Study of abnormal haemoglobin variants in patients of anaemia using high performance liquid chromatography (HPLC) in Gujarat, India

Abstract

Introduction: Haemoglobinopathies are the most common inherited red cell disorders worldwide. Identification of these disorders is immensely important epidemiologically, for early diagnosis, improved management protocols and prevention of disease in upcoming generation. Our aim is to study the abnormal haemoglobin variants in patients of anaemia using High Performance Liquid Chromatography (HPLC) BIO-RAD D-10 Dual Program analyser in Vadodara region of Gujarat. Methods: A total of 1890 cases of patient's with anaemia having haemoglobin up to 11 gm% were studied for HPLC for diagnosing any abnormal haemoglobin disorder by BIO-RAD D-10 Dual Program analyser. Results: Out of 1890 cases of anaemia studied, 1236 (65.3%) cases showed abnormal haemoglobin, and rest 654 (52.9%) cases showed normal result on HPLC. Of these, 1236 cases, 686 cases of sickle cell trait (55.5%) the predominant abnormality, followed by 247 cases of sickle cell disease (19.9%). There were 208 cases of beta Thalassemia trait (16.8%), followed by 89 cases of double heterozygous state of beta thalassemia and sickle cell trait (7.2%). There were three cases of Thalassemia major with high Hb F (0.24%), two cases of Hb D Punjab heterozygous patients (0.16%) and one case of Hb E heterozygous (0.08%). Conclusion: HPLC is an accurate, simple and superior technique in detection of various haemoglobin disorders, which helps in management of patients and prognostic significance. It is also important in premarital and antenatal screening tests, to prevent birth of children with severe Haemoglobin disorders.

Hemoglobin Variants in Patients With Microcytic Hypochromic Anemia: A Review of Indian Studies

“…The third most commonest hemoglobinopathy that was detected in the total population of 29,293 patients within the 14 studies was of Hb E. Hb E constituted about 18.9% of hemoglobinopathies. Except for the reports of Sachdev et al [ 1 ], Shrivastav et al [ 3 ], Bhalodia et al [ 6 ], Sarvaiya and Chauhan [ 10 ], Shankar et al [ 12 ], and Jain and Saxena [ 13 ], Hb E remained the third most common hemoglobin variant detected.…”

“…However, there are studies where some of the hemoglobins and hemoglobin variants have not been reported from certain regions of India. The study by Alam et al [ 7 ], Shankar et al [ 12 ], and Jain et al [ 13 ] did not report the abnormal hemoglobins of Hb Q India, Hb J Meerut, Hb D Iran, Hb Lepore, and HPFH, respectively. Similarly, the studies by Alam et al [ 7 ], Raman et al [ 9 ], and Sarvaiya and Chauhan [ 10 ] have not reported the presence of Hb Q India, Hb J Meerut, and Hb D Iran.…”

A Study Protocol for Evaluation of Microcytic Hypochromic Anemia by High-Performance Liquid Chromatography (HPLC)

“…The MCHCfor its etiologies includes the underlying causes of iron deficiency state, beta-thalassemia trait, hemoglobinopathies because of HB E, HB D, HB C, and many others. Such a situation of MCHC before being embarked for the treatment requires assessing the hemoglobin for its variants and detecting abnormal hemoglobin [3].…”

“…The treatment of MCHC is the iron replacement therapy if the iron deficiency is suspected as its cause. However, the therapeutic iron can produce harmfuleffects if the underlying pathology for MCHC is otherwise like, betathalassemia trait, sickle cell disease, or the other hemoglobinopathies [1][2][3][4][5].…”

“…A few studies have evaluated Microcytic erythrocytosis (MCHC) for the result of hemoglobin variants and hemoglobinopathies [1][2][3][4][5][6][7][8][9][10][11].…”