Hemoglobin Electrophoresis Interpretation: Normal Adult Pattern
This hemoglobin electrophoresis demonstrates a completely normal adult hemoglobin pattern with no evidence of hemoglobinopathy or thalassemia trait.
Pattern Analysis
Your results show:
- Hgb A: 97.8% (normal is 96-98%) 1
- Hgb F: 0% (normal is <1%) 2
- Hgb A2: 2.2% (normal range is 2.0-3.3%) 2
All three hemoglobin fractions fall within the expected reference ranges for a healthy adult without any globin gene abnormalities 2, 3.
Clinical Significance
No hemoglobinopathy is present. The Hgb A2 level of 2.2% specifically excludes beta-thalassemia trait, which would typically show elevated Hgb A2 levels above 3.3% 4. The absence of elevated Hgb F rules out conditions like hereditary persistence of fetal hemoglobin or certain thalassemia syndromes 5.
Key Interpretation Points
- Beta-thalassemia trait excluded: Hgb A2 is not elevated (would need to be >3.3% to suggest beta-thalassemia carrier status) 2, 3
- No hemoglobin variants detected: The predominance of Hgb A at 97.8% with no abnormal hemoglobin bands indicates no structural hemoglobin variants such as Hb S, C, E, or D 6, 7
- Normal fetal hemoglobin: The absence of Hgb F is appropriate for an adult and excludes hereditary persistence of fetal hemoglobin 5
Clinical Context
If microcytosis is present with these normal results, consider alternative causes. The British Society of Gastroenterology guidelines emphasize that when microcytosis occurs with normal iron studies and normal hemoglobin electrophoresis, other causes such as anemia of chronic disease should be investigated 4. However, hemoglobin electrophoresis is specifically recommended when microcytosis is present with normal iron studies to exclude thalassemia, particularly in patients of appropriate ethnic background 4.
No further hemoglobinopathy workup is indicated based on these completely normal electrophoresis results 6, 7.