HEMOGLOBIN ELECTROPHORESIS CASCADE, LEVEL 1

HEMOGLOBIN ELECTROPHORESIS CASCADE, LEVEL 1
Marquette General Health System

General Info

Alpha Code		HGBEL
MGH LIS Test No		745
Schedule		Monday through Saturday
Testing Time		1 day/1-10 days
Testing Lab		Mayo Labs
QORR Test Code		HGBEL

Specimen Info

Type
Volume
Temperature		Refrigerate
Preservative
Collection Info		Draw blood in a lavender-top (EDTA) tube, and send 3.0 mL (pediatric: 1.5 mL) of fresh EDTA whole blood refrigerated. (Keep specimen cool with frozen coolant April-October. Protect specimen from freezing by placing it in a bubble-pack bag [Supply T055] supplied by Mayo Medical Laboratories. Use refrigerated coolant November-March). SPECIMEN CANNOT BE FROZEN NOTE: 1. PATIENT'S AGE IS REQUIRED ON REQUEST FORM FOR PROCESSING. 2. Please complete a "Thalassemia/Hemoglobinopathy Information Sheet" (Supply T358) and forward it with the specimen.

Specimen Acceptability

Methods
Cellulose Acetate Electrophoresis, Hb F and Hb A2 by High-Performance Liquid Chromatography (HPLC) Level 1 Testing- May include agar gel electrophoresis, and hemoglobin S test, if results so warrant. Level 2 Testing- In the event that a rare hemoglobin variant is present, the appropriate tests will be performed and the results interpreted to identify the hemoglobinopathies or thalassemias (except alpha-thalassemia). The additional tests may include any or all of the following as the laboratory deems necessary: unstable hemoglobin; isoelectric focusing; globin-chain electrophoresis; Kleihauer-Betke; globin gene-amplification; and amino acid sequencing mass spectometry for alpha-globin chains; and DNA sequencing for beta-globin chains. NOTE: Alpha-Thalassemia -Hemoglobin variants H, Barts, and Constant Spring are usually easily identified in the hemoglobin electro- phoresis protocol. However, alpha-thalassemias that are from only 1 or 2 alpha-globin gene deletions are not recognized. To identify 1 or 2 globin-gene deletioned alpha-thalassemias, request an "Alpha-Globin Gene Analysis".
Clinical Utilities
CPT Codes
83020, 83021, 82664, 83068, 85660, 88180
Reference Range
Hb A
  0-30 days:  10-40%
  1-14 months:  Adult values attained by 6 months.
  > or = 15 months:  95-98%
Hb A2
  0-30 days:  <1%
  1-11 months:  Adult values attained by 12 months.
  > or = 1 year:  2.0-3.3%
Hb F
  0-30 days:  60-90%
  1-23 months:  Adult values attained by 24 months.
  > or = 24 months:  0-2%
No abnormal variants

Hb S
Negative (reported as positive or negative)
PRECAUTIONS:  The procedure does not distinguish hemoglobin
              S trait from homozygous sickle cell disease
              nor any of the following combinations:
              S/C, S/D, S/G, S/E, S/thalassemia, S/O-Arab,
              and C/Georgetown trait.

Unstable Hemoglobin
Normal (reported as normal [stable] or abnormal [unstable])
PRECAUTIONS: False-positive results will be obtained in blood specimens
             that contain >5% fetal hemoglobin or in specimens that
             are received more than a week after the blood has been
             drawn.

Hemoglobin F, Red Cell Distribution
Reported as heterogenous or homogenous
Component Information
Collection Notes
Additional Comments

Questions or Comments email support@mgh.org

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