EDTA Whole Blood

Pink top tube

Lavender top tube 3 mL (EDTA)

Preferred Minimum: 6 mL of fresh whole blood
Absolute Minimum: 1 mL of fresh whole blood

Submit specimen to laboratory as soon as possible after collection.

Patient's age is required on request form for processing.
Include recent transfusion information.

Monday - Saturday

1 day upon receipt at reference laboratory.
2-25 days if structural and/or molecular studies are required.

The types of hemoglobin present are identified, quantitated, and an interpretive report is issued.

Useful for the diagnosis of thalassemias and hemoglobin variants, also the evaluation of unexplained microcytosis.

Please print, complete and submit the following two forms to the lab, with the specimen and the A-1a Miscellaneous Request: Thalassemia/Hemoglobinopathy Information Sheet and the Informed Consent for DNA Testing from the Mayo Medical Laboratories.

Testing Algorithm
Hemoglobin electrophoresis cascade will always include: hemoglobin A(2) and F and hemoglobin electrophoresis

Reflex testing-Hemoglobin electrophoresis reflex testing performed at additional charge, may include any or all of the following as indicated to identify rare hemoglobin variant(s) present: hemoglobin S screen, unstable hemoglobin, IEF confirms, hemoglobin variant by mass spec, hemoglobin F red cell distribution, beta-globin gene, large del/dup, alpha-globin gene sequencing, and beta-globin gene sequencing.

Clinical Information
A large number (>800) of variants of hemoglobin (Hb) have been recognized. They are identified by capital letters (eg, Hb A or Hb S), or by the city in which the variant was first discovered (eg, Hb Koln).

The most common abnormality is an increase in Hb A2 to about 4% to 8%, which is diagnostic of beta-thalassemia minor. A wide variety of other hemoglobinopathies also have been encountered. Ranked in order of relative frequency, these are: Hb S (sickle cell disease and trait), C, E, Lepore, G-Philadelphia, H, D-Los Angeles, Koln, Constant Spring, O- Arab, and others. Hb C and S are found mostly in people from west or central Africa and Hb E and H in people from southeast Asia. Hemoglobin electrophoresis is often used in the evaluation of unexplained microcytosis, thus accounting for the frequent detection of Hb Lepore, which is relatively common in Italians and others of Mediterranean ancestry and in Hb E, which is relatively common in southeast Asians resettled in the United States; microcytosis is characteristic of both Hb Lepore and Hb E.

Alpha-thalassemia is very common in the United States, occurring in approximately 30% of African Americans and accounting for the frequent occurrence of microcytosis in persons of this ethnic group. Some alpha- thalassemias (ie, hemoglobin variants H, Barts, and Constant Spring) are usually easily identified in the hemoglobin electrophoresis protocol. However, alpha-thalassemias that are from only 1 or 2 alpha- globin gene deletions are not recognized. Unfortunately, there is no easy test for the diagnosis of these alpha-thalassemias.

Alpha-thalassemia trait itself is a harmless condition.

Cautions
Alpha-thalassemias with only 1 or 2 alpha-globin gene deletions are not recognized by this testing protocol. Alpha-Globin Gene Analysis is required to identify 1 or 2 globin gene deletions.