Q. Can hemoglobin A2 level 4. 3 indicate a carrier of beta-thalassemia?

Answered by
Dr. Parth R Goswami
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Oct 20, 2018

Hello doctor,

I was just wondering for a second opinion on some results which I have received being 8+4 weeks pregnant. My FBC was normal but my hemoglobin A2 Level is 4.3 and it says the normal range is 1.5 to 3.6. But I just wanted to know if this definitely means I am a carrier of beta-thalassemia.

#

Hi,

Welcome to icliniq.com.

Your attached CBC report shows normal hemoglobin and MCV with RBC count is also within range (attachment removed to protect patient identity). I have calculated Mentzer index as well which is also not in favor of thalassemia minor. Moreover, in the report, also it has been mentioned that referral to higher laboratory needed for confirmation. So, your chance of having thalassemia minor is less. I suggest you investigate with Hb electrophoresis by HPLC method to exclusively rule out thalassemia minor in a different laboratory.

Hi doctor,

Thank you for your response. I am a bit confused. Would you be able to interpret this in layman’s dictionary? What is the Mentzer index? Also, what is the investigation with Hb electrophoresis by HPLC method to exclusively rule out thalassemia minor?

#

Hello,

Welcome back to icliniq.com.

Kindly find answers to your questions below.

Mentzer index is calculated from MCV divided by RBC count. You can also calculate it from CBC report. If it is less than 13, then thalassemia more likely. If it is more than 13, then iron deficiency anemia or normal finding. In your case, it is 18, so thalassemia is unlikely. In short, it is used to differentiate between thalassemia and iron deficiency anemia.

HPLC is a gold standard test to rule out thalassemia like hemoglobinopathy. So you can investigate with HPLC method to rule out thalassemia minor conclusively. (HPLC is high-performance liquid chromatography).


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