{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T11:19:17Z","timestamp":1740136757019,"version":"3.37.3"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2022,10,14]],"date-time":"2022-10-14T00:00:00Z","timestamp":1665705600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,5,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Isolated low hemoglobin A2 (HbA2) is rarely encountered in our clinical practice using capillary zone electrophoresis. The study goal was to characterize the work-up at our institution of patients with low HbA2.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Patients with low HbA2 and a control cohort with normal capillary zone electrophoresis were identified and relevant information extracted from the medical record.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 44 patients with isolated decreased HbA2, 28 (64%) had corresponding complete blood count\/ferritin values. Compared to control patients, patients with low HbA2 were more likely to have iron deficiency and demonstrated a more microcytic, hypochromic blood picture. However, 46% (13\/28) of patients with low HbA2 and ferritin for evaluation did not have iron deficiency. Only 2 patients had genetic testing.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This study redemonstrates the association between low HbA2 and iron deficiency and reinforces the need for iron indices to interpret capillary zone electrophoresis results. Our study population showed incomplete or absent iron studies in most cases.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/labmed\/lmac114","type":"journal-article","created":{"date-parts":[[2022,10,14]],"date-time":"2022-10-14T21:18:50Z","timestamp":1665782330000},"page":"235-240","source":"Crossref","is-referenced-by-count":1,"title":["Work-up of Patients with Decreased Hemoglobin A2 Identified by Capillary Zone Electrophoresis: A North American Institutional Experience"],"prefix":"10.1093","volume":"54","author":[{"given":"Margaret","family":"Moore","sequence":"first","affiliation":[{"name":"University of Virginia School of Medicine and University of Virginia Health System , Charlottesville, VA 22908 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0528-9029","authenticated-orcid":false,"given":"Elizabeth L","family":"Courville","sequence":"additional","affiliation":[{"name":"University of Virginia School of Medicine and University of Virginia Health System , Charlottesville, VA 22908 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,10,14]]},"reference":[{"issue":"5","key":"2023050216514760300_CIT0001","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/j.bjhh.2015.06.002","article-title":"The importance of hemoglobin A2 determination","volume":"37","author":"Figueiredo","year":"2015","journal-title":"Rev Bras Hematol Hemoter."},{"issue":"18","key":"2023050216514760300_CIT0002","doi-asserted-by":"crossref","first-page":"1786","DOI":"10.1016\/j.clinbiochem.2009.06.026","article-title":"The significance of the hemoglobin A2 value in screening for hemoglobinopathies","volume":"42","author":"Giambona","year":"2009","journal-title":"Clin Biochem."},{"issue":"3","key":"2023050216514760300_CIT0003","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1093\/ajcp\/67.3.219","article-title":"Hemoglobin A2 levels in health and various hematologic disorders","volume":"67","author":"Alperin","year":"1977","journal-title":"Am J Clin Pathol."},{"issue":"9","key":"2023050216514760300_CIT0004","first-page":"2165","article-title":"Hemoglobin A2: origin, evolution, and aftermath","volume":"78","author":"Steinberg","year":"1991","journal-title":"Blood."},{"issue":"6","key":"2023050216514760300_CIT0005","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1046\/j.1442-200X.2002.01636.x","article-title":"Most reliable indices in differentiation between thalassemia trait and iron deficiency anemia","volume":"44","author":"Demir","year":"2002","journal-title":"Pediatr Int."},{"issue":"5","key":"2023050216514760300_CIT0006","doi-asserted-by":"crossref","first-page":"472","DOI":"10.3109\/08880018.2012.705230","article-title":"Indices used in differentiation of thalassemia trait from iron deficiency anemia in pediatric population: are they reliable?","volume":"29","author":"Nalbanto\u011flu","year":"2012","journal-title":"Pediatr Hematol Oncol."