A PATIENT WITH A HEMOGLOBIN-VARIANT (HB J(LOME)) UNEXPECTEDLY DETECTED BY HPLC FOR GLYCATED HEMOGLOBIN (HB A(1C))

Citation
Y. Oshima et al., A PATIENT WITH A HEMOGLOBIN-VARIANT (HB J(LOME)) UNEXPECTEDLY DETECTED BY HPLC FOR GLYCATED HEMOGLOBIN (HB A(1C)), International journal of hematology, 68(3), 1998, pp. 317-321
Citations number
12
Categorie Soggetti
Hematology
ISSN journal
09255710
Volume
68
Issue
3
Year of publication
1998
Pages
317 - 321
Database
ISI
SICI code
0925-5710(1998)68:3<317:APWAH(>2.0.ZU;2-S
Abstract
A rare hemoglobin variant, Hb J(Lome), was identified by chance in a m ale patient with diabetes mellitus (DM). The patient had no evidence o f anemia or hemolysis. However, when his glycated hemoglobin (Hb A(1c) ) was examined by high-performance liquid chromatography (HPLC) to ass ess the state of his DM, an abnormal Hb was unexpectedly detected on t he chromatogram. The morphology of the red blood cells was normal. A f ast-moving band as well as a normally moving Hb band, of roughly equal intensities, were observed by cellulose acetate membrane electrophore sis. The oxygen equilibrium curve was essentially normal (P-50 = 3.59 kPa). In other words, the ability of the patient's Hb to carry oxygen was nearly the same as that of typical Hb A. The stability of his Hb i n isopropanol was normal, and all the functions of his Kb that were te sted were essentially normal. The identity of the abnormal Hb was fina lly determined, by sequencing the globin gene, to be Hb J(Lome), which is produced by a point mutation changing AAG to AAC at the 59th codon in exon 2 of the Hb beta chain. As previously reported, replacing the beta 59 lysine with asparagine does not affect the function of Hb or the red blood cells. There have been only five documented cases of Hb J(Lome) in Japan. Interestingly, all these cases are from Kyushu Islan d. When an abnormal chromatogram for Hb A(1c) is unexpectedly obtained , it is worthwhile searching for an abnormal Hb, even if there are no signs that suggest its existence, such as anemia, hemolysis, erythrocy tosis, or cyanosis. (C) 1998 Elsevier Science Ireland Ltd. All rights reserved.