Hemoglobin Electrophoresis

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