Pediatric reference intervals of the hemoglobin fractions HbA2, HbF and HbA0 using high-performance liquid chromatography and capillary electrophoresis

Abstract

Introductionβ-thalassemia is a common genetic disorder with an estimated prevalence of 80–90 million carriers worldwide. As elevated hemoglobin A2 (HbA2) is a primary feature of carriers, hemoglobin fraction analysis is a common technique used for initial screening. However, pediatric reference intervals (RIs) are scarce. Hence, the aim was to establish pediatric RIs of hemoglobin fractions using high-performance liquid chromatography (HPLC) and capillary electrophoresis (CE). MethodsSamples were collected from assumed healthy children and adolescents of 1–18 years. Analyses were conducted using the Tosoh Automated Glycohemoglobin Analyzer HLC-723®G11 (Tosoh G11, HPLC) and the Capillarys 3 Octa (CE). Data were investigated for need of partitioning by both age (1–6 years vs. 6–18 years) and sex. ResultsIn total, 189 and 196 subjects were included in the statistical analysis of HPLC and CE, respectively. The 95% RI of HbA2 was 2.00–2.90% by HPLC and 2.2–3.0% by CE. Partitioning of data was not clinically relevant by HPLC. However, partitioning by age was suggested by CE. ConclusionRIs of hemoglobin fractions in individuals of 1–18 years using commercially available HPLC and CE equipment were reported. This is the first report of a pediatric RI of HbA2 using the Tosoh G11.