Test Catalog

Test Id : HBELI

Hemoglobin Electrophoresis Interpretation

Useful For
Suggests clinical disorders or settings where the test may be helpful

Interpretation for the results of hemoglobin electrophoresis

 

Diagnosis and classification of hemoglobin disorders, including thalassemias and hemoglobin variants

Special Instructions
Library of PDFs including pertinent information and forms related to the test

Method Name
A short description of the method used to perform the test

Only orderable as part of a profile. For more information see HBEL1 / Hemoglobin Electrophoresis Evaluation, Blood.

 

Medical Interpretation

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Hb Electrophoresis Interpretation

Aliases
Lists additional common names for a test, as an aid in searching

A2 Hemoglobin

Alpha Globin Variant

Alpha Thalassemia

Barts Hemoglobin

Beta Globin Variant

Beta Thalassemia

H Disease

Hemoglobin A2

Hemoglobin Cascade

Hemoglobin Electrophoresis Cascade Level 1

Hemoglobin Molecular studies

Hemoglobin Variant

HGB (Hemoglobin) Electrophoresis

Isoelectric Focusing

Capillary electrophoresis

HPLC

High performance liquid chromatography

Mass Spectrometry

Microcytosis

Sickle cell

Sickling Test

Thalassemia

Specimen Type
Describes the specimen type validated for testing

Whole Blood EDTA

Special Instructions
Library of PDFs including pertinent information and forms related to the test

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Whole Blood EDTA Refrigerated (preferred) 7 days

Useful For
Suggests clinical disorders or settings where the test may be helpful

Interpretation for the results of hemoglobin electrophoresis

 

Diagnosis and classification of hemoglobin disorders, including thalassemias and hemoglobin variants

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

A large number of variants of hemoglobin (Hb) have been recognized. Although many do not result in clinical or hematologic effects, clinical symptoms that can be associated with Hb disorders include microcytosis, sickling disorders, hemolysis, erythrocytosis/polycythemia, cyanosis/hypoxia, anemia (chronic, compensated or episodic), and increased methemoglobin or sulfhemoglobin results (M-Hb).

 

For many common Hb variants (eg, Hb S, Hb C, Hb D and Hb E, among many others), protein studies will be sufficient for definitive identification. However, some Hb conditions may be difficult to identify by protein methods alone and may require molecular methods for confirmation. Hb disorders commonly occur as compound disorders (2 or more genetic variants) that can have complex interactions and variable phenotypes. In these situations molecular testing may be necessary for accurate classification. It is important to note that although powerful as an adjunct for a complete and accurate diagnosis, molecular methods without protein data can give incomplete and possibly misleading information due to limitations of the methods. Accurate classification of Hb disorders and interpretation of genetic data requires the incorporation of protein analysis results. This profile is well-suited for the classification of Hb disorders.

 

Mayo Clinic Laboratories receives specimens from a wide geographic area and nearly one-half of all specimens tested exhibit abnormalities. The most common abnormality is an increase in Hb A2 to about 4% to 8%, which indicates beta-thalassemia minor when present in the correct clinical context. A wide variety of other hemoglobinopathies are also frequently encountered. Ranked in order of relative frequency, these are: Hb S (sickle cell disease and trait), C, E, Lepore, G-Philadelphia, Hb H disease, D-Los Angeles, Koln, Constant Spring, O-Arab. Other variants associated with hemolysis, erythrocytosis/polycythemia, microcytosis, cyanosis/hypoxia are routinely identified; however, some will not be detected by routine screening methods and require communication of clinical findings to prompt indicated reflex testing options. Alpha-thalassemia genetic variants are very common in the United States, occurring in approximately 30% of African Americans and accounting for the frequent occurrence of microcytosis in persons of this ethnic group. Some alpha-thalassemia conditions (eg, Hb H, Barts) can be identified in the Hb electrophoresis protocol, although Hb Constant Spring may or may not be evident by protein methods alone dependent upon the percentage present. It is important to note, alpha-thalassemias that are from only 1 or 2 alpha-globin gene deletions are not recognized by protein studies alone and alpha gene deletion and duplication testing is required.

Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

Only orderable as part of a profile. For more information see HBEL1 / Hemoglobin Electrophoresis Evaluation, Blood.

 

Definitive results and an interpretative report will be provided.

Interpretation
Provides information to assist in interpretation of the test results

Abnormal hemoglobin variants are identified. An interpretive report will be provided.

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

Some hemoglobin disorders and variants are not detected by our screening methods, including common alpha thalassemia conditions, and require further reflex testing to identify. If a family history of a known hemoglobin disorder, prior therapy for a hemoglobin disorder, or otherwise unexplained lifelong/familial symptoms such as hemolysis, microcytosis, erythrocytosis/polycythemia, cyanosis, or hypoxia are present, this should be clearly communicated to the laboratory so appropriate reflex testing can be added, see Metabolic Hematology Patient Information in Special Instructions.

 

Recent transfusion may mask protein results including hemoglobin electrophoresis, hereditary persistence of fetal hemoglobin (HPFH) by flow cytometry, stability studies and sickle solubility studies depending on percentage of transfused cells present.

 

Some hemoglobin variants can originate from the donor blood product and not from the tested recipient. These are typically found in low percentage.

 

If the patient has undergone a bone marrow transplant, the results may show atypical results and should be interpreted in the context of clinical information.

 

Some therapies cause artefactual effects in protein studies, including hydroxyurea and decitabine (increased Hb F levels), Voxelotor (artefactual peaks) and gene therapy (alternate protein detection, Beta T87Q, by mass spectrometry). Clear communication of prior therapy is strongly recommended.

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Hoyer JD, Hoffman DR: The Thalassemia and hemoglobinopathy syndromes. In: McClatchey KD, Amin HM, Curry JL, eds. Clinical Laboratory Medicine. 2nd ed. Lippincott Williams and Wilkins; 2002:866-895

2. Oliveira, JL: Diagnostic strategies in hemoglobinopathy testing, the role of a reference laboratory in the USA. Thalassemia Reports. 2018;8(1). doi: 10.4081/thal.2018.7476

3. Brancaleonai V, Di Pierro E, Motta I, Cappellini MD: Laboratory diagnosis of thalassemia. Int J Lab Haematol. 2016;38(suppl 1):32-40

4. Hartveld CI: State of the art and new developments in molecular diagnostics for hemoglobinopathies in multiethnic societies. Int J Lab Haematol. 2014;36:1-12

5. Szuberski J, Oliveira JL, Hoyer JD: A comprehensive analysis of hemoglobin variants by high-performance liquid chromatography (HPLC). Int J Lab Hematol. 2012;34(6):594-604

6. Riou J, Szuberski J, Godart C, et al: Precision of CAPILLARYS 2 for the Detection of Hemoglobin Variants Based on Their Migration Positions. Am J Clin Pathol. 2018;149(2):172-180

Special Instructions
Library of PDFs including pertinent information and forms related to the test

Method Description
Describes how the test is performed and provides a method-specific reference

A hematopathologist evaluates all of the testing performed and an interpretive report is provided.

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Saturday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

2 to 25 days if molecular studies are required.

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their Regional Manager. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

Not Applicable

CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

NA - Not billable

LOINC® Information

Test Id Test Order Name Order LOINC Value
HBELI Hb Electrophoresis Interpretation In Process
Result Id Test Result Name Result LOINC Value
Result LOINC Value Tooltip
608088 Hb Electrophoresis Interpretation 49316-3
609421 Hb Electrophoresis Interp Cancel No LOINC Needed

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports