Hemoglobin electrophoresis (synonym: Hb electrophoresis) allows separation based on different hemoglobins (blood pigments) on their different migration speed in the electric field. It is used to show the percentages of physiological hemoglobin variants and the presence of pathological forms.
Hemoglobin electrophoresis is performed when hemoglobinopathy (diseases resulting from impaired formation of hemoglobin (Hb) due to genetic defects) is suspected. The most important representatives of hemoglobinopathies are thalassemias and sickle cell anemia. The following hemoglobin constellations of erythrocytes (red blood cells) are known:
- HbA0 (old name: HBA1) – in healthy adults; up to 40% of healthy newborns.
- HbA2 – up to 70% of individuals with ß-thalassemia.
- HbF – up to 80% of healthy newborns; up to 95% of individuals with ß-thalassemia.
- HbS – circa 80% of individuals with sickle cell anemia.
- Tetramer γγγ/Tetramer ββββ
The procedure
Material needed
- EDTA blood serum
Preparation of the patient
- Not required
Disruptive factors
- Not known
Normal values – blood serum
Gang | Expression | |
Adult | HbA0 band (old: HBA1) | Strongly |
HbA2 band (also captures HbC, HbE, HbO). | Weaker | |
Other/pathological bands | not detectable | |
Children | HbA0 band | strong |
Hba2 gang | very weak | |
HbF Gang | strong | |
Other/pathological bands | not detectable |
Reference range
- HbA > 96.3
- HbA2 < 3.5 %
- HbF < 0.5 %
Indications
- Unclear anemia (anemia of the blood)
- Hemolysis (dissolution of red blood cells) or hemolytic anemia.
- Interstitial nephritis (inflammation of the kidneys).
- Methemoglobinemia – increased concentration of methemoglobin in the erythrocytes.
- Polycythaemia vera – rare myeloproliferative (affecting the formation of blood in the bone marrow) disease in which there is a proliferation of all three series of blood cells (especially erythrocytes, but also platelets (blood cells) and leukocytes (white blood cells) in the blood, without a physiological stimulus.
- Polyglobulia – increased erythrocyte count (erythrocytosis) or hemoglobin concentration in the blood due to increased new blood formation.
- Sickle cell anemia (med.: Drepanocytosis; also sickle cell anemia) – genetic disease of erythrocytes (red blood cells); it belongs to the group of hemoglobinopathies (disorders of hemoglobin; formation of an irregular hemoglobin, the so-called sickle cell hemoglobin, HbS).
- Splenomegaly (splenomegaly).
- Thalassemia – disease of erythrocytes (red blood cells), in which hemoglobin is not sufficiently formed or increased degradation due to a genetic defect (hemoglobinopathy).
Interpretation
- HbA0 – in healthy adults; up to 40% of healthy newborns.
- HbA2 – up to 70% of individuals with ß-thalassemia.
- HbF – up to 80% of healthy newborns; up to 95% of individuals with ß-thalassemia.
- HbS – circa 80% of individuals with sickle cell anemia.
- Tetramer γγγ/Tetramer ββββ
The following laboratory parameters should also be investigated when hemoglobinopathy is suspected:
- Small blood count
- Erythrocyte morphology
- Hemoglobin-A2
- Hemoglobin-F
- Hemoglobin-S
- Unstable (denatured) hemoglobin