Premature neonate with apnea and trace amounts of hemoglobin S and A detected by high-performance liquid chromatography. Sickle cell trait/disease in a prematurely born baby with hampered switch from gamma-globin to beta-globin chain synthesis.

Abstract

Prematurity may be associated with so-called F-only status that interferes with early diagnosis of hemoglo-binopathies and thalassemias. We present the case of a 4-week-old, prematurely born (at 31 weeks, 3 days) African American boy whose blood shows exclusively hemoglobin F on alkaline and acid electrophoresis. Meanwhile, high-performance liquid chromatography testing revealed the presence of trace amounts of hemoglobin A and S, which prompted the correct diagnosis and suggested further patient follow-up This demonstrates the superior analytical sensitivity of high-performance liquid chromatography in detecting trace amounts of hemoglobin A and S that is helpful in the early diagnostic process.