Discordantly high glycated hemoglobin might assist in diagnosing α-thalassemia, but not diabetes: A case report.

Glycated hemoglobin (HbA1c) is an important method for monitoring blood glucose and diagnosing diabetes. High-performance liquid chromatography is more commonly used in the laboratory for the detection of HbA1c. Although HbA1c detected by high-performance liquid chromatography is susceptible to abnormal hemoglobin, there are few reports that it is affected by α-thalassemia. Previous reports have generally concluded that α-thalassemia does not affect or lower HbA1c. Here, we report a case of discordantly high HbA1c inconsistent with fasting blood glucose. Finally, the patient was diagnosed with α-thalassemia and insulin resistance. α-Thalassemia might lead to a discordantly high HbA1c result, which could be attributed to elevated hemoglobin H. In this case, glycated albumin might accurately reflect the real average level of blood glucose. When finding discordant HbA1c, patients should be advised to undergo thalassemia and hemoglobinopathy screening by diabetologists/endocrinologists or primary care physicians to avoid a missed diagnosis of hematopathy.