Lin XP, Yuan QR, Niu SQ, Jiang X, Wu ZK, Luo ZF. Hemoglobin Fukuoka caused unexpected hemoglobin A1c results: A case report. World J Clin Cases 2021; 9(20): 5568-5574 [PMID: 34307611 DOI: 10.12998/wjcc.v9.i20.5568]
Corresponding Author of This Article
Zhao-Fan Luo, PhD, Professor, Department of Clinical Medical Laboratory, The Seventh Affiliated Hospital of Sun Yat-sen University, No. 628 Zhenyuan Road, Guangming District, Shenzhen 518107, Guangdong Province, China. luozhaofan@qq.com
Research Domain of This Article
Biochemistry & Molecular Biology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jul 16, 2021; 9(20): 5568-5574 Published online Jul 16, 2021. doi: 10.12998/wjcc.v9.i20.5568
Hemoglobin Fukuoka caused unexpected hemoglobin A1c results: A case report
Xue-Ping Lin, Qiu-Rong Yuan, Shi-Qiong Niu, Xi Jiang, Zhi-Kun Wu, Zhao-Fan Luo
Xue-Ping Lin, Qiu-Rong Yuan, Shi-Qiong Niu, Xi Jiang, Zhi-Kun Wu, Zhao-Fan Luo, Department of Clinical Medical Laboratory, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen 518107, Guangdong Province, China
Author contributions: Lin XP encountered the case while working on the manuscript, reviewed the literature, and participated in drafting the manuscript; Yuan QR and Niu SQ reviewed the literature and participated in drafting the manuscript; Jiang X and Wu ZK participated in image processing and analysis; Luo ZF revised the manuscript for important intellectual content; all authors approved the final version of the manuscript as submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest to report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhao-Fan Luo, PhD, Professor, Department of Clinical Medical Laboratory, The Seventh Affiliated Hospital of Sun Yat-sen University, No. 628 Zhenyuan Road, Guangming District, Shenzhen 518107, Guangdong Province, China. luozhaofan@qq.com
Received: December 11, 2020 Peer-review started: December 11, 2020 First decision: April 4, 2021 Revised: April 14, 2021 Accepted: May 20, 2021 Article in press: May 20, 2021 Published online: July 16, 2021
Abstract
BACKGROUND
Glycated hemoglobin (Hb) (HbA1c) is an indicator that is used to diagnose and monitor the treatment of diabetes. Many factors can affect the detection of HbA1c. One of the most important of these factors is the Hb variant. Here, we report a rare Hb variant and evaluate its effect on HbA1c.
CASE SUMMARY
A 35-year-old man was suspected of harboring an Hb variant following the measurement of HbA1c with the Variant II Turbo 2.0 Hb detection system during a routine examination. Subsequently, we used the Arkray HA-8160 and ARCHITECT c4000 system to reanalyze HbA1c. Finally, the Hb variant was detected with a Capillary2FP analyzer that operates on the principle of capillary electrophoresis. We also used gene sequencing to investigate the mutation site. The value of HbA1c detected with the Variant II Turbo 2.0 system was 52.7%. However, the Arkray HA-8160 system did not display a result while the ARCHITECT c16000 system showed a result of 5.4%. The Capillary2FP analyzer did not reveal any abnormal Hb zones. However, gene sequencing identified the presence of a mutation in the Hb β2 chain [CD2(CAC>TAC), His>Tyr, HBB: c.7C>T]; the genotype was Hb Fukuoka.
CONCLUSION
Hb variants could cause abnormal HbA1c results. For patients with Hb variants, different methods should be used to detect HbA1c.
Core Tip: Hemoglobin A1c (HbA1c) is an indicator of diabetes diagnosis and blood glucose monitoring. Therefore, the accuracy of HbA1c results is of great significance to clinical diagnosis and treatment. This case had an abnormal HbA1c result and traced back to a rare hemoglobin variant. Hemoglobin variants are one of the important factors affecting the accuracy of HbA1c results. In this case, different methods were used to detect HbA1c, which can provide reference evidence for subsequent cases and reduce false results reports.
