Could an HbA2 level of 4.3 suggest beta-thalassemia carrier?

Question

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.

Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

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

I suggest you investigate with Hb electrophoresis by the HPLC method to exclusively rule out thalassemia minor in a different laboratory.

I hope it helps.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

Kindly find answers to your questions below.

The Mentzer index is calculated from MCV divided by RBC count. You can also calculate it from the CBC report. If it is less than 13, then thalassemia is more likely. If it is more than 13, then it is iron deficiency anemia or a 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 the HPLC method to rule out thalassemia minor conclusively. (HPLC is high-performance liquid chromatography).

I hope it helps.

Thank you.