Hb HPLC (Hb Variants Estimation by HPLC)
Understanding Hb HPLC (Hb Variants Estimation by HPLC)
What is Hb HPLC (Hb Variants Estimation by HPLC)?
The Hemoglobin High-Performance Liquid Chromatography (Hb HPLC) test is used to identify and quantify normal and abnormal forms of hemoglobin present in the blood. This test helps diagnose and monitor various blood disorders, such as thalassemia and sickle cell disease.
Hemoglobin (Hb) is an iron-rich protein that carries oxygen to organs and tissues. An Hb HPLC test provides a detailed analysis of the different types of hemoglobin, including HbA (normal adult hemoglobin) and various abnormal hemoglobin variants such as HbD and HbF (fetal hemoglobin). It identifies certain disorders characterized by abnormal hemoglobin production. Furthermore, for individuals undergoing treatments such as blood transfusions or medications, the Hb HPLC test helps the doctor monitor the effectiveness of treatment and make adjustments as needed.
Your doctor may suggest an Hb HPLC test when a blood disorder such as thalassemia, or sickle cell disease is suspected (symptoms such as dizziness, weakness, pale skin, cold feet and hands, long-term infection, breath shortness, rapid heart rate, or significant weight loss). Additionally, individuals with a family history of inherited blood disorders, unexplained anemia, abnormal red blood cell indices, or abnormal findings on routine hemoglobin and hematocrit tests may also undergo Hb HPLC testing.
Fasting is not required for an Hb HPLC (Hb Variants Estimation by HPLC) test. Let the doctor know if you have a recent history of blood transfusion, as it can affect the test results.
Test result ranges are approximate and vary depending on age, gender, health history, and methodology used by the laboratories. Talk to your doctor about your specific test results. Your doctor may consider several additional factors while interpreting the significance of abnormal hemoglobin, including your family history, the results of your CBC, and more. Based on your test results, the doctor decides whether or not medication will be required to manage your condition and formulate your overall treatment plan.
What is Hb HPLC (Hb Variants Estimation by HPLC) used for?
An Hb HPLC (Hb Variants Estimation by HPLC) test can be done:
- To determine different types of hemoglobin present in the blood, including normal and abnormal forms.
- As a screening test for genetic conditions characterized by abnormal hemoglobin production like thalassemia or sickle cell disease.
- To monitor the effectiveness of treatments in individuals with hemoglobinopathies.
- To monitor your health if you have a family history of thalassemia, sickle cell anemia, or other genetic blood disorders.
- As a follow-up of abnormal red blood cell indices or abnormal findings on routine hemoglobin and hematocrit tests.
What does Hb HPLC (Hb Variants Estimation by HPLC) measure?
An Hb HPLC (Hb Variants Estimation by HPLC) test is used to identify and quantify different types of hemoglobin in the blood to diagnose and monitor specific blood disorders. Different types of hemoglobin are Adult type (HbA2), Fetal type (HbF), Hemoglobin S (HbS), Hemoglobin C (HbC), and Hemoglobin E (HbE), etc.
Normal types of hemoglobin include:
- Hemoglobin (Hgb) A: The most common type of hemoglobin in healthy adults
- Hemoglobin (Hgb) F: Fetal hemoglobin, which is found in unborn babies and newborns. HgbF is replaced by HgbA shortly after birth.
A deranged level of HgbA or HgbF might indicate certain types of anemia.
Abnormal types of hemoglobin include:
- Hemoglobin (Hgb) S: This type of hemoglobin is found in sickle cell anemia, an inherited disorder that causes the body to make stiff, sickle-shaped red blood cells. Sickle cells can get stuck in the blood vessels, causing severe pain, long-term infections, and other complications.
- Hemoglobin (Hgb) C: This type of hemoglobin is associated with hemolytic anemia that develops when your red blood cells are destroyed more easily than normal red blood cells or have a shorter life span than normal red blood cells.
