{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T12:24:41Z","timestamp":1756383881112,"version":"3.40.4"},"reference-count":7,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,6,3]]},"abstract":"<jats:p>A 29-year-old woman was referred for new-onset diabetes mellitus after her glycosylated haemoglobin (HbA1c) was found to be 10.2%. Three years earlier, the patient\u2019s HbA1c\u2014measured by the same clinical laboratory\u2014had been 5.5%. The newer HbA1c was discordant with fasting glucose levels and a lack of diabetes-associated symptoms. The laboratory reported that their assay methodology remained unchanged and also that no haemoglobin variants were detected. Further investigation, however, revealed, first, that the patient carried a haemoglobin alpha chain mutation (Hb Wayne) that can sometimes cause assay interference and, second, that although the laboratory\u2019s assay methodology had not changed, their assay instrument had. Depending on assay methodology, haemoglobin variants can cause HbA1c assay interference and the presence of these variants may not be detected by the performing laboratory. Interference may not only be dependent on assay methodology but also on the assay instrument used.<\/jats:p>","DOI":"10.1136\/bcr-2018-225358","type":"journal-article","created":{"date-parts":[[2018,6,14]],"date-time":"2018-06-14T14:38:47Z","timestamp":1528987127000},"page":"bcr-2018-225358","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Alarming increase in HbA1c and near misdiagnosis of diabetes mellitus resulting from a clinical laboratory instrument upgrade and haemoglobin variant"],"prefix":"10.1136","volume":"2018","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0212-546X","authenticated-orcid":false,"given":"Steven D","family":"Chessler","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donald E","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,6,14]]},"reference":[{"key":"2025042703534675000_2018.jun14_1.bcr-2018-225358.1","doi-asserted-by":"publisher","DOI":"10.4103\/0973-3930.62598"},{"key":"2025042703534675000_2018.jun14_1.bcr-2018-225358.2","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1093\/clinchem\/47.2.153","article-title":"Effects of hemoglobin variants and chemically modified derivatives on assays for glycohemoglobin","volume":"47","author":"Bry","year":"2001","journal-title":"Clin Chem"},{"key":"2025042703534675000_2018.jun14_1.bcr-2018-225358.3","doi-asserted-by":"publisher","DOI":"10.1016\/0022-2836(84)90273-0"},{"key":"2025042703534675000_2018.jun14_1.bcr-2018-225358.4","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.73.3.882"},{"key":"2025042703534675000_2018.jun14_1.bcr-2018-225358.5","doi-asserted-by":"publisher","DOI":"10.2337\/dc11-9998"},{"key":"2025042703534675000_2018.jun14_1.bcr-2018-225358.6","doi-asserted-by":"publisher","DOI":"10.1309\/AJCPQ23GTTMLAEVL"},{"key":"2025042703534675000_2018.jun14_1.bcr-2018-225358.7","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.1016\/j.clinbiochem.2015.07.100","article-title":"Identification of Hb Wayne and its effects on HbA1c measurement by 5 methods","volume":"48","author":"Rodr\u00edguez-Capote","year":"2015","journal-title":"Clin Biochem"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2018-225358","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T10:53:55Z","timestamp":1745751235000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2018-225358"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,6,14]]},"references-count":7,"alternative-id":["10.1136\/bcr-2018-225358"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2018-225358","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2018,6,14]]}}}