{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T10:13:21Z","timestamp":1756462401557,"version":"3.44.0"},"reference-count":23,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2018,11,1]],"date-time":"2018-11-01T00:00:00Z","timestamp":1541030400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2018,11,11]]},"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:p>We report the unusual case of a patient found to have a low glycosylated haemoglobin (HbA1c) despite having recently been diagnosed with diabetes mellitus type 2. The patient, who was not anaemic, with no symptoms or family history of haematological conditions, was subsequently found to have an elevated reticulocyte count, inferring increased red cell turnover as the culprit for the discordant HbA1c result. A diagnosis of hereditary spherocytosis was made based on characteristic peripheral blood film appearances and confirmed by eosin-5-maleimide binding test. Exposure of an undiagnosed haemolytic anaemia by virtue of a low HbA1c is uncommon. However, conditions that distort HbA1c measurements are not infrequent. This case should serve to remind clinicians of the limitations of HbA1c in specified situations, and to remain vigilant when interpreting results.<\/jats:p>","DOI":"10.1136\/bcr-2018-227668","type":"journal-article","created":{"date-parts":[[2018,12,18]],"date-time":"2018-12-18T17:19:47Z","timestamp":1545153587000},"page":"e227668","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Glycosylated haemoglobin: a false sense of security"],"prefix":"10.1136","volume":"11","author":[{"given":"Emily","family":"Finan","sequence":"first","affiliation":[{"name":"Department of Haematology, Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust, Doncaster, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joe","family":"Joseph","sequence":"additional","affiliation":[{"name":"Department of Haematology, Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust, Doncaster, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,12,7]]},"reference":[{"key":"2025082702354494000_11.1.e227668.1","unstructured":"WHO. Use of Glycated Haemoglobin (HbA1c) in the Diagnosis of Diabetes Mellitus. 2011. http:\/\/www.who.int\/diabetes\/publications\/report-hba1c_2011.pdf"},{"key":"2025082702354494000_11.1.e227668.2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.25.2.275"},{"key":"2025082702354494000_11.1.e227668.3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2796.2012.02513.x"},{"key":"2025082702354494000_11.1.e227668.4","doi-asserted-by":"publisher","DOI":"10.1177\/0004563213485002"},{"key":"2025082702354494000_11.1.e227668.5","doi-asserted-by":"publisher","DOI":"10.1177\/1932296814567227"},{"key":"2025082702354494000_11.1.e227668.6","first-page":"31","article-title":"Fructosamine\u2013an underutilized tool in diabetes management: case report and literature review","volume":"101","author":"Youssef","year":"2008","journal-title":"Tenn Med"},{"issue":"Suppl 1","key":"2025082702354494000_11.1.e227668.7","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1111\/ijlh.12657","article-title":"Red cell membrane disorders","volume":"39","author":"Narla","year":"2017","journal-title":"Int J Lab Hematol"},{"key":"2025082702354494000_11.1.e227668.8","doi-asserted-by":"publisher","DOI":"10.1111\/j.1753-0407.2009.00009.x"},{"key":"2025082702354494000_11.1.e227668.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.blre.2013.04.003"},{"key":"2025082702354494000_11.1.e227668.10","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2016.142463"},{"key":"2025082702354494000_11.1.e227668.11","doi-asserted-by":"publisher","DOI":"10.1053\/j.seminhematol.2004.01.002"},{"key":"2025082702354494000_11.1.e227668.12","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2008-07-161166"},{"key":"2025082702354494000_11.1.e227668.13","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)61588-3"},{"key":"2025082702354494000_11.1.e227668.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.blre.2006.03.005"},{"key":"2025082702354494000_11.1.e227668.15","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.12546"},{"key":"2025082702354494000_11.1.e227668.16","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.2007.01.060086"},{"key":"2025082702354494000_11.1.e227668.17","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":"2025082702354494000_11.1.e227668.18","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.23.3.339"},{"key":"2025082702354494000_11.1.e227668.19","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.483"},{"key":"2025082702354494000_11.1.e227668.20","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b4432"},{"key":"2025082702354494000_11.1.e227668.21","unstructured":"NGSP. HbA1c Assay Interferences. 2010. http:\/\/www.ngsp.org\/interf.asp"},{"key":"2025082702354494000_11.1.e227668.22","doi-asserted-by":"crossref","first-page":"bcr-2018-225358","DOI":"10.1136\/bcr-2018-225358","article-title":"Alarming increase in HbA1c and near misdiagnosis of diabetes mellitus resulting from a clinical laboratory instrument upgrade and haemoglobin variant","volume":"2018","author":"Chessler","year":"2018","journal-title":"BMJ Case Rep"},{"key":"2025082702354494000_11.1.e227668.23","unstructured":"NICE. Type 2 diabetes in adults: management. 2015."}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/data.bmj.org\/tdm\/10.1136\/bcr-2018-227668","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2018-227668","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T09:35:55Z","timestamp":1756287355000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2018-227668"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,11]]},"references-count":23,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2018,12,7]]},"published-print":{"date-parts":[[2018,11]]}},"alternative-id":["10.1136\/bcr-2018-227668"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2018-227668","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2018,11]]}}}