Mulpuri Neha, Bryant Ananda, Shahin Daryoush, Soe Kyaw
UT Southwestern Medical Center, Department of Internal Medicine, Dallas, TX 75390, USA.
VA North Texas Health Care System, Division of Endocrinology, Dallas, TX 75216, USA.
JCEM Case Rep. 2023 May 8;1(3):luad043. doi: 10.1210/jcemcr/luad043. eCollection 2023 May.
The objective of this work is to explain the effect of the clinically silent hemoglobinopathy hemoglobin Wayne (Hb Wayne) variant on glycated hemoglobin A (HbA) assay. This variant can result in falsely high HbA values among euglycemic individuals without diabetes mellitus (DM). We discuss 3 patients who were diagnosed with type 2 DM based on spuriously high HbA values due to the presence of Hb Wayne. All 3 patients were found to have elevated HbA values that did not correlate with other glycemic parameters such as capillary blood sugar, 2-hour oral glucose tolerance test, and fructosamine levels. Hemoglobin electrophoresis revealed that each patient had a rare hemoglobinopathy called Hb Wayne variant. These patients were reassured that they did not have DM and were able to avoid unnecessary treatment. These cases emphasize the importance of clinical judgment in recognizing the limitations and caveats of the HbA test. It is always necessary to investigate further any discordance between HbA values and the clinical picture or other glycemic parameters.
这项工作的目的是解释临床上无症状的血红蛋白病——血红蛋白韦恩（Hb Wayne）变体对糖化血红蛋白A（HbA）检测的影响。这种变体可导致无糖尿病（DM）的血糖正常个体的HbA值出现假性升高。我们讨论了3例因存在Hb Wayne而基于假性升高的HbA值被诊断为2型糖尿病的患者。所有3例患者的HbA值均升高，且与其他血糖参数如毛细血管血糖、口服葡萄糖耐量试验2小时结果及果糖胺水平无关。血红蛋白电泳显示，每位患者都有一种罕见的血红蛋白病，称为Hb Wayne变体。这些患者得到了 reassured，即他们没有糖尿病，从而避免了不必要的治疗。这些病例强调了临床判断在认识HbA检测的局限性和注意事项方面的重要性。对于HbA值与临床表现或其他血糖参数之间的任何不一致，总是有必要进一步调查。
