Hemoglobin Electrophoresis
(HBELI)

Sample type:

• Specimen Whole blood (Lavender-top (EDTA) tube).

Use:

• Hemoglobin electrophoresis measures hemoglobin levels and looks for abnormal types of hemoglobin

• Diagnosis and classification of hemoglobin disorders, including thalassemias and hemoglobin variants

Interfering factors:

• Cellulose acetate electrophoresis and citrate agar electrophoresis:

• Quantitative densitometry of abnormal hemoglobin is inaccurate at low concentrations (e.g., HbA2 and HbF in adults) This leads to an error in percentage of HbA2 and HbF in adults.

Precautions:

• Handling of blood should take place with the maintenance of proper aseptic precautions.

• There is no need to fast before the test – you can eat and drink as normal. The results should be available within 24 hours.

• The anticoagulant should be EDTA

Pre analytical errors:

1) Hemolyzed, clotted, and insufficient samples

2) Inappropriate blood to anticoagulant ratio

3) Not taking the patient’s complete data such as age, gender, and if he is taking therapeutic drugs

Corrective action:

1) Request for another sample

2) Fill the EDTA tube by blood at the marker on the tube

3) Communicate with the patient and identify his age, gender and write it in the test report

Post analytical errors:

1) Result sent to wrong patient.

Corrective action:

1) tell the patient that the result that was delivered to him is wrong and that the correct report should be received to him, and we apologize to the patient for this error

Reference range:

• In adults, these are normal percentages of different hemoglobin molecules:

• HbA: 95% to 98% (0.95 to 0.98)

• HbA2: 2% to 3% (0.02 to 0.03)

• HbE: Absent

• HbF: 0.8% to 2% (0.008 to 0.02)

• HbS: Absent

• HbC: Absent

• In infants and children, these are normal percentage of HbF molecules:

• HbF (newborn): 50% to 80% (0.5 to 0.8)

• HbF (6 months): 8%

• HbF (over 6 months): 1% to 2%