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HPLC hemoglobin fractionation HbA2 thalassemia interpretation Bio-Rad D10
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HbA2 normal range beta thalassemia trait diagnosis HPLC
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HPLC Report Interpretation — Patient: Khushboo
Instrument: Bio-Rad D-10 | Method: HbA2/F | Date: 03/26/2026
Peak Table Summary
| Peak | Retention Time | Area % | Interpretation |
|---|---|---|---|
| Unknown | 0.14 min | 2.3% | Non-specific early eluting peak |
| A1b | 0.27 min | 18.5% | Glycated Hb sub-fraction (includes labile HbA1c) |
| LA1c/CHb-1 | 0.63 min | 71.0% | HbA0 — normal adult hemoglobin (dominant fraction) |
| P3 | 1.50 min | 1.4% | Minor peak, within normal limits |
| A0 | 1.77 min | 4.0% | Additional normal adult Hb fraction |
| A2 | 3.20 min | 3.1% | HbA2 — KEY diagnostic value |
Key Result: HbA2 = 3.1%
Normal range for HbA2: 2.0–3.5%
A value of 3.1% is within the normal range.
Interpretation
This report does NOT support a diagnosis of Beta-Thalassemia trait.
| Condition | Expected HbA2 |
|---|---|
| Normal | 2.0–3.5% |
| Beta-Thalassemia trait | >3.5% (typically 4–8%) |
| Delta-Beta Thalassemia / HPFH | Low/absent, elevated HbF |
| Alpha-Thalassemia trait | Normal HbA2 (can be low-normal) |
- HbA2 of 3.1% is normal — beta-thalassemia trait is effectively excluded by this result (Harrison's, p. 2928).
- The dominant peak is the normal adult HbA (LA1c/CHb-1 at 71%), which is expected.
- HbF is not separately reported/elevated, making delta-beta thalassemia or HPFH unlikely.
- The A1b fraction (18.5%) is the glycated sub-fraction and not clinically alarming in this context; note this is not equivalent to HbA1c — the D-10 in HbA2/F mode is not validated for HbA1c reporting.
- No abnormal hemoglobin peaks (e.g., HbS at ~4.0 min, HbC at ~4.4 min, HbE) are present.
Clinical Correlation
| Finding | Status |
|---|---|
| Beta-thalassemia trait | Not supported (HbA2 normal) |
| Sickle cell trait/disease | Not seen (no HbS peak) |
| HbC/HbE variants | Not seen |
| Abnormal hemoglobin | None detected |
Conclusion: This is a normal HPLC hemoglobin fractionation pattern with no evidence of a significant hemoglobinopathy or thalassemia syndrome. If the patient has microcytosis or hypochromia on CBC, alpha-thalassemia trait should be considered (HbA2 is typically normal in alpha-thal, as seen here), and iron deficiency should be excluded. Molecular genetic testing would be needed to confirm alpha-thalassemia.
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