Hemoglobin Electrophoresis

Haemoglobin electrophoresis is a blood test that helps measure and identify various forms of haemoglobin present in blood. If the individual has an abnormal type of haemoglobin, it indicates the inheritance of gene mutations. A haemoglobin electrophoresis test is recommended by the doctor to determine the cause of production of abnormal haemoglobin.

The most common types of normal haemoglobin are as follows:

• Haemoglobin A is commonly found in adults
• Haemoglobin F, also referred to as foetal haemoglobin, is normally found in foetuses and newborn babies
• Haemoglobin A2 is a type of normal haemoglobin found in low amounts in adults

Abnormal types of haemoglobin include haemoglobins S, C, E and D.

Haemoglobin electrophoresis is done to:

• Diagnose specific types of anaemia, such as all thalassemias, including beta-thalassemia
• Evaluate the treatment of diseases that have abnormal haemoglobin in the blood
• Help couples determine the probability of passing certain types of anaemia to their children

No specific preparations are needed for this test. However, the individual must inform the doctor if they are taking any forms of iron therapy for iron-deficiency anaemia.

This test requires collection of a blood sample, which is done as per to the following procedure:

• An elastic band is wrapped around the upper arm of the individual to stop the flow of blood. This will ensure that the veins present below the band are larger and the needle can be easily inserted into the vein
• The injection site is cleaned using alcohol to sanitise the area
• A needle is inserted into the vein. One or more needle sticks may be required occasionally
• Blood is then withdrawn in a tube attached to the needle
• Once enough blood has been collected, the band is removed from the arm
• Cotton is placed over the injection site as the needle is removed, and some pressure is applied at the site to stop bleeding
• A bandage is placed thereafter to prevent infection

A sense of tightness may be felt when the band is wrapped around the upper arm. Few individuals report no pain from the needle, and some may feel a pricking sensation.

There are no specific risks associated with haemoglobin electrophoresis. The individual may get a small bruise at the site; however, the possibility of bruising may reduce by applying pressure on the site for several minutes after the sample is withdrawn. 

If you notice swelling in the vein after the collection of blood, use a warm compress to subside it. In case it doesn’t go away, check in with a doctor immediately.

Results of this blood test may take several days to arrive. It is important to note that the reference range can differ slightly between laboratories. Proper interpretation of the results is best provided by a doctor.

• The normal reference range for different haemoglobins are listed below:

Higher levels of haemoglobin A2 and haemoglobin F may indicate a mild form of thalassaemia.

Extremely low levels of haemoglobin A and high levels of haemoglobin F may indicate a severe form of thalassaemia.

The results obtained from this test can also help in diagnosing sickle cell disease (high amounts of haemoglobin S) and anaemia (high amounts of haemoglobin E trait).

Haemoglobin C in low amounts can indicate the presence of haemoglobin C trait (generally do not manifest as a clinical condition).

Haemoglobin types S and C denote the presence of haemoglobin S-C disease (it causes a mild or moderate form of sickle cell disease).

Along with thalassemia and sickle cell anaemia, abnormal test results might also indicate rare haemoglobinopathy and haemoglobin C disease.

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. The above information is provided from a purely educational perspective and is in no way a substitute for medical advice from a qualified doctor.