HAEMOGLOBIN E HETEROZYGOUS WITH NEUTROPHILIA- IMPACT ON HbA1c BY HPLC
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2018, Vol 5, Issue 15
Abstract
PRESENTATION OF THE CASE 70 Years female resident of Jadcherla, Mahabubnagar district attended the emergency department of SVS Medical College with complaints of fever since 8 days, 5 episodes of vomiting and epigastric pain since 1 day. She was diagnosed diabetes mellitus type II, 8 years back. She has been using oral hypoglycaemics (Glycomet GP 1) since 3 years. Blood samples were received for routine blood investigations, fasting plasma glucose postprandial plasma glucose were analysed in Beckman coulter AU 480 by hexokinase method, values obtained as 224 mg/dl & 302 mg/dl respectively. For HbA1c, whole blood (K2 EDTA tube) processed in HPLC based Biorad D-10 analyser and found HbA1c value as 14.1% with a variant window value 24.9%. We analysed the same sample for HbA1c in boric acid affinity method and reported as 11.2% and advised for fructosamine. We processed the fresh sample in the Bio-Rad D10 for haemoglobin electrophoresis and found Hb A2 as 20.9%, Foetal Hb F = <0.8%, Hb A0 = 56.3%, P3 = 10.4%. Serum Iron studies as follows Iron = 15 µg/dl, TIBC = 202 µg/dl, UIBC = 182 µg/dl, Ferritin = 290 ng/ml. Complete blood picture (Sysmax XS- 800i) findings as follows Hb = 9gm/dl; MCV = 64.3 fl (N:80-100 fl); MCH = 21.6 pg (N:27 – 32 pg); RDW – SD = 35.6fL; RDW – CV= 15.4%, Neutrophils = 80%, Lymphocytes 15%, Eosinophils 2%,Monocytes = 3%, White blood cells 13,500; platelets 4.3 lacks/ cu.mm and peripheral smear findings as follows microcytic hypochromic anaemia with neutrophilic leucocytosis. Liver function tests as follows total bilirubin = 0.4 mg/dl, direct bilirubin = 0.1 mg/dl, alkaline phosphatase = 80 U/L, alanine transaminase = 20 U/L, total proteins = 6.7 gm/dl, albumin = 3.0 gm/dl, globulin = 3.7 gm/dl. Serum electrolytes as follows (ISE method) sodium = 129 meq/l, potassium = 5.6 meq/l, chlorides = 101 meq/l. Next day repeated the serum electrolytes, results retained as follows sodium = 133 meq/l, potassium = 5.2 meq/l, chlorides = 102 meq/l. Potassium obtained on higher side of normal range or higher than the normal as of pseudohyperkalaemia.
Authors and Affiliations
Ranjith Kumar Chikine
Keywords
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- EP ID EP555879
- DOI 10.18410/jebmh/2018/279
- Views 82
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