A Case of Pseudoelevation of Glycosylated Hemoglobin.

Abstract

Background: Glycosylated hemoglobin (HbA1c) is a stable compound in human blood that covalently binds the N-terminal valine residue of the β-chain in hemoglobin A to the free aldehyde group of glucose. It can reflect the average blood glucose level of patients in the past 2 - 3 months. Therefore, the accuracy of HbA1c detection results is of great significance for the diagnosis and differential diagnosis of diabetes.

Methods: We report a case of false elevation of HbA1c measured by a high-performance liquid chromatography (HPLC) system. Using different detection platforms and capillary electrophoresis analysis to identify the causes of abnormally elevated HbA1c levels.

Results: HbA1c levels decreased to the normal reference range on a different testing platform. Meanwhile, capillary electrophoresis analysis showed the presence of hemoglobin variants. Therefore, the patient's HbA1c result is abnormally elevated, which is considered a pseudo elevation caused by hemoglobin variants.

Conclusions: When HbA1c is abnormally high but there is no clinical symptom of diabetes, the staff should consider the possibility of hemoglobin variants interfering with HbA1c detection. They should simultaneously use different methods to detect HbA1c and conduct hemoglobin component analysis if necessary.