haemoglobinopathy cases on hplc dr. archana vazifdar head pathologist hindlabs, hll lifecare ltd
TRANSCRIPT
![Page 1: HAEMOGLOBINOPATHY CASES on HPLC Dr. Archana Vazifdar Head Pathologist Hindlabs, HLL Lifecare Ltd](https://reader036.vdocuments.us/reader036/viewer/2022081504/56649c775503460f9492b8fa/html5/thumbnails/1.jpg)
HAEMOGLOBINOPATHY CASESon HPLC
Dr. Archana VazifdarHead Pathologist
Hindlabs, HLL Lifecare Ltd.
![Page 2: HAEMOGLOBINOPATHY CASES on HPLC Dr. Archana Vazifdar Head Pathologist Hindlabs, HLL Lifecare Ltd](https://reader036.vdocuments.us/reader036/viewer/2022081504/56649c775503460f9492b8fa/html5/thumbnails/2.jpg)
![Page 3: HAEMOGLOBINOPATHY CASES on HPLC Dr. Archana Vazifdar Head Pathologist Hindlabs, HLL Lifecare Ltd](https://reader036.vdocuments.us/reader036/viewer/2022081504/56649c775503460f9492b8fa/html5/thumbnails/3.jpg)
HPLC Automated system precalibrated column and gradient
Direction of flow Detector
![Page 4: HAEMOGLOBINOPATHY CASES on HPLC Dr. Archana Vazifdar Head Pathologist Hindlabs, HLL Lifecare Ltd](https://reader036.vdocuments.us/reader036/viewer/2022081504/56649c775503460f9492b8fa/html5/thumbnails/4.jpg)
• Hemoglobin is eluted in a stepped manner by Buffers of Increasing Ionic strength
![Page 5: HAEMOGLOBINOPATHY CASES on HPLC Dr. Archana Vazifdar Head Pathologist Hindlabs, HLL Lifecare Ltd](https://reader036.vdocuments.us/reader036/viewer/2022081504/56649c775503460f9492b8fa/html5/thumbnails/5.jpg)
CHROMATOGRAMS
Output
Time
Peak
RT (min)
Area
Total Area Count: 1-3 million
HbF: 1-2% RT: 1.03-1.13HbA2: 1.75-3.25% (2-3.6%) RT: 3.63-3.64
![Page 6: HAEMOGLOBINOPATHY CASES on HPLC Dr. Archana Vazifdar Head Pathologist Hindlabs, HLL Lifecare Ltd](https://reader036.vdocuments.us/reader036/viewer/2022081504/56649c775503460f9492b8fa/html5/thumbnails/6.jpg)
P2- Glycemic status, upto 6% acceptableP3- 6% acceptable, 6-15% deterioration
15-25% HbJ
![Page 7: HAEMOGLOBINOPATHY CASES on HPLC Dr. Archana Vazifdar Head Pathologist Hindlabs, HLL Lifecare Ltd](https://reader036.vdocuments.us/reader036/viewer/2022081504/56649c775503460f9492b8fa/html5/thumbnails/7.jpg)
8 mnth/M, pallor, failure to thrive
![Page 8: HAEMOGLOBINOPATHY CASES on HPLC Dr. Archana Vazifdar Head Pathologist Hindlabs, HLL Lifecare Ltd](https://reader036.vdocuments.us/reader036/viewer/2022081504/56649c775503460f9492b8fa/html5/thumbnails/8.jpg)
![Page 9: HAEMOGLOBINOPATHY CASES on HPLC Dr. Archana Vazifdar Head Pathologist Hindlabs, HLL Lifecare Ltd](https://reader036.vdocuments.us/reader036/viewer/2022081504/56649c775503460f9492b8fa/html5/thumbnails/9.jpg)
Homozygous beta thalassemia
![Page 10: HAEMOGLOBINOPATHY CASES on HPLC Dr. Archana Vazifdar Head Pathologist Hindlabs, HLL Lifecare Ltd](https://reader036.vdocuments.us/reader036/viewer/2022081504/56649c775503460f9492b8fa/html5/thumbnails/10.jpg)
