Study of abnormal haemoglobin variants in patients of anaemia using high performance liquid chromatography (HPLC) in Gujarat, India

  • Dr. Richa Jain Assistant Professor, Department of Pathology, Smt. B.K. Shah Medical Institute and Research Centre, Vadodara, Gujarat, India
  • Dr. Shubhi Saxena Assistant Professor, Department of Pathology, Smt. B.K. Shah Medical Institute and Research Centre, Vadodara, Gujarat, India
Keywords: Abnormal Haemoglobin variants, Anaemia, Gujarat, HPLC

Abstract

Introduction: Haemoglobinopathies are the most common inherited red cell disorders world-wide. Identification of these disorders is immensely important epidemiologically, for early diagnosis, improved management protocols and prevention of disease in upcoming generation. Our aim is to study the abnormal haemoglobin variants in patients of anaemia using High Performance Liquid Chromatography (HPLC) BIO-RAD D-10 Dual Program analyser in Vadodara region of Gujarat.

Methods: A total of 1890 cases of patient’s with anaemia having haemoglobin up to 11 gm% were studied for HPLC for diagnosing any abnormal haemoglobin disorder by BIO-RAD D-10 Dual Program analyser.

Results: Out of 1890 cases of anaemia studied, 1236 (65.3%) cases showed abnormal haemoglobin, and rest 654 (52.9%) cases showed normal result on HPLC. Of these, 1236 cases, 686 cases of sickle cell trait (55.5%) the predominant abnormality, followed by 247 cases of sickle cell disease (19.9%). There were 208 cases of beta Thalassemia trait (16.8%), followed by 89 cases of double heterozygous state of beta thalassemia and sickle cell trait (7.2%). There were three cases of Thalassemia major with high Hb F (0.24%), two cases of Hb D Punjab heterozygous patients (0.16%) and one case of Hb E heterozygous (0.08%).

Conclusion: HPLC is an accurate, simple and superior technique in detection of various haemoglobin disorders, which helps in management of patients and prognostic significance. It is also important in premarital and antenatal screening tests, to prevent birth of children with severe Haemoglobin disorders.

Downloads

Download data is not yet available.

References

WHO. Management of haemoglobin disorders. Report of joint WHO-TIF meeting on the management of haemoglobin disorders. Nicosia, Cyprus, 16-18 November 2007. World Health Organization 2008;1-2. Available from: http://www.who.int/genomics/WHO TIF genetics.

Vaz FE, Thakur CB, Banerjee MK, Gangal SG. Distribution of beta-thalassemia mutations in the Indian population referred to a diagnostic center. Hemoglob. 2000;24(3):181-194. doi: https://doi.org/10.3109/03630260008997526.

Balgir RS. Genetic epidemiology of the three predominant abnormal hemoglobins in India. J Assoc Physicians India. 1996;44(1):25-28.

Singh Tejindar. Atlas and Text of Hematology. 4th ed. New Delhi: Avichal Publishing Company; 2018.

Sood SK, Bhargava M, Shirish, Colah Roshan, Chandra S, Saxena Renu et al. Underlying principle of D-10TM dual mode. www.bio-rad.com/diagnostics.

Kawthalkar SM. Essentials of clinical pathology. Jaypee Brothers, Medical Publishers Pvt. Limited; 2018.

BIO-RAD: D-10 Dual Program. Customer Notification: Release of cartridge Resin Lot no. 70468. United States;2018.

Kawthalkar SM. Essent Haematol. 2nd ed. New Delhi: Jaypee Brothers Medical Publishers; 2013.

Kumar V, Abbas AK, Fausto N, Aster JC. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier Health Sci; 2014.

Patel AG, Shah AP, Sorathiya SM, Gupte SC. Hemoglobinopathies in South Gujarat population and incidence of anemia in them. Indian J Hum Genet. 2012;18(3):294-298. doi: 10.4103/0971-6866.107979.

