A Study on the Incidence of Abnormal Haemoglobin in a Quaternary Care Setup Along with the Estimation of Their Retention Time by HPLC

Introduction: In the world, haemoglobin abnormalities are one of the most common inherited disorders, which can be either quantitative (thalassaemia) or qualitative (haemoglobinopathy). Along with complete blood count (CBC), cation exchange-high performance liquid chromatography (CE-HPLC) helps in classifying them as traits, homozygous, and compound heterozygous disorders. Materials and Methods: It is a prospective study conducted for a period of two years in Apollo Hospitals, Chennai, Tamil Nadu (South India). We included a total of 500 patients for whom HPLC was asked, and excluded those with a recent history of blood transfusion (three months before sample collection). An EDTA anticoagulated blood sample was used for doing CBC using DxH 800 haematology analyser, sickling test using sodium metabisulfite and HPLC using Bio-Rad D10 analyser. Results: In our study, the commonest disorder was found to be heterozygous HbE (35.53%), followed by beta-thalassemia trait (31.47%), homozygous HbE (19.80%), HbE/beta-thalassemia and heterozygous HbS (each 3.55%), homozygous HbS (2.03%), HbSE and HbS-beta-thalassemia (each1.02%), heterozygous HbD, heterozygous HbC, beta-thalassemia intermedia and HbH (each 0.51%). The diseased groups mostly showed decreased RBC count, haemoglobin, haematocrit, MCV, MCH and MCHC and increased RDW. Sickling test showed positivity for 10 out of 12 cases with HbS peak. Conclusion: HPLC is superior and more advantageous than other methods for screening and detection of various haemoglobin disorders, as it provides rapid and accurate results. Both HbF and HbA2 can be detected and measured in a single run. It can detect even minor quantities of various haemoglobin variants, helping in the diagnosis of heterozygous states and uncommon haemoglobin disorders. It helps in the detection of various genetically inherited haemoglobin disorders in the antenatal screening, aiding early treatment and management.