Uncommon cause of polycythemia in a pregnant female

Case Report : A 23-year-old pregnant woman presented with erythrocytosis an d a spuriously elevated HbA(1c). Family history revealed that her father ha s been treated with phlebotomies for the last 2 years because of erythrocyt osis of unknown cause. An examination of the family members demonstrated th at the patient and her father were carriers of the hemoglobin (Hb) valiant Hb Andrew-Minneapolis. Discussion: Hb Andrew-Minneapolis belongs to a group of hemoglobin variants with a high oxygen affinity resulting in compensatory erythrocytosis. The carriers of such hemoglobin variants are usually clinically asymptomatic,ex ercise tolerance appears unimpaired and there is no higher incidence of car diovascular diseases. There is no clear-cut evidence that a maternal hemogl obinopathy with high oxygen affinity is accompanied by negative consequence s for the fetus or a higher abortion rate. Conclusion: Hemoglobinopathies with a high oxygen affinity are a rare but i mportant differential diagnosis of polycythemia. Under these circumstances erythrocytosis has to be accepted as the primary mode of compensation and d oes not require treatment, as tong as blood viscosity is kept within tolera ble limits. An excessively elevated or lowered HbA(1c) without a history or symptoms of diabetes should lead to further investigations concerning the possibility of hemoglobinopathy.