Evaluation of Hemoglobinopathies in Cases of Microcytic Hypochromic Anemia by High-Performance Liquid Chromatography

Background: Anemia remains a widespread public health problem with major consequences for human health as well as social and economic development. Although estimates of the prevalence of anemia vary widely and accurate data are often lacking, it can be assumed that significant proportions of young children and women of childbearing age are anemic. Hemoglobinopathies are the most common inherited disorders worldwide. These hereditary disorders are a major public health problem in many parts of the world, including India. Materials and Methods: The cross-sectional study was conducted over one year on 126 cases of microcytic hypochromic anemia. EDTA samples were analyzed using an automated 3-part cell counter (HORIBA) to obtain hemoglobin values and RBC indices. High-Performance Liquid Chromatography (HPLC) was performed using the HbA2-HbF program of D10 (BIO-RAD), based on the principle of cation exchange chromatography. Results: Out of 126 cases of microcytic hypochromic anemia, hemoglobinopathy was detected in 42 (33%) cases. The results show Beta thalassemia trait constituted 20 (47.6%) cases, followed by 6 (14.5%) cases of Hemoglobin D-Punjab heterozygous, Beta thalassemia major in 5 (11.9%) cases, Hemoglobin D-Iran heterozygous in 2 (4.8%) cases, HbE heterozygous in 3 (7.1%) cases, Hemoglobin E/β+ thalassemia in 1 (2.4%) case, Hemoglobin S heterozygous in 2 (4.8%) cases, and Hemoglobin S/β+ thalassemia in 3 (7.1%) cases. Conclusion: Our study revealed a substantial presence of hemoglobinopathies in cases with microcytic hypochromic anemia. Most of the hemoglobinopathies detected were accurately quantified by High-Performance Liquid Chromatography (HPLC), which emerges as an optimal method for the routine screening of hemoglobinopathies. HPLC offers advantages such as rapid and accurate results, along with the detection and quantification of abnormal hemoglobin, compared to other tests.