Specimen:

EDTA Whole Blood

Collection Medium:

Minimum:

3 mL EDTA whole blood

Rejection Criteria:

Specimen cannot be frozen.
Specimens Other Than: Whole blood
Anticoagulants Other Than: EDTA, ACD

Delivery Instructions:

Submit specimen to laboratory as soon as possible after collection.

Testing Schedule:

Monday - Saturday

Analytic Time:

1 week

Reference Range:

HEMOGLOBIN A
0-30 days:  10-40% *
1-14 months:  Adult values attained by 6 months. *
> or = 15 months:  95-98%

HEMOGLOBIN A(2)
0-30 days:  <1% *
1-11 months:  Adult values attained by 12 months. *
> or = 1 year:  2.0-3.3%

HEMOGLOBIN F
0-30 days:  60-90% *
1-23 months:  Adult values attained by 24 months. *
> or = 24 months:  0-2%

VARIANT
No abnormal variants
VARIANT 2
No abnormal variants
VARIANT 3
No abnormal variants

*Altman PL, Katz DD:  Human Health and Disease. Bethesda, MD, 
Federation of American Societies for Experimental Biology, 1977.

HEMOGLOBIN S
Negative

Interpretive Data:

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

Cautions:  Alpha-thalassemias with only 1 or 2 alpha-globin gene 
deletions are not recognized by this testing protocol.

Comments:

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

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
Level 1 Testing - Hgb electrophoresis cascade will always include: hgb 
A(2) and F and hgb electrophoresis.  If results so warrant, it may also 
include: agar elec. confirms and hgb S.

Level 2 Testing - Hgb electrophoresis cascade performed at additional 
charge, may include any or all of the following as indicated to 
identify a rare hemoglobin variant: unstable hgb, IEF confirms, globin 
elec. confirms, and hgb F red cell distribution.  HBELEC2 will be added 
on to patient's testing if reflexed by reference laboratory.

Level 3 Testing - Hgb electrophoresis cascade performed at additional 
charge, may include any or all of the following as indicated to 
identify a rare hemoglobin variant:  beta-globin gene, large del/dup; 
alpha-globin gene sequencing; and beta-globin gene sequencing.  HBELEC3 
will be added on to patient's testing if reflexed by reference 
laboratory.

Methodology:

Cation Exchange/High-Pressure Liquid Chromatography (HPLC)
Alkaline Gel Electrophoresis
Agar Gel Electrophoresis
Hemoglobin S Solubility
Isopropanol Stability
Electrophoresis
Flow Cytometry
Polymerase Chain Reaction (PCR) Analysis/Multiplex Ligation-Dependent 
Probe Amplification (MLPA), Polymerase Chain Reaction (PCR)/DNA 
Sequencing

CPT Code:

83020, 83021

CPT codes for Hemoglobin Electrophoresis Cascade 2:  83068, 88184, 
82664(x3), 85660

CPT codes for Hemoglobin Electrophoresis Cascade 3:  83898(x4),
83904(x2), 83909(x3), 83914(x2), 83900