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

Acta Clin Belg. 2016 Dec;71(6):458-461. doi: 10.1080/17843286.2016.1203559. Epub 2016 Jun 30.


Objective and importance: Suspected hemoglobin (Hb) variants, detected during HbA1C 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 HbA1C analysis or Hb variant screening are apparently unable to detect these Hb variants, their presence might be underestimated. HbA1C 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 HbA1C should be expected.

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

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Belgium / epidemiology
  • Chromatography, High Pressure Liquid / methods*
  • Diabetes Mellitus / blood*
  • Diabetes Mellitus / epidemiology
  • Female
  • Glycated Hemoglobin / analysis*
  • Hemoglobins, Abnormal / analysis*
  • Humans
  • Male
  • Mass Screening / methods*
  • Middle Aged
  • Prevalence


  • Glycated Hemoglobin A
  • Hemoglobins, Abnormal
  • hemoglobin Melusine
  • hemoglobin Athens-Georgia