Clinical and Hematological Characteristics of Patients with Fast Moving Hemoglobins   Diagnosed in a Tertiary Level Laboratory

Objective: To analyze hematological and clinical characteristics of fast-moving hemoglobin variants. Study Design: Descriptive cross-sectional. Place and Duration of Study: Department of Hematology, Armed Forces Institute of Pathology, Rawalpindi Pakistan, from March 2021 to March 2022. Methodology: A total of 637 patients, enrolled over a period of two years, were included in this cross-sectional study. Inclusion criteria comprised of all patients reporting for hemoglobin studies for screening hemoglobin disorders. Sysmex XN 3000 automated hematology analyzer was used to perform complete blood counts, peripheral blood smears were assessed for red blood cell morphology and hemoglobin electrophoresis was done using three parallel techniques. Results: Fast moving hemoglobins were diagnosed in 12(1.8%) patients, with a male to female ratio of 0.8:1 and mean age of 25.6±15.1 years. Clinical presentations of the patients included anemia in 7(58%) and transfusion history in 3(25%) patients. Peaks of Hb H and J were seen on Sebia capillary zone electrophoresis, in zones of Z15 (20-40 seconds) for Hb H and Z12 (80-100 seconds) for Hb J respectively. Retention times at High Performance Liquid Chromatography of Hb H and Hb J were 0.39 and 0.6 mins respectively. Cellulose acetate membrane revealed fast moving bands in all patients. Conclusion: Fast moving hemoglobins remain an underdiagnosed entity, needing urgent allocation of resources for assisting patients in diagnosis and management.