patient
Container type Lavender top, Citrate (blue) or Heparin (green) acceptable]
Amount to Collect 2 mL blood
Sample type EDTA whole blood
Preferred volume 2 mL blood
Min. Volume 1 mL blood
UCSF Rejection Criteria Samples collected in outdated blue top vacutainer.
Processing notes Do not centrifuge.
Units %
Normal range
Hgb F Hgb A2 Hgb A
0-1 months 50-90% < 2% 10-50%
1-2 months 30-80% < 3% 20-70%
2-3 months 10-55% < 3% 40-90%
3-4 months 5-30% < 3% 65-95%
4-6 months < 20% < 3% > 77%
6-12 months < 10% < 3% > 87%
1-2 years < 5% < 3.2% > 92%
2+ years < 2% < 3.3% > 94%
Synonyms Alkali denaturation; sickle hemoglobin; HbSS; Hemoglobin A2; Hemoglobin F; fetal hemoglobin; hemoglobin E; Hemoglobin C; hemoglobin electrophoresis; Hemoglobin Bart's; sickle screen; sickledex; HbC; HbS; HbE; Hgb S; Hgb C; HGB E
Turn around times 1-8 days
Reflex? If variant hemoglobin is detected by HPLC, hemoglobin electrophoresis is performed to characterize the abnormality.
Additional information Only A, A2 and F are normally present; the latter is almost completely replaced by A at age two. Hemoglobins A, A2, S, C, F, D or G, E or O, and fast hemoglobins, e.g., Hgb Bart's, are separated and quantitated.

Alkaline and/or citrate agar electrophoresis will be performed (at an additional charge) if abnormal hemoglobin(s) cannot be resolved by HPLC alone.

Once an abnormal hemoglobin has been confirmed by electrophoresis, all subsequent hemoglobinopathy requests that reveal the confirmed abnormal hemoglobin will be directly reported by the HPLC method.

HPLC is a rapid and reproducible method for identifying variants; however, it is possible that a rare variant may be missed. If clinical indications strongly suggest a variant hemoglobin not identified by HPLC, please contact the Chemistry Laboratory at 353-4820.

Iron deficiency decreases Hgb A2, and the characteristic elevation of Hgb A2 in beta-thalassemia may easily be missed.

Note: This test was developed by the Clinical Laboratories at the Medical Center at UC San Francisco. It has not been cleared or approved by the U.S. Food and Drug Administration.

Intracellular Kappa & Lambda Light Chains
LOINC code 49322-1
LDT or Mod FDA? Yes
Last Updated 2/24/2014 9:55:24 AM
Entry Number 444

If you have additional questions regarding this test, please call: 415-353-1667

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