- Hemoglobin (Hgb) E: This type of hemoglobin is mainly found in people of Southeast Asian descent and may be associated with mild anemia or no symptoms.
- Hemoglobin (Hgb) D: Hb D disease (HbDD) is characterized by mild hemolytic anemia and mild to moderate splenomegaly. Hb D Punjab occurs with the most significant prevalence in Gujarat and Sikhs of Punjab.
Interpreting Hb HPLC (Hb Variants Estimation by HPLC) results
Interpretations
In children
|
Age |
Hemoglobin F |
|
Newborn |
60 to 80% |
|
1+ Year |
1 to 2% |
In adults
Normal levels
|
Type of Hemoglobin |
Percentage |
|
Hemoglobin A |
95% - 98% |
|
Hemoglobin A2 |
2% - 3% |
|
Hemoglobin F |
1% - 2% |
|
|
All the results should be carefully analyzed and interpreted in correlation with the patient's signs and symptoms and other laboratory findings.
-
Increased fetal hemoglobin (HbF) levels on HPLC are associated with beta-thalassemia major. Sometimes, it can also be seen in sickle cell anemia.
-
High HbA2 levels are primarily associated with beta thalassemia minor or trait. Recent studies say that HbA2 level between 4% and 9% indicates beta thalassemia trait
Answers to Patient Concerns & Frequently Asked Questions (FAQs) about Hb HPLC (Hb Variants Estimation by HPLC)
Frequently Asked Questions about Hb HPLC (Hb Variants Estimation by HPLC)
Q. What happens during an Hb HPLC (Hb Variants Estimation by HPLC) test?
Q. Is there any risk associated with an Hb HPLC (Hb Variants Estimation by HPLC) test?
Q. What factors can affect my Hb HPLC (Hb Variants Estimation by HPLC) test results?
Q. Can this test be used to screen family members for hemoglobin disorders?
Q. Is this test done for newborns?
Q. What is hemoglobinopathy?
Q. What are the common examples of hemoglobinopathies?
Q. In which conditions abnormal hemoglobin levels can be seen?
Q. What are the complications of thalassemia?
Q. How can I increase my hemoglobin levels if they are low?
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References
- Wajcman H, Moradkhani K. Abnormal haemoglobins: detection & characterization. Indian J Med Res. 2011 Oct;134(4):538-46. PMID: 22089618; PMCID: PMC3237254. [Accessed 30 Oct. 2023]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3237254/
- Kohne E. Hemoglobinopathies: clinical manifestations, diagnosis, and treatment. Dtsch Arztebl Int. 2011 Aug;108(31-32):532-40. [Accessed 30 Oct. 2023]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3163784/
- Forget BG, Bunn HF. Classification of the disorders of hemoglobin. Cold Spring Harb Perspect Med. 2013 Feb 1;3(2):a011684. [Accessed 30 Oct. 2023]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3552344/
- Khera R, Singh T, Khuana N, Gupta N, Dubey AP. HPLC in characterization of hemoglobin profile in thalassemia syndromes and hemoglobinopathies: a clinicohematological correlation. Indian J Hematol Blood Transfus. 2015 Mar;31(1):110-5. [Accessed 30 Oct. 2023]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4275515/
- What is Thalassemia? [Internet]. CDC; 24 April 2023; [Accessed 30 Oct. 2023]. Available from: https://www.cdc.gov/ncbddd/thalassemia/facts.html
- What is Sickle Cell Disease? [Internet]. CDC; 06 July 6 2023; [Accessed 30 Oct. 2023]. Available from: https://www.cdc.gov/ncbddd/sicklecell/facts.html
- Billett HH. Hemoglobin and Hematocrit. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 151. Available from: https://www.ncbi.nlm.nih.gov/books/NBK259/
- Ahmed MH, Ghatge MS, Safo MK. Hemoglobin: Structure, Function and Allostery. Subcell Biochem. 2020;94:345-382. [Accessed 30 Oct. 2023]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7370311/
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