},{"issue":"10","key":"2023050216514760300_CIT0007","doi-asserted-by":"crossref","first-page":"1582","DOI":"10.1515\/cclm-2016-0856","article-title":"Critical appraisal of discriminant formulas for distinguishing thalassemia from iron deficiency in patients with microcytic anemia","volume":"55","author":"Urrechaga","year":"2017","journal-title":"Clin Chem Lab Med."},{"issue":"5","key":"2023050216514760300_CIT0008","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/j.blre.2011.04.001","article-title":"Haemoglobinopathy diagnosis: algorithms, lessons and pitfalls","volume":"25","author":"Bain","year":"2011","journal-title":"Blood Rev."},{"issue":"2","key":"2023050216514760300_CIT0009","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1111\/j.1749-6632.1965.tb54056.x","article-title":"method for the quantitative determination of Hgb A2*","volume":"119","author":"Chernoff","year":"1964","journal-title":"Ann N Y Acad Sci."},{"issue":"1","key":"2023050216514760300_CIT0010","first-page":"85","article-title":"The effect of iron deficiency on the levels of hemoglobins A2 and E","volume":"71","author":"Wasi","year":"1968","journal-title":"J Lab Clin Med."},{"issue":"2","key":"2023050216514760300_CIT0011","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1159\/000208609","article-title":"Decreased hemoglobin A2 concentration in iron deficiency anemia","volume":"45","author":"Steiner","year":"1971","journal-title":"Acta Haematol."},{"issue":"5","key":"2023050216514760300_CIT0012","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1046\/j.1365-2257.2002.00464.x","article-title":"The effect of iron deficiency anaemia on the levels of haemoglobin subtypes: possible consequences for clinical diagnosis","volume":"24","author":"El-Agouza","year":"2002","journal-title":"Clin Lab Haematol."},{"key":"2023050216514760300_CIT0013","doi-asserted-by":"crossref","first-page":"858294","DOI":"10.1155\/2013\/858294","article-title":"Hemoglobin A2 lowered by iron deficiency and \u03b1-thalassemia: should screening recommendation for \u03b2-thalassemia change?","volume":"2013","author":"Denic","year":"2013","journal-title":"ISRN Hematol."},{"issue":"1","key":"2023050216514760300_CIT0014","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1002\/ajh.22188","article-title":"Is HbA2 level a reliable diagnostic measurement for \u03b2-thalassemia trait in people with iron deficiency?","volume":"87","author":"Verhovsek","year":"2012","journal-title":"Am J Hematol."},{"issue":"2","key":"2023050216514760300_CIT0015","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1136\/jcp.14.2.164","article-title":"Quantitative determination of haemoglobin A2 using paper electrophoresis","volume":"14","author":"Ibbotson","year":"1961","journal-title":"J Clin Pathol."},{"issue":"5","key":"2023050216514760300_CIT0016","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1111\/ijlh.12413","article-title":"ICSH recommendations for assessing automated high-performance liquid chromatography and capillary electrophoresis equipment for the quantitation of HbA2","volume":"37","author":"Stephens","year":"2015","journal-title":"Int J Lab Hematol."},{"issue":"4","key":"2023050216514760300_CIT0017","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1111\/j.1751-553X.2012.01403.x","article-title":"Interlaboratory comparison of current high-performance methods for HbA2","volume":"34","author":"Paleari","year":"2012","journal-title":"Int J Lab Hematol."},{"issue":"5","key":"2023050216514760300_CIT0018","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1111\/j.1751-553X.2009.01158.x","article-title":"Evaluating five dedicated automatic devices for haemoglobinopathy diagnostics in multi-ethnic populations","volume":"31","author":"Van Delft","year":"2009","journal-title":"Int J Lab Hematol."},{"issue":"2","key":"2023050216514760300_CIT0019","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1111\/ijlh.12000","article-title":"Analytical evaluation of the Capillarys 2 Flex piercing for routine haemoglobinopathies diagnosis","volume":"35","author":"Agouti","year":"2013","journal-title":"Int J Lab Hematol."},{"issue":"5","key":"2023050216514760300_CIT0020","doi-asserted-by":"crossref","first-page":"824","DOI":"10.1309\/AJCPQY80HZWHHGZF","article-title":"Comparison of Sebia Capillarys capillary electrophoresis with the Primus high-pressure liquid chromatography in the evaluation of hemoglobinopathies","volume":"130","author":"Keren","year":"2008","journal-title":"Am J Clin Pathol."