A hemoglobin other than hemoglobins A and A2 can cause a false level of glycosylated hemoglobin when measured with the ion exchange resin method. This can result in management decisions that can harm the patient.
Method affected: ion exchange resin
Type of Hemoglobin
Effect
hemoglobin F
falsely elevated
"fast" hemoglobin (H, I, J and N)
falsely elevated
"slow" hemoglobin (C, D, E, G and S)
false depressed
"Fast" hemoglobins move more rapidly towards the anode under alkaline conditions than hemoglobin A, and will appear as one or more bands located to the side of hemoglobin A opposite to A2, C and S.
The typical scenario is a diabetic patient with a hemoglobin A1c reading that does not match the history (high value despite good management; low value despite poor compliance).
Affinity chromatography can be used to measure glycosylated hemoglobin in these patients.
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