Extraordinarily Low Level of HbA1c due to Hemolytic Anemia
AbstractHbA1c measurement gives us information about glycemic levels in patients with diabetes mellitus for the last 3 months. Some factors such as drugs, anemia (hemolytic anemia, hemoglobinopathies etc.), alcoholism, renal failure may affect HbA1c levels via decreasing erythrocyte survival. Herein, we report a very rare clinical presentation of a case of geriatric male patient with an extraordinarily low level of HbA1c (2.7%) which was caused by immune hemolytic anemia associated with chronic lymphocytic leukemia.
Mcdonald MJ, Shapiro R, Bleichman M, Solway J, Bunn HF. Glycosylated minor components of human adult hemoglobin. Purification, identification, and partial structural analysis. J Biol Chem 1978; 253: 2327-32.
Bry L, Chen PC, Sacks DB. Effects of hemoglobin variants and chemically modified derivatives on assays for glycohemoglobin. Clin Chem 2001; 47: 153-63.
Unnikrishnan R, Anjana RM, Jayashri R, Mohan V. Unexpectedly low HbA1c levels in two diabetes patients following dapsone use. Indian J Endocrinol Metab 2012; 16: 658-9.
Albright ES, Ovalle F, Bell DS. Artificially low hemoglobin A1c caused by use of dapsone. Endocr Pract 2002; 8: 370-2.
Fluckiger R, Woodtli T, Berger W. Quantitation of glycosylated hemoglobin by boronate affinity chromatography. Diabetes 1984; 33: 73-6.
Panzer S, Kronik G, Lechner K, Bettelheim P, Neumann E, Dudczak R. Glycosylated hemoglobins (GHb): an index of red cell survival. Blood 1982; 59: 1348-50.
Levitan EB, Liu S, Stampfer MJ, Cook NR, Rexrode KM, Ridker PM, Buring JE, Manson JE. HbA1c measured in stored erythrocytes and mortality rate among middle-aged and older women. Diabetologia 2008; 51: 267-75.
Wiener K. A falling HbA1c is not necessarily an indicator of improving diabetes control. Ann Clin Biochem 2001; 38: 406-7.
All opinions and reports within the articles that are published in the Gazi Medical Journal are the personal opinions of author(s). Gazi University, Editors and the publisher do not accept any responsibility for these articles. The journal is printed on acid-free paper.