},{"issue":"129","key":"2023050216514760300_CIT0021","first-page":"e41","article-title":"Carrier screening for genetic conditions, committee opinion number 691","year":"2017","journal-title":"Obstet Gynecol."},{"issue":"12","key":"2023050216514760300_CIT0022","doi-asserted-by":"crossref","first-page":"3998","DOI":"10.1182\/blood.V97.12.3998","article-title":"Granulocyte colony-stimulating factor\u2013induced sickle cell crisis and multiorgan dysfunction in a patient with compound heterozygous sickle cell\/\u03b2+ thalassemia","volume":"97","author":"Wei","year":"2001","journal-title":"Blood."},{"issue":"6","key":"2023050216514760300_CIT0023","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1016\/j.bbmt.2008.03.001","article-title":"Granulocyte colony-stimulating factor-based stem cell mobilization in patients with sickle cell disease","volume":"14","author":"Rosenbaum","year":"2008","journal-title":"Biol Blood Marrow Transplant."},{"issue":"6","key":"2023050216514760300_CIT0024","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1093\/labmed\/lmaa030","article-title":"Verification of 20 mathematical formulas for discriminating between iron deficiency anemia and &#x2028;thalassemia trait in microcytic anemia","volume":"51","author":"Hoffmann","year":"2020","journal-title":"Lab Med."},{"issue":"4","key":"2023050216514760300_CIT0025","article-title":"#262 Differentiating iron deficiency anemia from thalassemia minor by using an RDW-based index","volume":"21","author":"Jayabose","year":"1999","journal-title":"J Ped Hematol\/Onc."},{"issue":"7808","key":"2023050216514760300_CIT0026","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1016\/S0140-6736(73)91446-3","article-title":"Differentiation of iron deficiency from thalassaemia trait","volume":"1","author":"Mentzer","year":"1973","journal-title":"Lancet."},{"author":"WHO.","key":"2023050216514760300_CIT0027"},{"issue":"10021","key":"2023050216514760300_CIT0028","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1016\/S0140-6736(15)60865-0","article-title":"Iron deficiency anaemia","volume":"387","author":"Lopez","year":"2016","journal-title":"Lancet."},{"issue":"19","key":"2023050216514760300_CIT0029","doi-asserted-by":"crossref","first-page":"1832","DOI":"10.1056\/NEJMra1401038","article-title":"Iron-deficiency anemia","volume":"372","author":"Camaschella","year":"2015","journal-title":"N Engl J Med."},{"key":"2023050216514760300_CIT0030","first-page":"9394060","article-title":"Limitations of serum ferritin in diagnosing iron deficiency in inflammatory conditions","volume":"2018","author":"Dignass","year":"2018","journal-title":"Int J Chronic Dis."},{"volume-title":"Variant Haemoglobins: A Guide to Identification","year":"2020","author":"Bain","key":"2023050216514760300_CIT0031"},{"issue":"7","key":"2023050216514760300_CIT0032","doi-asserted-by":"crossref","first-page":"592","DOI":"10.3109\/07853890.2015.1091942","article-title":"Increasing prevalence of thalassemia in America: implications for primary care","volume":"47","author":"Sayani","year":"2015","journal-title":"Ann Med."},{"issue":"1","key":"2023050216514760300_CIT0033","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1136\/jclinpath-2016-203879","article-title":"Haemoglobinopathies that occur with decreased HbA2 levels: a gene mutation set involving the \u03b4 gene at a Spanish centre","volume":"70","author":"Villegas","year":"2017","journal-title":"J Clin Pathol."}],"container-title":["Laboratory Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/labmed\/article-pdf\/54\/3\/235\/50171205\/lmac114.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/labmed\/article-pdf\/54\/3\/235\/50171205\/lmac114.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,2]],"date-time":"2023-05-02T17:07:22Z","timestamp":1683047242000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/labmed\/article\/54\/3\/235\/6761111"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,14]]},"references-count":33,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,10,14]]},"published-print":{"date-parts":[[2023,5,2]]}},"URL":"https:\/\/doi.org\/10.1093\/labmed\/lmac114","relation":{},"ISSN":["0007-5027","1943-7730"],"issn-type":[{"type":"print","value":"0007-5027"},{"type":"electronic","value":"1943-7730"}],"subject":[],"published-other":{"date-parts":[[2023,5,1]]},"published":{"date-parts":[[2022,10,14]]}}}