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Changes to Cheltenham A&E in response to industrial action

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Haemoglobin HPLC

Department of Haematology

Notes

High Performance Liquid Chromatography to distinguish normal and abnormal Haemoglobins. Tests include:

  • Haemoglobin S (HbS solubility may be performed if required)
  • Haemoglobin A2
  • Haemoglobin F

  • For antenatal requests please ensure a Family Origin Questionnaire is completed at booking. Ideally this should be done before 10 weeks gestation.
  • Pre operative Hb S solubility tests are only performed at GRH and the results confirmed later by HPLC.
  • Where Thalassaemia is suspected a Ferritin level should be considered, as it is not possible to exclude Thalassaemia when the patient is iron deficient. If required a follow up Ferritin request will be needed.
  • Depending upon the findings of Haemoglobin HPLC the laboratory will carry out further tests in order to identify any abnormalities found. This may involve sending the sample to the referral laboratory for confirmation of the result (address below) which will prolong the turnaround time. Further fresh samples may be required.
  • If any abnormalities are demonstrated in antenatal patients samples may be requested from the biological father. Cord blood samples may also be requested at delivery, and a further sample from the infant at 6 months of age. It is important to provide sufficient information on the request form to link such requests with the mother.

Sample Requirements

1ml, 2ml or 4ml EDTA sample.

EDTA with cap

If performing HPLC as part of a thalassaemia screen, please send a separate sample for Ferritin analysis.

Referral laboratory address:

Haematology Diagnostics Laboratory,

Department of Haematology,

University Hospital of Wales.

Cardiff

Turnaround Time

Haemoglobin S solubility: 2 hours for urgent requests

HPLC: 3 working days

Add on requests will be accepted up to 7 days post sample collection, provided the sample has been stored between 2-8°C and has not been discarded. Please discuss with laboratory.

Reference Ranges
Haemoglobin A2 1.8 - 3.5%
Haemoglobin F 0 - 2.0%

These reference ranges are for non-antenatal adults.

For antenatal requests refer to the following website for interpretative comments in relation to A2 and F levels. Link

All tests will be provided with an interpretive comment, please read carefully and action if required.

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