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Acid Hemoglobin Electrophoresis - Usage, Need, Risks, and Results

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Hemoglobin electrophoresis is the confirmatory test for sickle cell disease and its variants. Read the article mentioned below to learn more.

Medically reviewed by

Dr. Kaushal Bhavsar

Published At September 29, 2022
Reviewed AtMay 23, 2023

Introduction

Hemoglobin is the protein attached to the red blood cells that transport oxygen to the tissues and organs for cell functioning. Genetic mutations trigger the body to produce abnormal hemoglobin that is formed incorrectly. This abnormal hemoglobin can cause too little oxygen to reach the tissues and organs.

Other names for acid hemoglobin electrophoresis are-

  • Hb electrophoresis.

  • Hemoglobin evaluation.

  • Hemoglobinopathy evaluation.

  • Hemoglobin fractionation.

  • Hb ELP.

  • Sickle cell screen.

What Is Acid Hemoglobin Electrophoresis?

Hemoglobin electrophoresis is a test measuring different types of hemoglobin in the blood sample.

Standard types of hemoglobin include:

  • Hemoglobin (Hgb) A- It is the most common type of hemoglobin in healthy adults.

  • Hemoglobin (Hgb) F- It is fetal hemoglobin; this type of hemoglobin is found in unborn babies and newborns. HgbA replaces HgbF shortly after birth.

If levels of HgbA or HgbF are too high or too low, it can indicate certain types of anemia.

Abnormal types of hemoglobin include:

  • Hemoglobin (Hgb) S- This type of hemoglobin is found in sickle cell disease. Sickle cell disease is an inherited disorder that causes the body to make stiff, sickle-shaped red blood cells. Healthy red blood cells are flexible and can move quickly through blood vessels. Sickle cells can get stuck in the blood vessels, causing severe chronic pain, infections, and other complications.

  • Hemoglobin (Hgb) C- This type of hemoglobin does not carry oxygen properly, resulting in a mild form of anemia.

  • Hemoglobin (Hgb) E- This type of hemoglobin is mainly found in people of Southeast Asian descent. People with HgbE usually have no symptoms or mild symptoms of anemia.

What Is Acid Hemoglobin Electrophoresis Used For?

Hemoglobin electrophoresis calculates hemoglobin levels in the blood sample and identifies abnormal types of hemoglobin. It mainly aids in diagnosing anemia, sickle cell disease, and other hemoglobin disorders.

A hemoglobin electrophoresis test works by applying an electric current to a blood sample. This causes separation between normal and abnormal types of hemoglobin. Every kind of hemoglobin can then be measured individually.

What Is the Need for Hemoglobin Electrophoresis?

Testing is required if there are symptoms of hemoglobin disorder such as:

  • Fatigue (tiredness).

  • Pale skin (lighter than usual).

  • Jaundice (a condition that causes your skin and eyes to turn yellow).

  • Sickle cell disease (causing severe pain).

  • Growth problems in children.

Newborn screening is a group of tests given to most babies shortly after birth. Many conditions can be treated if found early, such as sickle cell disease or another inherited hemoglobin disorder. Risk factors include:

  • Presence of family history.

  • Ethnic background-

    • Thalassemia, another inherited hemoglobin disorder, is most commonly seen among people of Italian, Greek, Middle Eastern, Southern Asian, and African descent.

What Happens During Hemoglobin Electrophoresis?

A healthcare professional will take a blood sample from a vein in the arm using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. It will cause discomfort when the needle goes in and when taken out. This usually takes less than a couple of minutes. To test a newborn, a health care provider will clean the baby's heel with alcohol and poke the heel with a small needle. The provider will collect a few drops of blood and put a bandage on the site.

Are There Any Risks to Hemoglobin Electrophoresis?

There is minimal risk of having a blood test. However, there might be a residual bruise at the needle’s location that fades away eventually. The baby may feel a little pinch when the heel is poked, and a small bruise may form at the site, which heals with no scarring.

What Do the Acid Hemoglobin Electrophoresis Results Mean?

The results will show the types of hemoglobin found and the levels. Hemoglobin levels that are too high or too low may mean:

  • Thalassemia- A condition that impairs hemoglobin production. Symptoms vary from mild to severe.

  • Sickle Cell Trait- In this condition, one sickle cell gene and one normal cell gene are present. Most people with sickle cell traits do not have significant health concerns.

  • Sickle Cell Disease- In children with normocytic hemolytic anemia, if results of electrophoresis show only HbS with an HbF concentration of less than 30 %, the diagnosis is sickle cell anemia.

  • Hemoglobin C- This disease is a condition that causes a mild form of anemia and results in an enlarged spleen and joint pain.

  • Hemoglobin S-C Disease- A mild to moderate form of sickle cell disease (stiffening of blood cells).

The results may also show whether a specific disorder is mild, moderate, or severe.

There are several options for treating thalassemia and other hemoglobin disorders.

Hemoglobin electrophoresis test results are often compared with other tests, including a complete blood count and a blood smear.

Conclusion

Hemoglobin electrophoresis is a test that identifies the types of hemoglobin in the given blood sample. It further distinguishes abnormal types of hemoglobin. Adult human blood typically contains three types of hemoglobin: hemoglobin A, which makes up approximately 95 % of the total; hemoglobin A2, which accounts for less than 3.5 %; and a minute amount of hemoglobin F. If abnormal hemoglobin variants such as hemoglobin S (which occurs in sickle cell disease), C or E are present, they will appear as unexpected bands on electrophoresis (provided they do not migrate to the same place as other hemoglobins). Hemoglobin electrophoresis can also be used to investigate thalassemias, which are caused by decreased production of subunits of the hemoglobin molecule.

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Dr. Kaushal Bhavsar
Dr. Kaushal Bhavsar

Pulmonology (Asthma Doctors)

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