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 Level 3 Testing - DNA sequencing for beta-globin chains, beta globin gene del/dup, manual DNA extraction, alpha globin gene sequencing, beta globin gene sequencing. Reflex to Levels 2 and 3 are done at additional charge. 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/Quantitation by electrophoresis 83021/Quantitation by HPLC 82664/Electrophoresis, agar (if appropriate) 82664/Electrophoresis x2, not elsewhere specified (if appropriate) 83068/Unstable hemoglobin (if appropriate) 85660/Sickling of red blood cells, reduction (if appropriate) 88184/Hemoglobin F, RBC distribution (if appropriate) 83898X2 (if appropriate) 83904X8 (if appropriate) 83909X8 (if appropriate) 83898X2 (if appropriate) 83904X4 (if appropriate) 83909X4 (if appropriate) 83900 (if appropriate) 83909 (if appropriate) 83914X8 (if appropriate) 83891 (if appropriate)

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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