Hemoglobin A at 98% Rules Out Sickle Cell SS Disease
A hemoglobin A value of 98% definitively excludes sickle cell SS pattern (HbSS disease), as HbSS patients have 80-95% HbS with no HbA present. 1, 2
Understanding Hemoglobin Patterns in Sickle Cell Disease
Your result indicates an essentially normal hemoglobin pattern. Here's why this cannot be HbSS:
HbSS Disease Pattern (What You Don't Have)
- HbSS disease shows 80-95% HbS with 0% HbA - the complete absence of normal adult hemoglobin is the defining feature 1, 2
- This represents the most severe form of sickle cell disease with early painful crises, severe anemia (hemoglobin 60-90 g/L), and highest complication rates 2
- HbSS patients have only HbS, small amounts of HbF (fetal hemoglobin), and HbA2, but never significant HbA 1
What 98% HbA Actually Means
- Your pattern is essentially normal - healthy individuals without sickle cell disease have predominantly HbA 1
- You are neither a carrier (sickle cell trait) nor affected by sickle cell disease 1
Common Pitfalls to Avoid
Do not confuse different sickle cell genotypes - the terminology matters critically for clinical management:
- Sickle cell trait (HbAS): Shows 55-65% HbA and 30-40% HbS - a benign carrier state 1
- HbSS disease: Shows 80-95% HbS with 0% HbA - severe disease requiring aggressive management 1, 2
- Sickle beta-plus thalassemia: Shows 10-25% HbA and 70-80% HbS - mild sickle cell disease 1
- Sickle beta-zero thalassemia: Shows 0% HbA and 80-90% HbS - severe disease resembling HbSS 1
Clinical Significance
With 98% HbA, you have no clinically significant sickle hemoglobin and require no sickle cell disease-specific management 1, 2. The specific genotype determination is critical because HbSS patients require the most aggressive preventive measures perioperatively and have the highest complication rates, but this does not apply to you 2.