Afliações:
1 - Área de Diagnóstico Biomédico ,Servico de Patologia Clínica, Hospital Curry Cabral, Centro Hospitalar Lisboa Central EPE, Lisboa, Portugal
2 - Serviço de Endocrinologia, Diabetes e Metabolismo, Hospital Curry Cabral, Centro Hospitalar Lisboa Central EPE, Lisboa, Portugal
3 - Serviço de Hematologia Clınica, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
4 - Área de Diagnóstico Biomédico ,Servico de Patologia Clínica, Hospital Curry Cabral, Centro Hospitalar Lisboa Central EPE, Lisboa, Portugal
5 - Área de Diagnóstico Biomédico ,Servico de Patologia Clínica, Hospital Curry Cabral, Centro Hospitalar Lisboa Central EPE, Lisboa, Portugal
6 - Área de Diagnóstico Biomédico ,Servico de Patologia Clínica, Hospital Curry Cabral, Centro Hospitalar Lisboa Central EPE, Lisboa, Portugal
7 - Área de Diagnóstico Biomédico ,Servico de Patologia Clínica, Hospital Curry Cabral, Centro Hospitalar Lisboa Central EPE, Lisboa, Portugal
8 - Área de Diagnóstico Biomédico ,Servico de Patologia Clínica, Hospital Curry Cabral, Centro Hospitalar Lisboa Central EPE, Lisboa, Portugal
International Journal of Laboratory Hematology.- “letter to the editor”, publicação on line em novembro 2015, publicação em papel em Fevereiro 2016.
Resumo:
Introduction - The periodical evaluation of diabetic patients, with the assessment of glycohaemoglobin by high-performance liquid chromatography (HPLC), allows us to detect by chance structural variants of haemoglobin that can hamper the correct measurement of HbA1c. We report here the incidental finding of Haemoglobin Kenitra in a diabetic man during HbA1c analysis.
Case - A Caucasian diabetic man was admitted to the hospital for surgical resection of a pheochromocytoma. Catecholamine metabolism products were assessed in urine using an HPLC system. A full blood count was performed using a Coulter LH 780 haematology analyser. Biochemical parameters were measured on a Vitros 350 chemistry system. HbA1c was performed in Variant II (HPLC). For the remaining studies the cover slide method and DNA sequencing were used. Urinary amines were increased and the abdomen computed tomography scan showed a mass in the left adrenal gland, confirming the diagnosis of pheochromocytoma. Observation of the chromatogram in Variant II revealed a haemoglobin variant, subsequently identified as Haemoglobin Kenitra (beta 69(E13) Gly>Arg HBB:c.208G>C) by DNA sequencing.
The result of HbA1c reported was that obtained in the B-thalassemia Programme of Variant II.
Conclusion: Although Hb Kenitra and HbA1c are fully separable in HPLC, interpretation of chromatograms and following the manufacturer’s recommendations are important for reporting accurate results.
Palavras Chave: Hemoglobinopathy, Hemoglobin Kenitra, hemoglobin variant, glycated hemoglobin (HbA1c), High-Performance Liquid Chromatography (HPLC)