Haemoglobin A1C Levels Constantly Below Lower Reference Limit in a Diabetic Patient With Microcytic Anaemia
Introduction: Haemoglobin A1C (A1C), as a parameter of long-term glycaemic control, has been adopted to guide diabetic therapy all over the world. However, falsely high or low A1C could be troublesome in daily practice. Case description: A 75-year-old male diabetic patient affected by a reasonably...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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SMC MEDIA SRL
2019-11-01
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| Series: | European Journal of Case Reports in Internal Medicine |
| Subjects: | |
| Online Access: | https://www.ejcrim.com/index.php/EJCRIM/article/view/1338 |
| _version_ | 1818260278890987520 |
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| author | Frank Sheng Fan Chih-Hao Chen Hui-Chun Yang |
| author_facet | Frank Sheng Fan Chih-Hao Chen Hui-Chun Yang |
| author_sort | Frank Sheng Fan |
| collection | DOAJ |
| description | Introduction: Haemoglobin A1C (A1C), as a parameter of long-term glycaemic control, has been adopted to guide diabetic therapy all over the world. However, falsely high or low A1C could be troublesome in daily practice.
Case description: A 75-year-old male diabetic patient affected by a reasonably inferred life-long history of microcytic anaemia was found to have abnormally low A1C values in the previous 5 months. Subsequent laboratory assessment with brilliant cresyl blue staining and haemoglobin electrophoresis detected haemoglobin H disease as the underlying cause of both the microcytic anaemia and the disturbed A1C measurement.
Discussion: Enhanced erythrocyte destruction such as in haemoglobin H disease could explain a falsely decreased A1C level very well. Upon facing a questionable A1C value, physicians dealing with diabetes should consider the possibility of undiscovered underlying causes rather than too tightly glycaemic control. |
| first_indexed | 2024-12-12T18:28:48Z |
| format | Article |
| id | doaj.art-1b1a84aa095a48779c51ac595ce3d7ad |
| institution | Directory Open Access Journal |
| issn | 2284-2594 |
| language | English |
| last_indexed | 2024-12-12T18:28:48Z |
| publishDate | 2019-11-01 |
| publisher | SMC MEDIA SRL |
| record_format | Article |
| series | European Journal of Case Reports in Internal Medicine |
| spelling | doaj.art-1b1a84aa095a48779c51ac595ce3d7ad2022-12-22T00:15:58ZengSMC MEDIA SRLEuropean Journal of Case Reports in Internal Medicine2284-25942019-11-0110.12890/2019_0013381338Haemoglobin A1C Levels Constantly Below Lower Reference Limit in a Diabetic Patient With Microcytic AnaemiaFrank Sheng Fan0Chih-Hao Chen1Hui-Chun Yang2Section of Haematology and Oncology, Ministry of Health and Welfare Taitung Hospital, Taitung County, TaiwanSection of Cardiology, Department of Medicine, Ministry of Health and Welfare Taitung Hospital, Taitung County, TaiwanDepartment of Laboratory Medicine, Ministry of Health and Welfare Taitung Hospital, Taitung County, TaiwanIntroduction: Haemoglobin A1C (A1C), as a parameter of long-term glycaemic control, has been adopted to guide diabetic therapy all over the world. However, falsely high or low A1C could be troublesome in daily practice. Case description: A 75-year-old male diabetic patient affected by a reasonably inferred life-long history of microcytic anaemia was found to have abnormally low A1C values in the previous 5 months. Subsequent laboratory assessment with brilliant cresyl blue staining and haemoglobin electrophoresis detected haemoglobin H disease as the underlying cause of both the microcytic anaemia and the disturbed A1C measurement. Discussion: Enhanced erythrocyte destruction such as in haemoglobin H disease could explain a falsely decreased A1C level very well. Upon facing a questionable A1C value, physicians dealing with diabetes should consider the possibility of undiscovered underlying causes rather than too tightly glycaemic control.https://www.ejcrim.com/index.php/EJCRIM/article/view/1338haemoglobin a1chaemoglobin h diseasemicrocytic anaemiathalassaemia |
| spellingShingle | Frank Sheng Fan Chih-Hao Chen Hui-Chun Yang Haemoglobin A1C Levels Constantly Below Lower Reference Limit in a Diabetic Patient With Microcytic Anaemia European Journal of Case Reports in Internal Medicine haemoglobin a1c haemoglobin h disease microcytic anaemia thalassaemia |
| title | Haemoglobin A1C Levels Constantly Below Lower Reference Limit in a Diabetic Patient With Microcytic Anaemia |
| title_full | Haemoglobin A1C Levels Constantly Below Lower Reference Limit in a Diabetic Patient With Microcytic Anaemia |
| title_fullStr | Haemoglobin A1C Levels Constantly Below Lower Reference Limit in a Diabetic Patient With Microcytic Anaemia |
| title_full_unstemmed | Haemoglobin A1C Levels Constantly Below Lower Reference Limit in a Diabetic Patient With Microcytic Anaemia |
| title_short | Haemoglobin A1C Levels Constantly Below Lower Reference Limit in a Diabetic Patient With Microcytic Anaemia |
| title_sort | haemoglobin a1c levels constantly below lower reference limit in a diabetic patient with microcytic anaemia |
| topic | haemoglobin a1c haemoglobin h disease microcytic anaemia thalassaemia |
| url | https://www.ejcrim.com/index.php/EJCRIM/article/view/1338 |
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