Patne SC, Shukla J. Hemoglobin E disorders in Eastern Uttar Pradesh. Indian J Pathol Microbiol. 2009;52(1):110-112.

Baruah MK, Saikia M, Baruah A. Pattern of hemoglobinopathies and thalassemias in upper Assam region of North Eastern India: high performance liquid chromatography studies in 9000 patients. Indian J Pathol Microbiol. 2014;57(2):236-43. doi: http://www.ijpmonline.org/text.asp?2014/57/2/236/134680.

Patel U, Shrivastav A, Joshi JR, Agnihotri AS, Kaur A, Thakkar B. Detection of hemoglobinopathies and thalasemias in population of Gujarat State using HPLC: Analysis of 2022 cases. Pathol Lab Med. 2012;4(2):80-84.

Philip J, Sarkar RS, Kushwaha N. Microcytic hypochromic anemia: Should high performance liquid chromatography be used routinely for screening anemic and antenatal patients? Ind J Pathol Microbiol. 2013;56(2):109-113. doi: https://doi.org/10.4103/0377-4929.118699.

Patel AP, Naik MR, Shah NM, Sharma N, Parmar P. Prevalence of common hemoglobinopathies in Gujarat: An analysis of a large population screening programme. Natl J Community Med. 2012;3(1):112-116.

Parikh UR, Goswami HM, Mehta RC, Patel PS, Gonsai RN. Incidence of hemoglobinopathies in women attending antenatal clinics in their first trimester. NHL J Med Sci. 2014;3(1).

Campbell M, Henthorn JS, Davies SC. Evaluation of cation-exchange HPLC compared with isoelectric focusing for neonatal hemoglobinopathy screening. Clin Chem. 1999;45(7):969-975.

Sachdev R, Dam AR, Tyagi G. Detection of Hb variants and hemoglobinopathies in Indian population using HPLC: report of 2600 cases. Indian J Pathol Microbiol. 2010;53(1):57-62. doi: 10.4103/0377-4929.59185.

Rao S, Kar R, Gupta SK, Chopra A, Saxena R. Spectrum of haemoglobinopathies diagnosed by cation exchange-HPLC & modulating effects of nutritional deficiency anaemias from north India. Indian J Med Res. 2010;132:513-519.

Chandrashekar V, Soni M. Hemoglobin disorders in South India. ISRN Hematol. 2011;2011:748939. doi: 10.5402/2011/748939. Epub 2011 Jun 28.

Bhalodia JN, Oza HV, Modi PJ, Shah AM, Patel KA, Patel HB. Study of hemoglobinopathies in patients of anemia using high performance liquid chromatography (HPLC) in Western India. Natl J Community Med. 2015;6(1):35-40.

Pant L, Kalita D, Singh S, Kudesia M, Mendiratta S, Mittal M, Mathur A. Detection of abnormal hemoglobin variants by HPLC method: common problems with suggested solutions. Int Scholar Res Not. 2014;2014. doi: http://dx.doi.org/10.1155/2014/257805.

Mondal SK, Mandal S. Prevalence of thalassemia and hemoglobinopathy in eastern India: a 10-year high-performance liquid chromatography study of 119,336 cases. Asian J Transfus Sci. 2016;10(1):105-110. doi: 10.4103/0973-6247.175424.

Banerjee S, Singh RK, Shrivastava RK, Mahto SK. Study of haemoglobinopathies in patients of anaemia using High Performance Liquid Chromatography (HPLC) in rims (a premier institute of Jharkhand). J Evol Med Dent Sci-JEMDS. 2016;5(46):3029-3033. doi: 10.14260/jemds/2016/681.

CITATION
DOI: 10.17511/jopm.2019.i11.15
Published: 2019-11-30
How to Cite
Jain, R., & Saxena, S. (2019). Study of abnormal haemoglobin variants in patients of anaemia using high performance liquid chromatography (HPLC) in Gujarat, India. Tropical Journal of Pathology and Microbiology, 5(11), 925-933. https://doi.org/10.17511/jopm.2019.i11.15
Section
Original Article