22/Female
![Page 11: HAEMOGLOBINOPATHY CASES on HPLC Dr. Archana Vazifdar Head Pathologist Hindlabs, HLL Lifecare Ltd](https://reader036.vdocuments.us/reader036/viewer/2022081504/56649c775503460f9492b8fa/html5/thumbnails/11.jpg)
![Page 12: HAEMOGLOBINOPATHY CASES on HPLC Dr. Archana Vazifdar Head Pathologist Hindlabs, HLL Lifecare Ltd](https://reader036.vdocuments.us/reader036/viewer/2022081504/56649c775503460f9492b8fa/html5/thumbnails/12.jpg)
Heterozygous Beta thalassemia
Mother of 8 mnth old child
![Page 13: HAEMOGLOBINOPATHY CASES on HPLC Dr. Archana Vazifdar Head Pathologist Hindlabs, HLL Lifecare Ltd](https://reader036.vdocuments.us/reader036/viewer/2022081504/56649c775503460f9492b8fa/html5/thumbnails/13.jpg)
HbA2- Normal
• RBC indices- Normal– Silent β thalassaemia
• RBC indices s/o thal– Co existing IDA– Co inheritance of α thalassaemia – δβ thalassaemia
HbA2 LOW in α thalassaemia
![Page 14: HAEMOGLOBINOPATHY CASES on HPLC Dr. Archana Vazifdar Head Pathologist Hindlabs, HLL Lifecare Ltd](https://reader036.vdocuments.us/reader036/viewer/2022081504/56649c775503460f9492b8fa/html5/thumbnails/14.jpg)
HbA2%
2-3.6
HbF%
≤ 2
Hb
N
MCV
N
Symptoms
-
FINAL
NORMAL
4-10 ≤ 2/ m Borderline
Asymptomatic
β THAL TRAIT
10-18 2- 10 N N Asymptomatic
Hb LEPORE TRAIT
25-35 ≤ 1 N N Asymptomatic
HbE TRAIT
40-48 ≤ 2 N N Asymptomatic
HbD IRAN
Heterozygous
50-60 ≥ 10 SevereHbE/Hbβ double
heterozygous
≥ 60 2-10 m Asymptomatic
HbE homozygo
us
![Page 15: HAEMOGLOBINOPATHY CASES on HPLC Dr. Archana Vazifdar Head Pathologist Hindlabs, HLL Lifecare Ltd](https://reader036.vdocuments.us/reader036/viewer/2022081504/56649c775503460f9492b8fa/html5/thumbnails/15.jpg)
Hb Lepore Trait
![Page 16: HAEMOGLOBINOPATHY CASES on HPLC Dr. Archana Vazifdar Head Pathologist Hindlabs, HLL Lifecare Ltd](https://reader036.vdocuments.us/reader036/viewer/2022081504/56649c775503460f9492b8fa/html5/thumbnails/16.jpg)
34/M, Kolkata
![Page 17: HAEMOGLOBINOPATHY CASES on HPLC Dr. Archana Vazifdar Head Pathologist Hindlabs, HLL Lifecare Ltd](https://reader036.vdocuments.us/reader036/viewer/2022081504/56649c775503460f9492b8fa/html5/thumbnails/17.jpg)
Heterozygous E thalassemia
![Page 18: HAEMOGLOBINOPATHY CASES on HPLC Dr. Archana Vazifdar Head Pathologist Hindlabs, HLL Lifecare Ltd](https://reader036.vdocuments.us/reader036/viewer/2022081504/56649c775503460f9492b8fa/html5/thumbnails/18.jpg)
• All criteria fit provided there is NO history of recent blood transfusion
• ALWAYS CORRELATE with clinical history with CBC & peripheral blood picture
• Degenerated sample
![Page 19: HAEMOGLOBINOPATHY CASES on HPLC Dr. Archana Vazifdar Head Pathologist Hindlabs, HLL Lifecare Ltd](https://reader036.vdocuments.us/reader036/viewer/2022081504/56649c775503460f9492b8fa/html5/thumbnails/19.jpg)
