Hemoglobin and Its Variants

Capillary isoelectric focusing (CIEF) has been helpful in making the differential diagnosis of S/beta thalassemia, G-Philadelphia trait, S/C-Harlem disease, and HbH disease (see Chapter 8). In addition, CIEF can identify hemoglobin-oxidation products, which can bias HbA1c results, produced by improper storage. Another important use of this method was in the detection of minor hemoglobin variants like HbA2', an indicator of an alpha globin mutation. CIEF has also been shown to be useful in the neonatal screening for hemoglobin variants using blood samples collected on filter paper (34).

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