Aggarwal Nidhi, Rai Anand Kumar, Kupfer Yizhak, Tessler Sidney
Division of Pulmonary & Critical Care Medicine, Department of Medicine, Maimonides Medical Center, Brooklyn, New York, USA.
BMJ Case Rep. 2013 Aug 8;2013:bcr2013200307. doi: 10.1136/bcr-2013-200307.
Glycosylated haemoglobin (HbA1c) is a measurement commonly performed in patients with diabetes. Factors causing a change in the life span of the red blood cell (RBC) can affect the measurement of HbA1c. Thus haemolysis is an important factor that may affect the HbA1c level determination. Haemolysis has been shown to cause a falsely low HbA1c. A 62-year-old man with a history of autoimmune haemolytic anaemia was admitted for severe haemolytic anaemia and an Hb of 2.9 g/dL. HbA1c tested during hospitalisation was unrecordable due to the extremely low Hb. The patient was treated with intravenous steroids, immunoglobulin, fluids and RBC transfusions but continued to haemolyse and eventually expired. We emphasise that an extremely low HbA1c level can serve as a marker of haemolysis and an unrecordable HbA1c level may point towards fatal haemolysis.
糖化血红蛋白（HbA1c）是糖尿病患者常做的一项检测。导致红细胞（RBC）寿命改变的因素会影响HbA1c的检测结果。因此，溶血是可能影响HbA1c水平测定的一个重要因素。已有研究表明，溶血会导致HbA1c结果假性降低。一名62岁男性，有自身免疫性溶血性贫血病史，因严重溶血性贫血和血红蛋白水平为2.9 g/dL入院。住院期间检测的HbA1c因血红蛋白水平极低而无法记录。该患者接受了静脉注射类固醇、免疫球蛋白、补液及红细胞输注治疗，但仍持续溶血，最终死亡。我们强调，极低的HbA1c水平可作为溶血的一个指标，而无法记录的HbA1c水平可能提示致命性溶血。
