Name of the Procedure:

Hemoglobin Fractionation and Quantitation; Chromatography (e.g., A2, S, C, and/or F)

Summary

Hemoglobin fractionation and quantitation using chromatography is a lab procedure that separates and measures different types of hemoglobin in the blood. This helps diagnose and manage various blood disorders, such as anemia and hemoglobinopathies, by identifying abnormal hemoglobin variants.

Purpose

This procedure is used to:

• Diagnose hemoglobin disorders such as sickle cell disease, thalassemia, and hemoglobin C or E disease.
• Monitor patients with known hemoglobinopathies.
• Guide treatment plans based on the type and quantity of hemoglobin variants present.

Indications

• Unexplained anemia or symptoms suggestive of a hemoglobinopathy (e.g., fatigue, jaundice).
• Newborn screening results indicating possible abnormal hemoglobin.
• Family history of hemoglobin disorders.
• Preoperative screening in individuals from regions with high prevalence of hemoglobinopathies.

Preparation

• No specific preparation or fasting is required.
• Inform the healthcare provider of any medications being taken.
• A quick blood draw is all that is required; no pre-procedure diagnostic tests are needed.

Procedure Description

1. A blood sample is drawn, typically from a vein in the arm.
2. The sample is prepared and placed into a chromatography machine.
3. The machine separates the different types of hemoglobin based on their properties.
4. Quantitative measurements of each hemoglobin type (e.g., A2, S, C, F) are reported.

Tools and Technology: Chromatography machine, syringes for blood draw, collection tubes.

Anesthesia or Sedation: None required.

Duration

The blood draw takes just a few minutes. Laboratory analysis and chromatographic separation typically take several hours. Results may be available within a day or two.

Setting

Performed in a hospital laboratory or specialized diagnostic lab.

Personnel

• Phlebotomist or nurse to draw blood.
• Laboratory technicians to process and analyze the blood sample.
• Hematologists or medical doctors to interpret the results.

Risks and Complications

• Minor risks associated with blood draw, including bruising or infection at the puncture site.
• Very rare: fainting or feeling lightheaded.

Benefits

• Accurate diagnosis of hemoglobinopathies, which can guide effective treatment.
• Better management of conditions like anemia or sickle cell disease.
• Early identification in newborns can lead to prompt care and better outcomes.

Recovery

• No specific recovery required; patients can resume normal activities immediately.
• Follow any additional advice from healthcare providers regarding ongoing treatment or follow-up tests.

Alternatives

• Hemoglobin electrophoresis: Another method to separate and measure hemoglobin types, sometimes used in combination.
• Genetic testing: Identifies specific mutations but may be more costly and not always necessary.
• Complete Blood Count (CBC): Provides general information on blood health but does not quantify hemoglobin types.

Patient Experience

• Minimal discomfort from the blood draw.
• No significant pain or side effects expected.
• Patients typically resume normal activities immediately after the procedure.

Pain Management and Comfort: Use of a small needle for the blood draw; if needed, topical anesthetics or distraction techniques can be utilized for patients sensitive to needles.