Hb Melusine and Hb Athens-Georgia: potentially underreported in the Belgian population? Four cases demonstrating the lack of detection using common CE-HPLC methods either for glycated hemoglobin (HbA1C) analysis or Hb variant screening

Abstract

Objective and importance: Suspected hemoglobin (Hb) variants, detected during HbA_1C measurements should be further investigated, determining the extent of the interference with each method.

Clinical presentation: This is the first report of Hb Melusine and Hb Athens-Georgia in Caucasian Belgian patients. Intervention & Technique: Since common CE-HPLC methods for HbA_1C analysis or Hb variant screening are apparently unable to detect these Hb variants, their presence might be underestimated. HbA_1C analysis using CZE, however, alerted for their presence. Moreover, in case of Hb Melusine, even Hb variant screening using CZE was unsuccessful in its detection.

Conclusion: Fortunately, carriage of Hb Melusine or Hb Athens-Georgia variants has no clinical implications and, as shown in this report, no apparent difference in HbA_1C should be expected.

Keywords: CE-HPLC; Glycated hemoglobin; Hb Athens-Georgia; Hb Melusine; HbA1C.