Hemoglobin (Hb; from Greek αἷμα haíma “blood” and Latin globus “sphere”) is the iron-containing protein complex that binds oxygen in erythrocytes (red blood cells) and gives them their red color (“blood pigment”).
In healthy adults, hemoglobin consists of 98% hemoglobin A1 (α2β2) and 2% hemoglobin A2 (α2δ2).
The healthy adult forms approximately 6 to 7 g of hemoglobin daily; this requires approximately 30 to 40 mg of iron.
When the erythrocytes reach the end of their life (about 120 days), they are degraded in the mononuclear phagocytes (phagocytes) mainly in the spleen (and also in the liver and bone marrow when there is a high accumulation of hemoglobin to be degraded).
The procedure
Material needed
- 3 ml EDTA blood (determined as part of the small blood count); mix tubes thoroughly by swirling immediately after collection.
Preparation of the patient
- Not necessary
Disruptive factors
- Poor mixing of the blood sample
Normal values
| Men | |
| Women |
Indications
- Basic diagnostics of hematopoiesis (blood formation).
Interpretation
Interpretation of increased values
- Dehydration (lack of fluids).
- Polyglobulia (high percentage of erythrocytes/red blood cells): think of polycythaemia vera (PV)!
- Stays at high altitudes (e.g., high-altitude mountaineering) [values > 70%].
Interpretation of lowered values
- Anemia (anemia)
Other notes
- Hemoglobin F (α2γ2) is the dominant hemoglobin in the fetus; it is detectable only in trace amounts in healthy adults.
- If sickle cell anemia is suspected:
- Hb electrophoresis (test method in which groups of molecules are spatially separated in an electric field) [detection of sickle cell hemogobin, HbS > 50%].
- Hb solubility assay – to distinguish HbS from non-sickling pathological hemoglobins (with identical electrophoretic or chromatographic properties).
- Beta-thalassemia: autosomal recessive inherited synthesis disorder of the beta chains of the protein portion (globin) in hemoglobin.
- Note: Iron deficiency anemia is the most common form of anemia; the second most common form is “anemia of chronic disease” (ACD). Causes of ACD include chronic inflammatory diseases, cancer, or chronic infections. [ACD: low Hb and serum Fe, high serum ferritin.]
