Published online Jul 16, 2021. doi: 10.12998/wjcc.v9.i20.5568
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
Processing time: 207 Days and 21.1 Hours
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.
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.
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.