Hb 7MCV 84 MCH 28MCHC 32.4RDW 20.2
Case 1: 2 yr/M, anemia, hepatosplenomegaly
![Page 20: HAEMOGLOBINOPATHY CASES on HPLC Dr. Archana Vazifdar Head Pathologist Hindlabs, HLL Lifecare Ltd](https://reader036.vdocuments.us/reader036/viewer/2022081504/56649c775503460f9492b8fa/html5/thumbnails/20.jpg)
Elevated HbF:
•HPFH (HbF 5-30%, CBC N, asymp)•Heterozygous δβ thal (HbF 3-20%, asymp)•Homozygous beta thal•Pregnancy
![Page 21: HAEMOGLOBINOPATHY CASES on HPLC Dr. Archana Vazifdar Head Pathologist Hindlabs, HLL Lifecare Ltd](https://reader036.vdocuments.us/reader036/viewer/2022081504/56649c775503460f9492b8fa/html5/thumbnails/21.jpg)
Recently transfused c/o homozygous beta thalassemia
![Page 22: HAEMOGLOBINOPATHY CASES on HPLC Dr. Archana Vazifdar Head Pathologist Hindlabs, HLL Lifecare Ltd](https://reader036.vdocuments.us/reader036/viewer/2022081504/56649c775503460f9492b8fa/html5/thumbnails/22.jpg)
Case 2:28/F, Severe anemia
![Page 23: HAEMOGLOBINOPATHY CASES on HPLC Dr. Archana Vazifdar Head Pathologist Hindlabs, HLL Lifecare Ltd](https://reader036.vdocuments.us/reader036/viewer/2022081504/56649c775503460f9492b8fa/html5/thumbnails/23.jpg)
Borderline HbA2 levels:
•Silent carrier of thalassemia•β thal with superadded IDA•Macrocytosis•αβ thalassemia
![Page 24: HAEMOGLOBINOPATHY CASES on HPLC Dr. Archana Vazifdar Head Pathologist Hindlabs, HLL Lifecare Ltd](https://reader036.vdocuments.us/reader036/viewer/2022081504/56649c775503460f9492b8fa/html5/thumbnails/24.jpg)
Borderline elevated HbA2 due to macrocytosis
![Page 25: HAEMOGLOBINOPATHY CASES on HPLC Dr. Archana Vazifdar Head Pathologist Hindlabs, HLL Lifecare Ltd](https://reader036.vdocuments.us/reader036/viewer/2022081504/56649c775503460f9492b8fa/html5/thumbnails/25.jpg)
P3: 6% acceptable, 6-12% deterioration15-25% HbJ
![Page 26: HAEMOGLOBINOPATHY CASES on HPLC Dr. Archana Vazifdar Head Pathologist Hindlabs, HLL Lifecare Ltd](https://reader036.vdocuments.us/reader036/viewer/2022081504/56649c775503460f9492b8fa/html5/thumbnails/26.jpg)
Hb: 6.5MCV: 63MCH: 23MCHC: 26RDW: 19.6
![Page 27: HAEMOGLOBINOPATHY CASES on HPLC Dr. Archana Vazifdar Head Pathologist Hindlabs, HLL Lifecare Ltd](https://reader036.vdocuments.us/reader036/viewer/2022081504/56649c775503460f9492b8fa/html5/thumbnails/27.jpg)
Double heterozygous for HbE and β thalassaemia
![Page 28: HAEMOGLOBINOPATHY CASES on HPLC Dr. Archana Vazifdar Head Pathologist Hindlabs, HLL Lifecare Ltd](https://reader036.vdocuments.us/reader036/viewer/2022081504/56649c775503460f9492b8fa/html5/thumbnails/28.jpg)
Tests may not be accurate if… Patient had a blood transfusion within
the past four months. Patient has polycythemia (increased red
blood cell production) or underlying anemia
If the patient is on certain medications Aged/ degenerated sample